A parsimonious methodological framework for short-term forecasting of groundwater levels.

Groundwater plays a significant role as a strategic resource in reducing the impact of droughts. In spite of its importance, there are still many groundwater bodies in which there is not enough monitoring data to define classic distributed mathematical models to forecast future potential levels. The main aim of this study is to propose and evaluate a novel parsimonious integrated method for the short-term forecasting of groundwater levels. It has low requirements in term of data, and it is operational and relatively easy to apply. It uses geostatistics, optimal meteorological exogenous variables and artificial neural networks. We have illustrated our method in the aquifer "Campo de Montiel" (Spain). The analysis of optimal exogenous variables revealed that, in general, the wells with stronger correlations with precipitation are located closer to the central part of the aquifer. NAR, which does not consider secondary information, is the best approach for 25.5 % of the cases and is associated with well locations with lower R2 between groundwater levels and precipitation. Amongst the approaches with exogenous variables, the ones that use effective precipitation have been selected more times as the best experiments. NARX and Elman using effective precipitation had the best approaches with 21.6 % and 29.4 % of the cases respectively. For the selected approaches, we obtained a mean RMSE of 1.14 m in the test and 0.76, 0.92, 0.92, 0.87, 0.90, and 1.05 m for the forecasting test for months 1 to 6 respectively for the 51 wells, but the accuracy of the results can vary depending on the well. The interquartile range of the RMSE is around 2 m for the test and forecasting test. The uncertainty of the forecasting is also considered by generating multiple groundwater level series.

Assessment of chloride natural background levels by applying statistical approaches. Analyses of European coastal aquifers in different environments.

Estimated natural background levels (NBLs) are needed to assess groundwater chemical status according to the EU Groundwater Directive. They are commonly derived for different substances by applying statistical methodologies. Due to the complexity of the sea water intrusion process, some of those methods do not always provide appropriate assessment of chloride NBLs. This paper analyzes the applicability of different NBL estimation methods in five EU coastal aquifers with significant differences in available datasets and hydrogeological settings. A sensitivity analysis of results to different constraints was performed to remove samples with anthropogenic impacts. A novel statistical approach combining different methods to identify the range of chloride NBLs is proposed. In all pilots the estimated NBLs were below 85 mg/L and fitted well with previous studies and expert judgment, except Campina del Faro aquifer (the maximum being 167.5 mg/L). Although this approach is more time consuming, it provides a more robust solution.

Pitiriasis «rubra pilaris» localizada / Pityriasis rubra pilaris localized

Incluimos la pitiriasis rubra pilaris (PRP) dentro del grupo de las dermatosis papuloescamosas hiperqueratósicas de origen desconocido. Aunque poco frecuente, se han constatado dos picos de incidencia en la primera y en la quinta década de la vida, lo cual determina su clasificación en cinco grandes grupos, los dos primeros típicos en la edad adulta y los tres restantes en la edad juvenil. En los últimos años se ha incluido un sexto grupo, asociado al virus de la inmunodeficiencia humana (VIH), independientemente de la edad. No existe un tratamiento estandarizado para la PRP, pero por lo general en casos localizados suelen emplearse tratamientos tópicos, entre los que incluimos los corticoides, los derivados de la vitamina D o los retinoides; en casos más extensos podría recurrirse a tratamientos sistémicos, y como primera elección los retinoides orales(AU)

Pityriasis rubra pilaris (PRP) is an uncommon papulosquamous keratotic dermatosis of unknown origin. It has a bimodal distribution of age onset concentrating in the first and fifth decades. Classification of PRP includes 5 types: types I and II represent the forms of adult PRP, respectively, whereas types III, IV, and V are seen in juveniles. In recent years, a type VI PRP associated with HIV infection has been proposed. A universal standard treatment for PRP is lacking. Topical therapy is the treatment of choice for patients with mild type III and type IV PRP, including corticoids, vitamin D analogue ortopical retinoids. Systemic therapy is reserved for patients with severe type III and type V. Acitretin and isotretinoin are the treatment of choice(AU)

Síndrome de Peutz-Jeghers / Peutz-Jeghers syndrome

Presentamos el caso de un niño de 6 años de edad con lesioneshiperpigmentadas en la región perioral. El padre del pacientehabía sido diagnosticado de síndrome de Peutz-Jeghers (SPJ)mediante un estudio genético. Las lesiones cutáneas, junto conlos antecedentes familiares, fueron la clave para el diagnósticotemprano de la enfermedad. El SPJ es una entidad rara, caracterizadapor la aparición de lentigos periorificiales y póliposgastrointestinales. Histológicamente, estos pólipos son hamartomasque pueden llegar a malignizarse. Además, el SPJ seasocia al desarrollo de tumores extraintestinales (mama, endometrio,ovario, testículo, páncreas...). Por ello, es necesariorealizar un diagnóstico precoz y un control periódico de laspersonas que padecen este síndrome y sus familiares(AU)

We report the case of a 6-year-old child with hyperpigmentedlesions in perioral region. His father had been diagnosed ofPeutz-Jeghers syndrome (PJS) by genetic testing. PJS is a rareentity characterized by the presence of hyperpigmented periorificiallesions and gastrointestinal polyps. Histologically, thesepolyps are hamartomas that can become malignant. Moreover,PJS is associated with the development of nongastrointestinalcancer (breast, endometrium, ovary, testicle, pancreas...). It istherefore necessary to make an early diagnosis and periodicmonitoring of the patients with this syndrome and their families(AU)

Actitud expectante como tratamiento eficaz en un caso de múltiples lesiones por «Molluscum contagiosum» / Attitude expectant as effective treatment in Molluscum contagiosum

El molusco contagioso es una infección cutánea frecuente causada por un virus de la familia de los poxvirus, que afecta principalmente a los niños. La enfermedad puede transmitirse por contacto directo a través de la piel, por fómites contaminados o por autoinoculación. La infección se resuelve habitualmente de forma espontánea en pacientes inmunocompetentes, en un tiempo que puede oscilar entre meses y años. Existe un debate continuo sobre si se debe tratar activamente o mantener una actitud expectante(AU)

Molluscum contagiosum is a common skin infection, caused by a poxvirus, that affect mainly children. The disease can be transmitted by direct contact, fomites, or auto-inoculation. The infection will usually resolve within months or years in people with normal immunity. There has been a continous discussion about whether physicians should treat Molluscum contagiosum actively or not(AU)

Síndrome del pelo impeinable / Uncombable hair syndrome

El síndrome del pelo impeinable es una anomalía infrecuente del tallo piloso, que determina la presencia de un pelo desorganizado y difícil de peinar. Esta entidad se caracteriza por la presencia de un surco longitudinal a lo largo del tallo piloso y una forma triangular en la sección transversal(AU)

Uncombable hair syndrome is a rare anomaly of the hair shaft that results in a disorganized, unruly hair pattern that it is impossible to comb flat. This condition has a characteristic longitudinal groove along the hair shaft and a triangular cross-section(AU)

Penfigoide ampolloso infantil en relación con la vacunación hexavalente, meningococo y neumococo / Infantile bullous pemphigoid developing after hexavalent, meningococcal and pneumococcal vaccinations

El penfigoide ampolloso es una enfermedad ampollosa adquirida, autoinmunitaria, extremadamente infrecuente en los niños, que se caracteriza por la presencia de anticuerpos IgG dirigidos contra antígenos de la zona de la membrana basal. En general, el curso clínico de esta entidad es muy bueno y no presenta recaídas. El diagnóstico y el tratamiento precoces son fundamentales. Presentamos el caso clínico de una lactante de 3 meses con aparición de lesiones ampollosas en ambas palmas y plantas, y lesiones urticariformes en el tronco y la cara 3 semanas después de la vacunación de los 2 meses (hepatitis B, difteria, tétanos, tos ferina, poliomielitis, Haemophilus influenzae B, meningococo C y neumococo). La clínica empeoró con la vacunación a los 4 y 6 meses de edad. Con deflazacort por vía oral a dosis de 1 mg/kg/día se controlaron las lesiones, interrumpiéndose el tratamiento de forma progresiva a los 3 meses. Tras 8 meses de seguimiento, la niña no ha presentado recidivas. El penfigoide ampolloso se ha relacionado con la ingesta de fármacos y con las vacunaciones, apareciendo las lesiones de 1 día a 4 semanas después. Aunque el mecanismo etiopatogénicono está demostrado, se aporta un caso con una relación clara con la vacunación (AU)

Bullous pemphigoid is an acquired autoimmune blistering disorder extremely uncommon in children, characterized by circulating IgG antibodies to antigens of the epidermal basement membrane zone. In general, the clinical course of this condition is good and relapses are rare. The early diagnosis and treatment are fundamental. We present a 3-month-old girl with a blistering eruption on her palms and soles, and urticarial plaques on trunk, and face, 3 weeks after vaccine at two months (hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B, meningococcal C, pneumococcus). The clinical course worsened with vaccinations at 4 and 6 months. The control of lesions was achieved with oral deflazacort 1 mg/kg/day, with a gradual decrease until 3 months of therapy. The patient is still in remission after 8 months of follow-up. Bullous pemphigoid has been connected with some drugs and vaccinations, 1 day to 4 weeks after receiving immunization. Although the exact mechanism of induction is unclear, this case report has a visible relationship with vaccinations (AU)

Hamartoma fibrolipomatoso congénito / Precalcaneal congenital fibrolipomatous hamartoma

El hamartoma fibrolipomatoso congénito precalcáneo es una entidad de la infancia de naturaleza benigna, que aparece en el nacimiento o unos meses después, en forma de una lesión nodular, unilateral o, más frecuentemente, bilateral y simétrica, en la parte posteromedial de los talones. Normalmente son lesiones asintomáticas y no se asocian otras alteraciones. Habitualmente no es necesario realizar ningún tratamiento(AU)

The precalcaneal congenital fibrolipomatous hamartoma is a benign condition of infancy present at birth or appearing a few months later, as a solitary nodule, unilateral or most commonly bilateral and symmetrical in the medial posterior region of the heels. They are usually asymptomatic and not associated with any other alterations. Usually no treatment is required(AU)

Sensory shelf-life limiting factor of high hydrostatic pressure processed avocado paste.

UNLABELLED: High hydrostatic pressure (HHP) processing pasteurizes avocado paste without a significant impact on flavor. Although HHP-treated avocado paste stored under refrigeration is safe for human consumption for months, sensory changes taking place during storage cause the rejection of the product by consumers within days. Although it is known that the shelf life of the product ends before its microbial counts are high, its sensory shelf life limiting factor remains unknown. The present study focused on the use of a trained panel and a consumer panel to determine the sensory shelf life limiting factor of HHP-treated avocado paste. The trained panel identified sour and rancid flavors as the main sensory descriptors (critical descriptors) that differentiated stored from freshly processed samples. Further data obtained from consumers identified sour flavor as the main cause for a significant decrease in the acceptability (shelf life limiting factor) of refrigerated HHP-treated avocado paste. The study allowed the elucidation of a proposed deterioration mechanism for HHP-treated avocado paste during its refrigerated shelf life. The information through this work enhances scientific knowledge of the product and proposes the sour flavor development during storage as a relevant sensory attribute that needs to be improved in order to enhance the product shelf life. PRACTICAL APPLICATION: At present, HHP is the most effective commercial nonthermal technology to process avocado paste when compared to thermal and chemical alternatives. HHP-treated avocado paste is a microbiologically stable food for a period of at least 45 d stored under refrigeration. However, previous published work indicated that consumers rejected the product after approximately 19 d of storage due to sensory changes. This manuscript presents a sensory study that permitted the identification of the critical sensory descriptor that is acting as the sensory shelf life limiting factor of the product. The data presented herein along with previous reported data allows a better understanding of the deterioration mechanism that occurs during the storage of HHP-treated avocado paste. This information is relevant and useful for the elucidation of possible alternatives to enhance the shelf life of HHP-treated avocado paste.

[Infantile bullous pemphigoid developing after hexavalent, meningococcal and pneumococcal vaccinations]. / Penfigoide ampolloso infantil en relación con la vacunación hexavalente, meningococo y neumococo.

Bullous pemphigoid is an acquired autoimmune blistering disorder extremely uncommon in children, characterized by circulating IgG antibodies to antigens of the epidermal basement membrane zone. In general, the clinical course of this condition is good and relapses are rare. The early diagnosis and treatment are fundamental. We present a 3-month-old girl with a blistering eruption on her palms and soles, and urticarial plaques on trunk, and face, 3 weeks after vaccine at two months (hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B, meningococcal C, pneumococcus). The clinical course worsened with vaccinations at 4 and 6 months. The control of lesions was achieved with oral deflazacort 1 mg/kg/day, with a gradual decrease until 3 months of therapy. The patient is still in remission after 8 months of follow-up. Bullous pemphigoid has been connected with some drugs and vaccinations, 1 day to 4 weeks after receiving immunization. Although the exact mechanism of induction is unclear, this case report has a visible relationship with vaccinations.

Cutis marmorata telangiectásica congénita / Cutis marmorata telangiectatica congenita

La cutis marmorata telangiectásica congénita es una malformación vascular de bajo flujo, caracterizada por su distintivo aspecto violáceo y reticulado grueso, como el mármol. Generalmente, está presente en el nacimiento, se hace más pronunciada en las primeras semanas de vida y suele perder intensidad de forma progresiva durante los 2 primeros años de vida. El diagnóstico se establece a partir de los hallazgos clínicos. Se han publicado numerosas anomalías asociadas con la cutis marmorata telangiectásica congénita, como la asimetría corporal y otras anomalías vasculares. Presentamos un nuevo caso de cutis marmorata telangiectásica congénita en un bebé de 2 meses de edad, que asociaba una hipoplasia de la extremidad inferior derecha y dos malformaciones capilares (AU)

Cutis marmorata telangiectatica congenita is a low-flow vascular malformation that is characterized by its distinctive violaceous coarsely reticulated marbled pattern. It is generally present at birth, may become more vivid within the first weeks, and typically slowly fades thereafter, particularly during the first years of life. The diagnosis is established on clinical grounds. Additional anomalies have been reported in association with cutis marmorata telangiectatica congenita, including body asymmetry and other vascular anomalies. We present a new case of cutis marmorata telangiectatica congenita in a 2 month-year-old baby, with an hypoplasia of the right limb and two capillary malformations associated (AU)

Exantema periflexural asimétrico / Asymmetric periflexural exanthem

El exantema periflexural asimétrico en la infancia es un exantema de causa desconocida, caracterizado por una erupción maculopapulosa escarlatiniforme, con un crecimiento centrífugo. Comienza típicamente cerca de la axila o la región inguinal, de forma predominantemente unilateral, aunque a medida quela erupción progresa suele extenderse de forma bilateral. Se resuelve de manera espontánea en 1-3 semanas. Presentamos el caso de un niño de 4 meses de edad con esta erupción (AU)

Asymmetric periflexural exanthem of childhood is an exanthema of unknown a etiology. It is described as a macular-papular periflexural scarlatiniform eruption with a centrifugal spreading. Tipically begins near an axilla or groin and retains a unilateral predominance, although it spreads to become bilateral as the eruption progresses. The eruption usually resolves in1-3 weeks without treatment. We report a 4-month-old boy with this exanthema (AU)

Buena respuesta al tratamiento con propranolol de un hemangioma «en Cyrano» / Good response to the treatment of the hemangioma of Cyrano nose with propranolol

Recientemente se han publicado varias series de casos que reflejan la utilidad de propranolol en el tratamiento de los hemangiomas cutáneos infantiles. Los hemangiomas pueden requerir tratamiento durante la fase proliferativa debido a localizaciones con riesgo vital, complicaciones locales o riesgos cosméticos o funcionales. El tratamiento de los hemangiomas en la punta nasal puede evitar deformidades permanentes. Presentamos el caso de una niña de 9 meses de edad con un hemangioma «en Cyrano» y otro de gran tamaño en el tórax, con muy buena respuesta clínica al tratamiento, y con ausencia de efectos secundarios (AU)

Recently various series of cases have reported the usefulness of propranolol for the treatment of cutaneous infantile hemangiomas. Infantile hemangioma may require treatment during the proliferative phase, because life-threatening locations, local complications, or cosmetic/functional risks. The treatment of nasaltip hemangioma may avoid permanent deformities. We present the case of a 9-month-old girl with a tip nasal hemangioma and a big one on the thorax, with a very good clinical outcome, and with no adverse effects (AU)

Biochemical changes during the storage of high hydrostatic pressure processed avocado paste.

High hydrostatic pressure (HHP) processing improves the shelf life of avocado paste without a significant impact on flavor; however, scarce information is available on biochemical modifications during its extended storage period. The present study focused on the changes in oxidative enzyme activities of pressurized avocado paste (600 MPa for 3 min) during refrigerated storage (45 d at 4 degrees C). Aerobic plate counts (APC), lactic acid bacteria counts (LAB), pH, and instrumental color were also evaluated during storage. Processing with HHP caused a decrease in polyphenol oxidase (PPO) and lipoxygenase (LOX) activities, resulting in residual enzyme levels of 50.72% and 55.16%, respectively. Although instrumental color values didn't change significantly during the evaluated storage period, both enzymes (PPO and LOX) recuperated their activities at 10 to 15 d of storage, reached the original values observed in the fresh paste, and then started a declining phase until the end of the storage period. Pulp pH presented a consistent decline during the first 20 d of storage. LAB counts were very low during storage, discarding lactic acid production as responsible for the observed pH decline. Enzyme reactivation, cell disruption, and a gradual migration of intracellular components such as organic acids are herein proposed as the main mechanisms for the deterioration of HHP treated avocado paste during its refrigerated storage. Practical Application: At the present, HHP is the most effective commercial nonthermal technology to process avocado paste when compared to thermal and chemical alternatives. Although it has proven to be an excellent product-technology match, little information is known on the biochemical changes that take place in the product during its refrigerated shelf life. Biochemical reactions during storage are important, since they can influence avocado paste nutritional and flavor qualities at the time of product consumption. The present study reports for the first time the re-activation of PPO and LOX during storage of avocado paste under commercial and economically feasible processing conditions (600 MPa and 3 min). The reactivation of oxidative enzymes observed in the present study is relevant for future studies on the HHP stability of food systems in general, and it is considered an important finding for the food industry and researchers seeking to deliver products with superior nutritional and flavor characteristics.

Survival analysis applied to the sensory shelf-life dating of high hydrostatic pressure processed avocado and mango pulps.

High hydrostatic pressure (HHP) pasteurized and refrigerated avocado and mango pulps contain lower microbial counts and thus are safer and acceptable for human consumption for a longer period of time, when compared to fresh unprocessed pulps. However, during their commercial shelf life, changes in their sensory characteristics take place and eventually produce the rejection of these products by consumers. Therefore, in the present study, the use of sensory evaluation was proposed for the shelf-life determinations of HHP-processed avocado and mango pulps. The study focused on evaluating the feasibility of applying survival analysis methodology to the data generated by consumers in order to determine the sensory shelf lives of both HHP-treated pulps of avocado and mango. Survival analysis proved to be an effective methodology for the estimation of the sensory shelf life of avocado and mango pulps processed with HHP, with potential application for other pressurized products. Practical Application: At present, HHP processing is one of the most effective alternatives for the commercial nonthermal pasteurization of fresh tropical fruits. HHP processing improves the microbial stability of the fruit pulps significantly; however, the products continue to deteriorate during their refrigerated storage mainly due to the action of residual detrimental enzymes. This article proposes the application of survival analysis methodology for the determination of the sensory shelf life of HHP-treated avocado and mango pulps. Results demonstrated that the procedure appears to be simple and practical for the sensory shelf-life determination of HHP-treated foods when their main mode of failure is not caused by increases in microbiological counts that can affect human health.