Groundwater intensive use and mining in south-eastern peninsular Spain: Hydrogeological, economic and social aspects.

Intensive groundwater development is a common circumstance in semiarid and arid areas. Often abstraction exceeds recharge, thus continuously depleting reserves. There is groundwater mining when the recovery of aquifer reserves needs more than 50years. The MASE project has been carried out to compile what is known about Spain and specifically about the south-eastern Iberian Peninsula and the Canary Islands. The objective was the synthetic analysis of available data on the hydrological, economic, managerial, social, and ethical aspects of groundwater mining. Since the mid-20th century, intensive use of groundwater in south-eastern Spain allowed extending and securing the areas with traditional surface water irrigation of cash crops and their extension to former dry lands, taking advantage of good soils and climate. This fostered a huge economic and social development. Intensive agriculture is a main activity, although tourism plays currently an increasing economic role in the coasts. Many aquifers are relatively high yielding small carbonate units where the total groundwater level drawdown may currently exceed 300m. Groundwater storage depletion is estimated about 15km(3). This volume is close to the total contribution of the Tagus-Segura water transfer, but without large investments paid for with public funds. Seawater desalination complements urban supply and part of cash crop cultivation. Reclaimed urban waste water is used for irrigation. Groundwater mining produces benefits but associated to sometimes serious economic, administrative, legal and environmental problems. The use of an exhaustible vital resource raises ethical concerns. It cannot continue under the current legal conditions. A progressive change of water use paradigm is the way out, but this is not in the mind of most water managers and politicians. The positive and negative results observed in south-eastern Spain may help to analyse other areas under similar hydrogeological conditions in a less advanced stage of water use evolution.

[Coronary endarterectomy experience in myocardial revascularization]. / Experiencia de la endarterectomía coronaria en cirugía de revascularización miocárdica.

BACKGROUND: Coronary endarterectomy is a surgical procedure to remove atheroma plaques from the coronary arteries, with a worldwide incidence of between 3.7% -42%. 10 years' experience on this technique in our hospital is presented. MATERIAL AND METHODS: A cross-sectional descriptive study was conducted by reviewing 486 clinical records of patients subjected to myocardial revascularisation with cardiopulmonary bypass, moderate hypothermia and ante grade cardioplegia, between January 2003 and June 2013. The risk factors included were: age, gender, left-ventricular-ejection-fraction, EuroSCORE, left main coronary disease, diabetes and systemic arterial hypertension, perioperative mortality, myocardial infarction, perioperative bleeding, surgery times, mediastinitis, sternal dehiscence, and days of hospital stay. RESULTS: A total of 97 patients were included; 77 males (79.4%) and 20 females (20.6%), with a mean age of 62 ± 8.9 years. 75.2% had arterial hypertension, 61.8% diabetes, and 46.3% both. There was left main coronary disease in 35%, and 18.5% in its equivalent (lesion > 70% in anterior descending and circumflex), 58.5% with depressed left ventricular ejection, and 11.3% was related to failed intervention. The endarterectomy of a single artery was present in 75.2%, mainly to the descending artery, average aorta-coronary bridges 3, arterial left mammary graft, 96.9%, perioperative myocardial infarction 3.09%, reoperation for bleeding 5.15%, dehiscence 3.09%, and mediastinitis 2.06%. The mean stay in the Critical Unit was 4 ± 6 days and in hospital room 5 ± 5 days. CONCLUSIONS: To perform coronary endarterectomy increases the morbidity rate, as described in the international literature. Increased mortality was observed in patients with EuroSCORE of intermediate and high risk, which suggests reconsidering the use of this technique in these patients.