Geochemical modeling of systems affected by irrigation: The case of Lerma basin (Spain, 2004-2020).

Geologically "saline" zones with scarce pluviometry, which are already susceptible to the salinization of natural drainage, can experience the acceleration of the salinization of the receiving water systems with the implementation of irrigation. The main objective of this paper is to analyze the geochemical processes that control the variations of the hydrosaline balance due to the implementation of irrigation of the Lerma basin (Spain) from the beginning of its transformation into irrigation land (2004) until the consolidation of irrigation (2020). The results of this study evidence the dissolution of some mineral phases, such as halite, gypsum, and dolomite, and the precipitation of others, such as calcite. Additionally, the final composition of the irrigation return flows cannot be explained without consideration of the NaCa exchange. Part of the dissolved Ca2+ is deposited in the soil, which, in turn, contributes with Na+ to the solution. These natural processes are accelerated with irrigation but progressively slow down as the soil salts are washed with time. Although less evident, there is an additional negative agroenvironmental effect associated with the precipitation of calcite and the possible formation of petrocalcic horizons in the soil. The results obtained herein indicate that studies focusing on the salinity of irrigated zones should go a step further and include the geochemical processes in quantifying the global mass of exported salts.

Hydrosaline balance evolution of an irrigated zone: The case of Lerma basin (Spain, 2004-2020).

Geologically saline zones with scarce pluviometry are areas susceptible to salinization of their natural drainage. However, the salinization of the receiving water systems can be accelerated with the implementation of irrigation. This work aims to analyze the effects of irrigation on some zones transformed into irrigation land, from the beginning of the process until its complete consolidation. To this end, salt balances are evaluated as a whole and for each significant chemical element. The study zone is the irrigable area of the Lerma basin (Spain), where hydrosaline balances have been carried out since the hydrological year 2004 (before the implementation of irrigation) until 2020 (after the consolidation of irrigation). The implementation of irrigation in the area has doubled the mass of exported salts up to an average of 3177 kg/ha irrigable·year, for the entire study period. 55 % of that amount results from a global mineral dissolution, although this process seems to decrease with time as these minerals are being flushed from the soil. Before irrigation was implemented, the general global dissolution pattern produced more concentration of most ions (SO42-, Cl-, Mg2+, Na+, and K+) in the water outputs than in the water inputs. After the implementation of irrigation, there were more water inputs than outputs in the balance and that was shown by the decrease in the dissolved HCO3- and Ca2+.These results indicate that the consolidation of irrigation progressively decreases the induced salinization in the water systems that receive the irrigation return flows. Further studies are required to expand the general understanding of the process and its effects, quantify the different geochemical processes involved, and identify possible additional environmental issues induced by irrigation.

Oropharyngeal dysphagia in head and neck cancer: how to reduce aspiration pneumonia.

OBJECTIVE: Oropharyngeal dysphagia is caused by difficulty in bolus preparation and transport from the mouth to the oesophagus; this may result in malnutrition and aspiration pneumonia. It has a high prevalence in head and neck cancer patients. The objective of this study is to reduce these complications using a new protocol of diagnosis and evaluation of oropharyngeal dysphagia. METHOD: This is a prospective study developed in a secondary hospital. All patients diagnosed with head and neck cancer in 2021 and 2022 are subjected to this protocol: an oropharyngeal dysphagia screening test, a swallowing-related quality of life questionnaire and a flexible endoscopic evaluation of swallow. RESULTS: A total of 72 evaluations are reported using this protocol, before and after cancer treatment, and only 1 presents with aspiration pneumonia. CONCLUSION: Using this protocol, the incidence of aspiration pneumonia can be reduced, and diet recommendations can be given earlier in order to maintain a patient's nutritional requirements.

Long-term follow-up of anterior cervical discectomy and fusion with bioabsorbable plates and screws.

OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) is an accepted technique for the management of cervical spinal degenerative disease. Recently, new resorbable materials have been proposed for the anterior cervical fusion to eliminate some of the disadvantages and complications of metal plates. The aim of our study was to evaluate the long-term clinical results of the ACDF implants made out of bioabsorbable materials. METHODS: We performed a retrospective descriptive study of a series of 17 ACDF patients operated with the Inion S-1™ resorbable screws and plates (made out of biodegradable copolymers composed of l-lactic acid and d,l-lactic acid 80/20) 5-7 years ago. The mean age of the patients was 45 years. A single-level procedure was carried out in 13 patients and a double-level procedure in four patients, and the most commonly fused level was C5-C6. Clinical background, preoperative and postoperative symptoms, previous trauma, complications, radiographic fusion and condition of the prevertebral space (preoperative and postoperative) were analyzed. RESULTS: We observed a good fusion rate and stability using resorbable plates and screws. None of the patients had associated severe complications such as adjacent tissue edema or infection, or had to be reoperated due to failure or migration of the used implants. CONCLUSIONS: The results of this retrospective clinical long-term follow up demonstrate that cervical fusion can be successfully achieved using resorbable implants.

Geochemical processes controlling water salinization in an irrigated basin in Spain: identification of natural and anthropogenic influence.

Salinization of water bodies represents a significant risk in water systems. The salinization of waters in a small irrigated hydrological basin is studied herein through an integrated hydrogeochemical study including multivariate statistical analyses and geochemical modeling. The study zone has two well differentiated geologic materials: (i) Quaternary sediments of low salinity and high permeability and (ii) Tertiary sediments of high salinity and very low permeability. In this work, soil samples were collected and leaching experiments conducted on them in the laboratory. In addition, water samples were collected from precipitation, irrigation, groundwater, spring and surface waters. The waters show an increase in salinity from precipitation and irrigation water to ground- and, finally, surface water. The enrichment in salinity is related to the dissolution of soluble mineral present mainly in the Tertiary materials. Cation exchange, precipitation of calcite and, probably, incongruent dissolution of dolomite, have been inferred from the hydrochemical data set. Multivariate statistical analysis provided information about the structure of the data, differentiating the group of surface waters from the groundwaters and the salinization from the nitrate pollution processes. The available information was included in geochemical models in which hypothesis of consistency and thermodynamic feasibility were checked. The assessment of the collected information pointed to a natural control on salinization processes in the Lerma Basin with minimal influence of anthropogenic factors.

Diagnóstico mediante angiorresonancia y resonancia magnética por difusión de la trombosis del seno longitudinal superior / Magnetic resonance angiography and diffusion-weighted magnetic resonance in the diagnosis of the superior sagittal sinus thrombosis

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[Predictive biochemical indicators of a postlaryngectomy pharyngocutaneous fistula: a clinical study]. / Indicadores bioquímicos predictivos de fístula faringocutánea postlaringuectomía: un estudio clínico.

UNLABELLED: The aim of this clinical study was to determinate biochemical predictor indicators of postlaryngectomy pharyngocutaneous fistula. PATIENTS AND METHODS: We have studied 100 patients with T2- 4 a laryngeal and piryform sinus carcinoma who underwent a laryngectomy. All patients were ASA 2-3. We studied serum albumin, protein serum level, cholesterol and lymphocites in each patient. These variables underwent statistical analysis (p < 0.05). RESULTS: 19% of the patients developed a postlaryngectomy pharyngocutaneous fistula, with a long-stay of 25 days vs. 10 days of stay in patients without postlaryngectomy pharyngocutaneous fistula. 7 postlaryngectomy pharyngocutaneous fistula needed surgical repair. Low serum albumin (< 3.5 g/dL) and a low level of serum proteins (< 6.5 g/dL) were predictive indicators of postlaryngectomy pharyngocutaneous fistula (p < 0.05). CONCLUSIONS: Our results suggest that a low-level of serum proteins and albumin are predictive clinical parameters of postlaryngeal pharyngocutaneous fistula.

[Diffuse pulmonary calcification in a patient with renal insufficiency]. / Calcinosis pulmonar difusa en paciente con insuficiencia renal.

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient's diffuse pulmonary calcification.

Calcinosis pulmonar difusa en paciente con insuficiencia renal / Diffuse pulmonary calcification in a patient with renal insufficiency

Se describe el caso de un varón de 37 años de edad con insuficiencia renal crónica en hemodiálisis y asintomático desde el punto de vista respiratorio, que presentó una radiografía de tórax con consolidaciones parenquimatosas en campos pulmonares medios y superiores. Los hallazgos de la tomografía computarizada de alta resolución mostraron un patrón alveolar difuso de alta atenuación, indicativo de depósito de calcio. La broncoscopia demostró calcificaciones metastásicas en septos alveolares y paredes de bronquiolos y arteriolas. Este artículo describe la patogenia y distribución anatómica de las calcificaciones pulmonares difusas basándose en los hallazgos radiológicos y broncoscópicos

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient´s diffuse pulmonary calcification

Cell therapy: a therapeutic alternative to treat focal cartilage lesions.

BACKGROUND: Human mesenchymal stem cells (MSCs) are present in most of the tissue matrix, taking part in their regeneration when injury or damage occurs. The aim of this study was to investigate the presence of cells with pluripotential characteristics in synovial membranes from osteoarthritic (OA) patients and the capacity of these cells to differentiate to chondrocytes. METHODS: Synovial membranes (n = 8) from OA patients were digested with collagenase. Isolated cells were cultured with DMEM, 20% FBS, and FGFb10 ng/mL. Cells from second subculture were used to carry out phenotypic characterization experiments (flow cytometry analysis with 11 monoclonal antibodies) and chondrogenic differentiation experiments(micropellet cultured in chondrogenic medium). Chondrogenic differentiation of cells was assessment by quantification of cartilage extracellular matrix components by following techniques: Safranin O, Toluidine Blue, and Alcian Blue stains to detect proteoglycans and immunohistochemistry to detect type I and II collagen. RESULTS: Flow cytometry analyses showed that in our population more than 90% of cells were positive for MSC markers: CD29 (95%), CD44 (90%), CD73 (95%), CD90 (98%). Cells were negative for hematopoietic markers (CD11b, CD34, and CD45). Furthermore, cells showed positive stain to multipotent markers such as CD117 (c-kit) (98%), CD166 (74%), and STRO-1 (88%) and to quiescent satellite cells like PAX-7 (35%). The micropellet analyses showed that the culture of these cells with TGFbeta-3 for 2 and 3 weeks stimulates proteoglycan and collagen type II synthesis. Both molecules are characteristic of hyaline articular cartilage. CONCLUSION: In this work, we demonstrate the presence of a cellular population with MSC characteristics in synovial tissue from OA patients. As MSC takes part in reparative processes of adult tissues, these cells could play an important role in OA pathogenesis and treatment.

[Neurilemmoma of the larynx: a case report]. / Neurinoma laríngeo: a propósito de un caso.

Neuromas or Schwannomas are extremely rare among tumors of the larynx. They are Schwann cell tumors that can be difficult to distinguish from neurofibromas. They present usually as supraglottic masses, since they may arise from the internal branch of the superior laryngeal nerve. Nuclear magnetic resonance imaging is the best diagnostic technique, conferring a high degree of suspicion. We present an exceptional case of a laryngeal neuroma, with a very long evolution, a large tumor volume, dyspnea and vocal cord fixation, with complete resolution through an external approach following surgical removal. The difficulties encountered with its pathological and clinical diagnosis are discussed as well as a review of the literature.

[Producing intravenous medications in a pharmacy]. / Elaboración en farmacia de los medicamentos intravenosos. Repercusiones en el personal de enfermería del hospital.

The authors explain the different intravenous mixtures and the types of preloaded syringes elaborated in a centralized unit, analysing their profitability and evaluating their repercussion on the daily work nurses have to perform. This study was carried out in the Hospital de Poniente in Almeria, a county hospital which has 165 beds. The hospital authorities defined those medications which were chosen to be prepared in a centralized unit in the Pharmacy Service of the hospital and they drew up a list/guide of their corresponding conservation conditions. The authorities determined the time which nursing personnel in the various hospital units would employ in the elaboration of these medications and compared that with the time employed in the Pharmacy Service.

Elaboración en farmacia de los medicamentos intravenosos / Producing intravenous medications in a pharmacy

Se explican las diferentes mezclas intravenosas (MIV) y jeringas precargadas elaboradas en una unidad centralizada, analizando su rentabilidad y evaluando su repercusión en el trabajo diario de enfermería. El estudio se realizó en el Hospital de Poniente de Almería, hospital comarcal de 165 camas. Se definen los medicamentos candidatos a su preparación centralizada en el Servicio de Farmacia y se elabora una lista-guía con sus condiciones de conservación. Se determinó el tiempo que emplearía el personal de enfermería de las diferentes unidades de hospitalización en su elaboración comparándolo con el empleado en el Servicio de Farmacia (AU)