Interventional Radiology and Spanish Medical Students: A Survey of Knowledge and Interests in Preclinical and Clinical Courses.

INTRODUCTION: Interventional Radiology (IR) is a medical activity that has experienced an extraordinary growth in the medical field in Spain in recent years. However, there is a lack of visibility in the Spanish Health Administration and the University community, especially among medical students. PURPOSE: The purpose of this study is to determine IR knowledge among medical students, preclinical and clinical, in a single University in Spain. MATERIAL AND METHODS: An electronic survey was uploaded (November-December 2017) to an online learning platform (Moodle) and sent to 414 students from second (183 PCs) and fourth (231 Cs) year of medical school. A total of 313 students of 414 (75.6%) answered the survey 142/45.4% PCs and 171/54.6% Cs. RESULTS: Students quantified their knowledge between adequate (41% PCs/80.7% Cs) and poor levels (50.7% PCs/14% Cs). Most of the students suggested that interventional radiologists (IRs) should have a mixed training, surgical and radiological (95% PCs/88.8% Cs). Majority of students indicated that the professionals in charge of carrying out angioplasty were the IRs (95% PCs/83.6% Cs) and only 20.4% PCs/12.8% Cs (P = 0.165) of students chose cardiologists. Almost all of the medical students in both groups said they wanted to know more about IR (99.3% PCs/100.0% Cs), and the majority of students (100.0% PCs/98.8% Cs) said they agree or strongly agree that IR should be taught as an undergraduate medical subject. CONCLUSION: This study demonstrates that medical students in our University have poor knowledge of IR; however, they are overwhelmingly positive in their desire to have this subject taught as distinct curriculum in medical school.

Low temperature geothermal systems in carbonate-evaporitic rocks: Mineral equilibria assumptions and geothermometrical calculations. Insights from the Arnedillo thermal waters (Spain).

Geothermometrical calculations in low-medium temperature geothermal systems hosted in carbonate-evaporitic rocks are complicated because 1) some of the classical chemical geothermometers are, usually, inadequate (since they were developed for higher temperature systems with different mineral-water equilibria at depth) and 2) the chemical geothermometers calibrated for these systems (based on the Ca and Mg or SO4 and F contents) are not free of problems either. The case study of the Arnedillo thermal system, a carbonate-evaporitic system of low temperature, will be used to deal with these problems through the combination of several geothermometrical techniques (chemical and isotopic geothermometers and geochemical modelling). The reservoir temperature of the Arnedillo geothermal system has been established to be in the range of 87±13°C being the waters in equilibrium with respect to calcite, dolomite, anhydrite, quartz, albite, K-feldspar and other aluminosilicates. Anhydrite and quartz equilibria are highly reliable to stablish the reservoir temperature. Additionally, the anhydrite equilibrium explains the coherent results obtained with the δ18O anhydrite - water geothermometer. The equilibrium with respect to feldspars and other aluminosilicates is unusual in carbonate-evaporitic systems and it is probably related to the presence of detrital material in the aquifer. The identification of the expected equilibria with calcite and dolomite presents an interesting problem associated to dolomite. Variable order degrees of dolomite can be found in natural systems and this fact affects the associated equilibrium temperature in the geothermometrical modelling and also the results from the Ca-Mg geothermometer. To avoid this uncertainty, the order degree of the dolomite present in the Arnedillo reservoir has been determined and the results indicate 18.4% of ordered dolomite and 81.6% of disordered dolomite. Overall, the results suggest that this multi-technique approach is very useful to solve some of the problems associated to the study of carbonate-evaporitic geothermal systems.

Characterisation and modelling of mixing processes in groundwaters of a potential geological repository for nuclear wastes in crystalline rocks of Sweden.

This paper presents the mixing modelling results for the hydrogeochemical characterisation of groundwaters in the Laxemar area (Sweden). This area is one of the two sites that have been investigated, under the financial patronage of the Swedish Nuclear Waste and Management Co. (SKB), as possible candidates for hosting the proposed repository for the long-term storage of spent nuclear fuel. The classical geochemical modelling, interpreted in the light of the palaeohydrogeological history of the system, has shown that the driving process in the geochemical evolution of this groundwater system is the mixing between four end-member waters: a deep and old saline water, a glacial meltwater, an old marine water, and a meteoric water. In this paper we put the focus on mixing and its effects on the final chemical composition of the groundwaters using a comprehensive methodology that combines principal component analysis with mass balance calculations. This methodology allows us to test several combinations of end member waters and several combinations of compositional variables in order to find optimal solutions in terms of mixing proportions. We have applied this methodology to a dataset of 287 groundwater samples from the Laxemar area collected and analysed by SKB. The best model found uses four conservative elements (Cl, Br, oxygen-18 and deuterium), and computes mixing proportions with respect to three end member waters (saline, glacial and meteoric). Once the first order effect of mixing has been taken into account, water-rock interaction can be used to explain the remaining variability. In this way, the chemistry of each water sample can be obtained by using the mixing proportions for the conservative elements, only affected by mixing, or combining the mixing proportions and the chemical reactions for the non-conservative elements in the system, establishing the basis for predictive calculations.

Expression of elastic components in healthy and varicose veins.

This study evaluates possible changes in the synthesis/degradation of elastic components of the vein wall in an attempt to explain the development of varicosis. Healthy and varicose saphenous veins were subjected to immunohistochemical analysis using anti-elastin, anti-fibrillin-1, anti-elastase, anti-transforming growth factor (TGF)-beta and anti-latent TGFbeta binding protein (LTBP)-2 monoclonal antibodies. In situ hybridization was performed using specific probes for tropoelastin and fibrillin-1. In healthy veins, elastin and fibrillin-1 showed even, overlapping distribution patterns indicating their particular abundance in the adventitia and at the intima/media interface. The expression of tropoelastin and fibrillin-1 was high in smooth muscle cells bordering the elastic laminae. Elastin, fibrillin-1, and cells expressing fibrillin-1 and tropoelastin mRNA showed a patchy disorganized pattern, particularly in the proximal varicose segments of patients under 50 years of age. Enhanced elastase activity was noted in both control and varicose specimens from elderly subjects. Varicose veins specimens showed greater LTBP-2 and TGF expression. Both molecules were detected in the subendothelium and the media, particularly in areas of marked injury. Our findings suggest that the development of the varicose condition involves a restructuring of the elastic component of the vein wall, perhaps as a consequence of changes in the transcription mechanisms of muscle layer cells.