Assessment of ground deformation and seismicity in two areas of intense hydrocarbon production in the Argentinian Patagonia.

The exploitation of both conventional and unconventional hydrocarbons may lead to still not well-known environmental consequences such as ground deformation and induced/triggered seismicity. Identifying and characterizing these effects is fundamental for prevention or mitigation purposes, especially when they impact populated areas. Two case studies of such effects on hydrocarbon-producing basins in Argentina, the Neuquén and the Golfo de San Jorge, are presented in this work. The intense hydrocarbon production activities in recent years and their potential link with the occurrence of two earthquakes of magnitude 4.9 and 5 near the operating well fields is assessed. A joint analysis of satellite radar interferometry and records of fluid injection and extraction demonstrate that, between 2017 and 2020, vertical ground displacements occurred in both study areas over active well fields that might indicate a correlation to hydrocarbon production activities. Coseismic deformation models of the two earthquakes constrain source depths to less than 2 km. The absence of seismicity before the beginning of the hydrocarbon activities in both areas, and the occurrence of the two largest and shallow earthquakes in the vicinity of the active well fields just after intensive production periods, points towards the potential association between both phenomena.

Severe thyrotoxicosis as initial presentation of gastric choriocarcinoma: a case report.

BACKGROUND: Extragonadal choriocarcinoma is rare and can be associated with hyperthyroidism when producing very high levels of human chorionic gonadotropin. CASE PRESENTATION: A 62-year-old Hispanic female presented with a 3-week history of shortness of breath, palpitations, extreme weakness, new-onset hot flashes, and right flank pain. Her physical examination was remarkable for tachycardia, hepatomegaly, hyperreflexia, and tremor; goiter was absent. Laboratory studies revealed increased lactate dehydrogenase, alkaline phosphatase, suppressed thyroid stimulating hormone, very elevated T4, and absent thyroid stimulating immunoglobulin. 18F-fluorodeoxyglucose positron emission tomography-computed tomography exhibited hepatomegaly with multiple large fluorodeoxyglucose-avid liver masses and a focus of fluorodeoxyglucose avidity in the stomach with no structural correlate. A thyroid scan (99mTcO 4 - ) showed diffusely increased tracer uptake. She was started on propranolol and methimazole. Upon stabilization of severe thyrotoxicosis, upper endoscopy was performed, showing a ~ 5 cm bleeding lesion in the greater stomach curvature body; biopsy was consistent with choriocarcinoma; beta-human chorionic gonadotropin hormone was 2,408,171 mIU/mL. The patient received methotrexate followed by etoposide and cisplatin. Methimazole was titrated down, and upon liver failure the medication was stopped. The thyrotoxicosis was effectively controlled with antithyroid drug and concurrent chemotherapy. At ~ 1.5 months after initial diagnosis, the patient died due to bleeding/acute liver failure with coagulation defects followed by multiple organ failure. CONCLUSIONS: Severe thyrotoxicosis can represent an unusual initial presentation of metastatic choriocarcinoma in the setting of extreme elevation of beta-human chorionic gonadotropin. Primary gastric choriocarcinoma is an aggressive malignancy with very poor outcomes. The co-occurrence of severe thyrotoxicosis with advanced primary gastric choriocarcinoma and imminent liver failure complicates management options.

Hydrogeological and hydrochemical framework of the distal section of the Salado-Juramento fluvial megafan (Bajos Submeridionales) in South America.

The Bajos Submeridionales (BBSS) (Argentina) is a 54,800 km2 hydrological system located at the distal part of the Salado-Juramento Fluvial Megafan (SJRM). Its climate evolves from humid-subtropical in the east to semiarid in the west. Its hydrogeological system is typical of extensive plains, topography locally imposes vertical flows and neotectonic elements define system boundaries and drains. These characteristics and poor data availability represent a major challenge for identifying a hierarchical subsurface flow system and the influence of neotectonics. This work characterizes the hydrogeology of the BBSS and proposes a conceptual model based on integrated systematic information including 453 water level, 145 hydrochemical, and 99 δ18O- δD data. Four hydrogeological units are identified (HU1-HU4), two of which are divided into sub-units based on their sedimentary sequence. The main chemical types are Na-Cl, Na-Cl/SO4, Na-HCO3/Cl, Na-Cl/HCO3, and HCO3-Na. Dominant ions are Na, Cl, and SO4. Measured electrical conductivity reaches values as high as 132,000 µS/cm. Water chemistry modifying processes include halite, gypsum, and carbonate dissolution; ion exchange; inter-HU water mixing; and evapo-concentration. δ18O-δD and EC-δ18O suggest the existence of subsurface flow sectors. In the south, shallow and medium depth groundwater flows respond to the current circulation of the SJRM. Recharge occurs in the sub-Andean Ranges and point discharges, at the western lakes and some lakes of the Golondrina-Calchaquí system. Precipitation recharges shallow flows locally in the north, center, and east. Extreme west HU2 and HU1 receive deep upward thermal flows through structural lineaments. Thus, the Otumpa Hills morpho-structure would be a barrier to shallow HU1 flow, though not to deep regional HU2 and HU4 flows. Regional groundwater flow is from NW to SE and both local and regional flows would discharge in the Paraná River. The new conceptual model developed helps to further understand the groundwater system of a large plain in South America.

Using isotope data to characterize and date groundwater in the southern sector of the Guaraní Aquifer System.

The Guaraní Aquifer System (SAG) is the largest transboundary aquifer in Latin America, extending beneath parts of Brazil, Paraguay, Argentina, and Uruguay. This paper presents the results of recent hydrogeological studies in the southern portion of the SAG. Locally, the abundance of surface water bodies precluded the use of conventional hydrological tools to characterize groundwater flows. Geological, hydrochemical and environmental isotope investigations were integrated to postulate a revised hydrogeological conceptual model. The revised geological model has provided a better definition of the geometry of the aquifer units and outlined the relevance of regional faults in controlling flow patterns. The new potentiometric map is consistent with groundwater flow from the SAG outcrops to the centre of the Corrientes Province, where upwards flows were identified. Hydrochemical and isotope data confirmed the widespread occurrence of mixing. Noble gas isotopes dissolved in groundwater (4He and 81Kr/Kr) provided residence times ranging from recent recharge up to 770 ± 130 ka. Groundwater age modelling confirmed the role of the geological structures in controlling groundwater flow. The southern sector of the SAG is a multilayer aquifer system with vertical flows and deep regional discharge near the Esteros del Iberá wetland area and along the Paraná and Uruguay rivers.

Splenectomy for Solitary Splenic Metastasis in Recurrent Papillary Thyroid Cancer. A Case Report and Literature Review.

Thyroid cancer is the most common endocrine malignancy, presenting with 23 500 new cases per year in the United States. About 7-23% of the patients will present recurrent metastases disease during follow-up. The classic variant of papillary carcinoma is less aggressive compared to its other variants like diffuse sclerosing, tall cell or columnar cell, and insular variants, and the sites to which this metastasizes is already well identified. Metastasis to the spleen is an extremely rare manifestation of papillary thyroid cancer. To date, only 3 cases have been reported in the literature. Herein, we present a 52-year-old male, who developed spleen metastases, 2.4 years after total thyroidectomy and central neck dissection followed by radioactive iodine ablation and seven months after treatment with sorafenib for lung metastases. The splenic lesion was detected in surveillance studies. This case highlights that splenic metastasis, although rare, may occur even in a patient with a locoregional and systemic controlled thyroid cancer and that it can be treated safely with surgical resection.

Unraveling the Hydrological Behavior of a Coastal Pond in Doñana National Park (Southwest Spain).

Time series analysis methods have been used to detect behavioral patterns in a set of nine time series. These series contained information in a 3-h time step about meteorological, hydrological and tidal data of a sand dune pond area located in Doñana National Park in the southwest of Spain. The methods used, such as wavelet analysis and additive seasonal decomposition, had never been applied before in the types of ecosystems studied. These approaches have improved the current knowledge of the conceptual model of the Santa Olalla pond system, the only system with a permanent hydroperiod located in this protected area. In addition, complex surface water-groundwater interactions, not visible through descriptive methods, have been distinguished to have a strong seasonal component. Finally, we evaluated the effect of pumping activity in a nearby coastal resort on the water supply of the Santa Olalla pond system. Although direct damage to this sand dune pond has not yet been identified, special attention must be paid in order to maintain groundwater inputs that are integral to maintaining its current status.

Immunohistochemical Expression of Nuclear ß-Catenin and STAT-6 in a Solitary Fibrous Tumor of the Soft Palate: A Case Report and Review of the Literature.

The solitary fibrous tumors (SFT) are rare tumors in the head and neck region and there have been only 5 cases reported in the literature in the soft palate. The current paper presents a unique case of a 62-year-old male with TFS arising in the soft palate. The tumor was highly cellular, composed of bland looking haphazardly arranged spindle cells. The signal transducer and activator of transcription (STAT)-6 and nuclear ß-catenin were reactive by immunohistochemistry (IHC). The current case highlights the importance of the STAT-6 and the ß-catenin as IHC markers to make a differential diagnosis with other entities. In summary, the paper presents the first reported case of a SFT of the soft palate in a male patient with nuclear expression of STAT-6 and ß-catenin.

[Parathyroid disease: The full spectrum, from adenoma to carcinoma. Report of 3 cases]. / Enfermedad paratiroidea: el espectro completo, de adenoma a carcinoma. Reporte de 3 casos.

BACKGROUND: Primary hyperparathyroidism is a disease characterised by the autonomous production of parathyroid hormone. The most common cause is an adenoma, followed by hyperplasia, and rarely carcinoma. CLINICAL CASES: Three cases are presented. The first case is associated with a brown tumour that was diagnosed as hyperplasia after study and surgery. The second case was related to pathological fractures, and a lower right adenoma 236 times bigger than a normal parathyroid was excised. The last case presented with abdominal pain and heartburn. Histopathology reported a carcinoma, which was removed using surgery en bloc. All patients have improved. CONCLUSION: Hyperparathyroidism symptoms are very difficult to identify and diagnose, thus a detailed and broad approach is needed when hyperparathyroidism is suspected.

La espirometría en la Neumología pública en Navarra. Análisis contrastado del estudio 3E / Spirometry in Public Hospitals in Navarre. A Comparative Analysis of the 3E Study

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Groundwater salinity and hydrochemical processes in the volcano-sedimentary aquifer of La Aldea, Gran Canaria, Canary Islands, Spain.

The origin of the groundwater salinity and hydrochemical conditions of a 44km(2) volcano-sedimentary aquifer in the semi-arid to arid La Aldea Valley (western Gran Canaria, Spain) has been studied, using major physical and chemical components. Current aquifer recharge is mainly the result of irrigation return flows and secondarily that of rainfall infiltration. Graphical, multivariate statistical and modeling tools have been applied in order to improve the hydrogeological conceptual model and identify the natural and anthropogenic factors controlling groundwater salinity. Groundwater ranges from Na-Cl-HCO3 type for moderate salinity water to Na-Mg-Cl-SO4 type for high salinity water. This is mainly the result of atmospheric airborne salt deposition; silicate weathering, and recharge incorporating irrigation return flows. High evapotranspiration produces significant evapo-concentration leading to relative high groundwater salinity in the area. Under average conditions, about 70% of the water used for intensive agricultural exploitation in the valley comes from three low salinity water runoff storage reservoirs upstream, out of the area, while the remaining 30% derives from groundwater. The main alluvial aquifer behaves as a short turnover time reservoir that adds to the surface waters to complement irrigation water supply in dry periods, when it reaches 70% of irrigation water requirements. The high seasonality and intra-annual variability of water demand for irrigation press on decision making on aquifer use by a large number of aquifer users acting on their own.

S100A8/A9 proteins mediate neutrophilic inflammation and lung pathology during tuberculosis.

RATIONALE: A hallmark of pulmonary tuberculosis (TB) is the formation of granulomas. However, the immune factors that drive the formation of a protective granuloma during latent TB, and the factors that drive the formation of inflammatory granulomas during active TB, are not well defined. OBJECTIVES: The objective of this study was to identify the underlying immune mechanisms involved in formation of inflammatory granulomas seen during active TB. METHODS: The immune mediators involved in inflammatory granuloma formation during TB were assessed using human samples and experimental models of Mycobacterium tuberculosis infection, using molecular and immunologic techniques. MEASUREMENTS AND MAIN RESULTS: We demonstrate that in human patients with active TB and in nonhuman primate models of M. tuberculosis infection, neutrophils producing S100 proteins are dominant within the inflammatory lung granulomas seen during active TB. Using the mouse model of TB, we demonstrate that the exacerbated lung inflammation seen as a result of neutrophilic accumulation is dependent on S100A8/A9 proteins. S100A8/A9 proteins promote neutrophil accumulation by inducing production of proinflammatory chemokines and cytokines, and influencing leukocyte trafficking. Importantly, serum levels of S100A8/A9 proteins along with neutrophil-associated chemokines, such as keratinocyte chemoattractant, can be used as potential surrogate biomarkers to assess lung inflammation and disease severity in human TB. CONCLUSIONS: Our results thus show a major pathologic role for S100A8/A9 proteins in mediating neutrophil accumulation and inflammation associated with TB. Thus, targeting specific molecules, such as S100A8/A9 proteins, has the potential to decrease lung tissue damage without impacting protective immunity against TB.

CXCR5⁺ T helper cells mediate protective immunity against tuberculosis.

One third of the world's population is infected with Mycobacterium tuberculosis (Mtb). Although most infected people remain asymptomatic, they have a 10% lifetime risk of developing active tuberculosis (TB). Thus, the current challenge is to identify immune parameters that distinguish individuals with latent TB from those with active TB. Using human and experimental models of Mtb infection, we demonstrated that organized ectopic lymphoid structures containing CXCR5+ T cells were present in Mtb-infected lungs. In addition, we found that in experimental Mtb infection models, the presence of CXCR5+ T cells within ectopic lymphoid structures was associated with immune control. Furthermore, in a mouse model of Mtb infection, we showed that activated CD4+CXCR5+ T cells accumulated in Mtb-infected lungs and produced proinflammatory cytokines. Mice deficient in Cxcr5 had increased susceptibility to TB due to defective T cell localization within the lung parenchyma. We demonstrated that CXCR5 expression in T cells mediated correct T cell localization within TB granulomas, promoted efficient macrophage activation, protected against Mtb infection, and facilitated lymphoid follicle formation. These data demonstrate that CD4+CXCR5+ T cells play a protective role in the immune response against TB and highlight their potential use for future TB vaccine design and therapy.

Evaluación de la utilización de una consulta de diagnóstico rápido de cáncer de pulmón. Tiempos de demora diagnóstica y terapéutica / Evaluation of the Use of a Rapid Diagnostic Consultation of Lung Cancer. Delay Time of Diagnosis and Therapy

Objetivo: Analizar los resultados conseguidos desde su creación hace 5 años en una consulta de diagnóstico rápido de cáncer de pulmón (CDR-CP) relacionados con el buen uso de la derivación, tiempos de demora diagnóstica y terapéutica, y días de estancia hospitalaria. Comparar las demoras diagnóstico-terapéuticas y estancias hospitalarias con las obtenidas en los pacientes evaluados mediante la sistemática habitual (NCDR-CP). Pacientes y método: Se ha incluido a todos los pacientes valorados en nuestra CDR-CP en los últimos 5 años. En los CP se han registrado las fechas de derivación al médico especialista, primera consulta, realización de pruebas diagnósticas, estadificación, inicio del tratamiento y días de hospitalización. Se han comparado estos mismos datos con los pacientes NCDR-CP diagnosticados en el periodo de octubre 2008 a octubre de 2010. Resultados: Se evaluaron 179 pacientes remitidos a CDR-CP que representan el 26,7% de las consultas ofertadas, siendo 166 (92,7%) las remisiones correctas, de las que el 44,5% correspondieron a un CP; en el 75,6% de ellos se realizó todo el estudio de forma ambulatoria y más del 85% de los casos cumplían con las recomendaciones existentes relacionadas con las demoras diagnóstico-terapéuticas. Al comparar estos datos con el grupo NCDR-CP (n=151), se encontraron diferencias relacionadas con los datos de hospitalización: menor porcentaje de ingresados (p<0,0001) y menos días de estancia (p<0,0001) en el grupo CDR-CP. No existieron diferencias entre ambos grupos en las demoras diagnósticas y terapéuticas. Conclusión: En nuestro medio la consulta de diagnóstico rápido de cáncer de pulmón permite realizar, en un gran porcentaje de casos, todos los estudios de forma ambulatoria y en plazos de tiempo acordes con las recomendaciones existentes. Pese a ello, hemos detectado una acusada infrautilización de las mismas(AU)

Objective: To analyze the results obtained in a lung cancer screening program since its inception five years ago regarding correct referrals, diagnostic and therapeutic delay times and days of hospitalization. To compare the diagnostic-therapeutic delays and hospital stays with those obtained in patients evaluated with the standard system. Patients and methods: Included for study were all those patients evaluated in our Lung Cancer Screening Program (LCSP) in the last five years. For the cases with LC, we recorded the dates the patients were referred to a specialist, the first consultation, diagnostic tests, stage, start of treatment and days of hospitalization. We compared these same data with lung cancer patients who did not partake in the LCSP and were diagnosed between October 2008 and October 2010. Results: We evaluated 179 patients remitted to the LCSP, which represented 26.7% of the consultations; 166 (92.7%) of the referrals were correct, out of which 44.5% were LC. In 75.6% of these, the entire study was completed in the outpatient setting, and more than 85% of the cases met the current recommendations related with diagnostic-therapeutic delays. When these results were compared with the non-LCSP group (n=151), differences were found in the data for hospitalizations: there was a lower percentage of hospitalizations (P<.0001) and shorter hospital stays (P<.0001) in the LCSP group. There were no differences between the two groups for diagnostic or therapeutic delays. Conclusion: In our setting, lung cancer screening programs allow for cancer studies to be carried out in the outpatient consultations in a large percentage of cases, and within the time periods recommended by current guidelines. In spite of this fact, we have detected that these programs are underused(AU)

Evaluation of the use of a rapid diagnostic consultation of lung cancer. Delay time of diagnosis and therapy.

OBJECTIVE: To analyze the results obtained in a lung cancer screening program since its inception five years ago regarding correct referrals, diagnostic and therapeutic delay times and days of hospitalization. To compare the diagnostic-therapeutic delays and hospital stays with those obtained in patients evaluated with the standard system. PATIENTS AND METHODS: Included for study were all those patients evaluated in our Lung Cancer Screening Program (LCSP) in the last five years. For the cases with LC, we recorded the dates the patients were referred to a specialist, the first consultation, diagnostic tests, stage, start of treatment and days of hospitalization. We compared these same data with lung cancer patients who did not partake in the LCSP and were diagnosed between October 2008 and October 2010. RESULTS: We evaluated 179 patients remitted to the LCSP, which represented 26.7% of the consultations; 166 (92.7%) of the referrals were correct, out of which 44.5% were LC. In 75.6% of these, the entire study was completed in the outpatient setting, and more than 85% of the cases met the current recommendations related with diagnostic-therapeutic delays. When these results were compared with the non-LCSP group (n=151), differences were found in the data for hospitalizations: there was a lower percentage of hospitalizations (P<.0001) and shorter hospital stays (P<.0001) in the LCSP group. There were no differences between the two groups for diagnostic or therapeutic delays. CONCLUSION: In our setting, lung cancer screening programs allow for cancer studies to be carried out in the outpatient consultations in a large percentage of cases, and within the time periods recommended by current guidelines. In spite of this fact, we have detected that these programs are underused.

[Bilateral tonsillar hypertrophy as the first manifestation of B cell-small lymphocytic lymphoma with interfolicular pattern]. / Hipertrofia amigdalina bilateral como primera manifestación de linfoma de linfocitos pequeños B con patrón interfolicular.

B-cell small lymphocytic lymphoma typically involves nodal or extranodal tissues as a diffuse proliferation with proliferation centers (pseudofollicules) obliterating normal architecture. But there are unusual patterns of involvement including interfollicular pattern that can be difficult to recognize histologically and probably represent partial or early involvement by neoplasm. Tonsillar lymphoma usually presents either as a unilaterally enlarged palatine tonsil or as an ulcerative and fungating lesion over the tonsillar area. Most lymphomas that involve the tonsil are diffuse large B cell lymphomas and primary low-grade lymphomas are exceptional. We present a primary B-cell small lymphocytic lymphoma affecting palatine tonsils with interfollicular pattern in a 54 year-old man that clinically presented with symmetric / bilateral tonsillar enlargement and sleep apnea.