Assessment of environmental radiological impact in former metallic mines in Extremadura (Spain): A case study.

Metal mining in the Extremadura region was very important in the 19th and 20th centuries. However, due to different reasons the great majority of mines ceased operations, leading to plenty of abandoned mining sites, most of them with on-site waste dumps. Although metal extraction is not radioactive per se, it is considered a NORM activity. In this study, three former mining sites, in which Pb-V-Zn-Ag, Pb-Ag, and Pb-Zn were extracted, were selected to assess the radiological impact on the population and the environment. The external γ exposure was estimated by determining the effective dose and elaborating isodose maps of the sites. The presence of the mining sites increased up to 0.41 mSv/y the effective dose over the surrounding background, which is below the reference value of 1 mSv/y. In only one mining site, the uranium and radium activity concentration of waste dumps were higher than the surrounding soil. The soil to plant (wild grass) transfer factors were similar to other reported values without the influence of NORM activities. So, no enhanced transfer of radionuclides was observed. The radiological impact on the environment was assessed by the risk to non-human biota using the tiered approach developed in ERICA Tool. The sum of the risk quotients of all considered radionuclides in the most conservative Tier 1 was below 1. Total dose rates for several terrestrial Reference Animal and Plants (RAPs) were estimated using Tier 3, obtaining values below 40 µGy/h. Therefore, the impact on non-human biota can be considered as negligible.

Design and development of a detector system and software tool installed on a mobile laboratory to provide both radiological characterisation of large areas and a simple tool for localising radioactive sources.

In emergency situations where an immediate response is required to make appropriate decisions by the competent authorities, it is essential to have measurement tools that provide results as accurate as possible in real-time. This paper presents the description of the upgrade of the mobile laboratory of the Radiological Alert Network of Extremadura, focusing on the characterisation of radioactive-contaminated land during emergency situations and the detection of radioactive sources. The detector system is based on two scintillation detectors and a car-borne dose rate monitor. Additionally, a software tool has been developed to collect information from the different devices involved (detectors, GPS, etc) and display it in an intuitive manner. This system has been tested in an area of a former phosphate facility where soils remain contaminated to varying degrees with radionuclides of TE-NORM origin.

Development of an advanced radioactive airborne particle monitoring system for use in early warning networks.

Automatic real-time warning networks are essential for the almost immediate detection of anomalous levels of radioactivity in the environment. In the case of Extremadura region (SW Spain), a radiological network (RARE) has been operational in the vicinity of the Almaraz nuclear power plant and in other areas farther away since 1992. There are ten air monitoring stations equipped with Geiger-Müller counters in order to evaluate the external ambient gamma dose rate. Four of these stations have a commercial system that provides estimates of the total artificial alpha and beta activity concentrations in aerosols, and of the 131I activity (gaseous fraction). Despite experience having demonstrated the benefits and robustness of these commercial systems, important improvements have been made to one of these air monitoring systems. In this paper, the analytical and maintenance shortcomings of the original commercial air monitoring system are described first; the new custom-designed advanced air monitoring system is then presented. This system is based mainly on the incorporation of gamma spectrometry using two scintillation detectors, one of NaI:Tl and the other of LaBr3:Ce, and compact multichannel analysers. Next, a comparison made of the results provided by the two systems operating simultaneously at the same location for three months shows the advantages of the new advanced air monitoring system. As a result, the gamma spectrometry analysis allows passing from global alpha and beta activity determinations due to artificial radionuclides in aerosols, and the inaccurate measurement of the gaseous 131I activity concentration, to the possibility of identifying a large number of radionuclides and quantifying each of their activity concentrations. Moreover, the new station's dual capacity is designed to work in early warning monitoring mode and surveillance monitoring mode. This is based on custom developed software that includes an intelligent system to issue the necessary warnings when radiological anomalies or technical problems are identified. Implicitly, for the construction of the advanced station, substantial mechanical and electronic developments have been required. They have essentially consisted of integrating a new replacement device, whose operation has reduced the maintenance tasks.

Susceptibility and PK/PD relationships of Staphylococcus aureus strains from ovine and caprine with clinical mastitis against five veterinary fluoroquinolones.

Minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC) of veterinary fluoroquinolones as enrofloxacin, its metabolite ciprofloxacin, danofloxacin, difloxacin and marbofloxacin against Staphylococcus aureus strains (n=24) isolated from milk of sheep and goats affected by clinical mastitis were evaluated. The authors have used the MIC and MPC, as well as the pharmacokinetic-pharmacodynamic relationships in plasma and milk. MIC values were significantly different between drugs, unlike MPC values. Lower MIC values were obtained for danofloxacin and difloxacin, middle and higher values for enrofloxacin, ciprofloxacin and marbofloxacin. However, differences in MPC values were not found between drugs. At conventional doses, the AUC24/MIC and AUC24/MPC ratios were close to 30-80 hours and 5-30 hours, with exception of danofloxacin, in plasma and milk. The time inside the mutant selection window (TMSW) was close to 3-6 hours for enrofloxacin, ciprofloxacin and marbofloxacin, near to 8 hours for danofloxacin and 12-22 hours for difloxacin. From these data, the mutant selection window could be higher for danofloxacin and difloxacin compared with the other fluoroquinolones tested. The authors concluded that enrofloxacin and marbofloxacin, at conventional doses, could prevent the selection of bacterial subpopulations of S aureus, unlike danofloxacin and difloxacin, where higher doses could be used.

Lessons learnt from the radiological measures performed by the Radiological Emergency Network of Extremadura in the International Emergency Exercise CURIEX 2013.

In late 2013 (5th-7th of November), the Cáceres Urgent Response International Exercise (CURIEX 2013) took place to test the Nuclear Emergency Plan of Cáceres (PENCA) with the collaboration of both national and international support teams. The theme of the exercise was the simulation of a nuclear accident at the Almaraz Nuclear Power Plant located in Extremadura (Spain) with release of radioactive plume. From the point of view of radioactive contamination, the CURIEX exercise objective was to assess the capability of the different radiological teams to quantify the radioactive impact that would occur in this environment, a goal in which the Radiological Emergency Network of Extremadura (RARE) is directly implicated. The present paper analyses in detail the environmental radiological and dosimetrical results obtained by the Radiological Emergency Network of Extremadura during the CURIEX exercise. The rapid radioactivity measurement techniques on air and soil samples performed by the RARE's mobile lab involves great uncertainties. However, the results show a relative good effectiveness both in dose rate car-borne measurements and gamma soil spectrometry with uncertainties over 40%. It also shows a good correlation between the dose rate values measured by car-borne apparatus and those calculated from gamma spectrometry measurements. The capability of the RARE's facilities are evaluated in both the measurements, showing whether or not there is a radiological problem, and the transmission of that data to the decision centres in the shortest time. Although the results were highly satisfactory, some shortcomings were detected and therefore some improvements are proposed in the paper, in order to achieve a greater capacity in response to an event with the characteristics simulated in the CURIEX exercise.

Pharmacokinetics and pharmacodynamics of ramipril and ramiprilat after intravenous and oral doses of ramipril in healthy horses.

The pharmacokinetics and pharmacodynamics (PK/PD) of the angiotensin-converting enzyme inhibitor (ACEI) ramiprilat after intravenous (IV) and oral (PO) administration of ramipril have not been evaluated in horses. This study was designed to establish PK profiles for ramipril and ramiprilat as well as to determine the effects of ramiprilat on serum angiotensin converting enzyme (ACE) and to select the most appropriate ramipril dose that suppresses ACE activity. Six healthy horses in a cross-over design received IV ramipril 0.050 mg/kg, PO at a dose of 0 (placebo), and 0.050, 0.10, 0.20, 0.40 and 0.80 mg/kg ramipril. Blood pressures were measured and blood samples obtained at different times. Serum ramipril and ramiprilat concentrations and serum ACE activity were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and spectrophotometry, respectively. Systemic bioavailability of ramiprilat after PO ramipril was 6-9%. Percentages of maximum ACE inhibitions from baseline were 98.88 (IV ramipril), 5.31 (placebo) and 27.68, 39.27, 46.67, 76.13 and 84.27 (the five doses of PO ramipril). Blood pressure did not change during the experiments. Although oral availability of ramiprilat was low, ramipril has sufficient enteral absorption and bioconversion to ramiprilat to induce serum ACE inhibitions of almost 85% after a dose of 0.80 mg/kg ramipril. Additional research on ramipril administration in equine patients is indicated.

Proposed improvements to existing water monitoring systems in automatic radiological warning networks.

The main objective of automatic environmental radiation warning networks is to quantify a set of radiological parameters corresponding to the medium being monitored (water, air, etc) in the shortest possible time so as to be able to provide rapid and precise information on the medium's radiological status, and on any alterations that may occur and their severity. Specifically, in this paper we present the substantial improvements that have been carried out in an automatic near-real-time radiation monitoring of a water system belonging to Radiation Alert Network of Extremadura (RARE) in southwest Spain. These improvements are based on the incorporation of (i) a gamma spectrometry system with solid scintillation detectors and compact digital electronics, (ii) continuous measurement of the water flow that is being monitored, (iii) improvements in the maintenance tasks required to optimise the operation of this type of equipment and (iv) the controlled and automated collection of water samples so that, in the case of a possible radiological anomaly, it will be possible to perform ulterior specific complementary determinations in a low-background laboratory.

[Mineral composition of different types of Canarian gofio; factors affecting the presence of Na, K, Mg, Ca, Mn, Fe, Cn and Zn]. / Composición mineral de los distintos tipos de gofio canario; factores que afectan a la presencia de Na, K, Mg, Ca, Mn, Fe, Cu y Zn.

The contents of Na, K, Mg, Ca, Mn, Fe, Cu and Zn were analyzed and evaluated in 181 samples of various types of gofio produced from different roasted cereal grains. Samples were analyzed by ICP-OES. Based on a daily gofio intake of 30 g/day for adults and 15 g/day for children, the daily intake of each metal, and its percentage contribution to the RDAs established for the Spanish population, were estimated. The metal with the highest concentration was K (2189 ± 766 mg/kg). The lowest concentration was observed for Cu in corn gofio samples (2.05 ± 0.36 mg/kg). With respect to daily intake, it is noteworthy that gofio contributes significantly to the recommended allowance of copper (53.77%-71.45% of the RDI), depending on the population group considered and on the type of gofio.

En este trabajo se ha estudiado la composición mineral de Na, K, Mg, Ca, Mn, Fe, Cu y Zn en 181 muestras de diversos tipos de gofio elaborados con diferentes cereales. Las muestras se analizaron mediante espectrometría de emisión óptica con plasma acoplado inductivamente (ICP-OES). Considerando un consumo medio diario de 30 g de gofio en adultos y de 15 g de gofio en niños, se estimaron las ingestas diarias de cada metal y sus contribuciones porcentuales a las IDRs establecidas para la población española. El elemento que presentó la mayor concentración de todos los estudiados fue el K en muestras de gofio de cereales, con una concentración media de 2189 ± 766 mg/kg. El de menor concentración fue el Cu en muestras de gofio de maíz, con 2,05 ± 0,36 mg/kg. Con respecto a la ingesta, cabe destacar que el gofio contribuye de manera significativa a la ingesta de cobre (53,77%- 71,45% de la IDR), en función del grupo de población que se trate y del tipo de gofio.

Calibration of an air monitor prototype for a radiation surveillance network based on gamma spectrometry.

The objective of this work is to present the improvements that have been made in quasi-real-time air radioactivity concentration monitors which were initially based on overall activity determinations, by incorporating gamma spectrometry into the current prototype. To this end it was necessary to develop a careful efficiency calibration procedure for both the particulate and the gaseous fractions of the air being sampled. The work also reports the values of the minimum detectable activity calculated for different isotopes and acquisition times.

Evaluation of metal concentrations in mentha herbal teas (Mentha piperita, Mentha pulegium and Mentha species) by inductively coupled plasma spectrometry.

Phytopharmaceuticals are gaining popularity worldwide; however, cases of adverse effects and drug interactions have also increased. One reason is in the high metal content both as ingredients but also as contaminants. Metal monitoring in food, like herbal teas, provides basic information on safety aspects in regulatory processes as well as nutritional values. In the present work, Cd, Pb, K, Na, Ca, Mg, Al, B, Ba, Co, Cr, Cu, Fe, Mn, Zn, Li, Ni, and Mo were determined by inductively coupled plasma spectrometry (ICPS) in 36 samples of Mentha sp. Mint tea bags and loose leaves were randomly obtained from supermarkets, traditional markets, herbal stores, and pharmacies in Tenerife (Canary Islands, Spain). Metal contents varied significantly, dependent on the stores the products were purchased in and on tea packaging (loose leaves versus tea bags). Pb analyses revealed levels (0.65±0.71mg/kg) below legal limits. The maximum permissible limit for Cd, 0.3mg/kg, set by the WHO for medicinal plants, was exceeded by 19.44% of the samples (0.22±0.13mg/kg), but all values were below the limit given in the European Pharmacopoeia for this metal (4mg/kg). We observed high Al (151.24±162.73mg/kg) and Li (5.46±3.94mg/kg) levels. B, Ba, Co, Cr, Cu, Fe, Mn, Ni, Zn, and Mo mean levels were 20.51, 14.15, 0.26, 1.65, 10.65, 406.00, 55.05, 1.72, 33.67, and 0.73mg/kg, respectively. Mean Ca, Mg, K, and Na were detected in concentrations of 10.32, 3.83, 7.23 and 1.17g/kg, respectively. In conclusion, metal exposure through herbal mint teas does not seem to be of health concern, as to most of the studied metals, but regulatory limits for Al contents should be imposed.

[Extracorporeal high-intensity focused ultrasound: therapeutic alternative for renal tumors]. / Ultrasonidos extracorpóreos de alta intensidad: alternativa terapéutica del tumor renal.

OBJECTIVES: High intensity focused ultrasound (HIFU) is known to be used for the treatment of solid tumors in minimally invasive procedures. Transducers allowing for application of ultrasound from an extracorporeal focus have recently been developed. A review is provided of the development, physical principles, and current status of this therapy, and our early experience with it for the treatment of renal tumors is reported. MATERIALS AND METHODS: Extracorporeal HIFU is currently being used for the treatment of tumors (mainly hepatic, gynecological, and bone tumors), and has been started to be used for renal tumors with good results. A literature review (structured search in the online MEDLINE electronic base) of the physical principles of this treatment and its biological action is provided. The therapeutic procedure used in the first few patients with renal carcinoma successfully treated with HIFU at our hospital is reported. RESULTS: This therapy has been successfully used to treat solid tumors at several centers in Europe, America, and Asia. Our center has a wide experience in treatment of gynecological tumors using extracorporeal HIFU, and has already treated renal tumors with no complications, although follow-up is still short. CONCLUSIONS: Extracorporeal use of this energy appears as a new option among non-invasive therapies for renal cancer in selected cases. A low complication rate has been noted, but much longer follow-up times are required for assessment of oncological results.

Ultrasonidos extracorpóreos de alta intensidad: alternativa terapéutica del tumor renal / Extracorporeal high-intensity focused ultrasound: Therapeutic alternative for renal tumors

Objetivos: Es conocida la aplicación de los ultrasonidos focalizados de alta intensidad (HIFU) en el tratamiento de los tumores sólidos dentro de las terapias mínimamente invasivas, habiéndose desarrollado en los últimos años transductores que permiten la aplicación de ultrasonidos desde un foco extracorpóreo. Presentamos una revisión del desarrollo, los principios físicos, el estado actual y la experiencia inicial propia de esta terapia en el tratamiento de los tumores renales. Material y métodos: Actualmente el HIFU extracorpóreo está siendo utilizado en el tratamiento de tumores, principalmente hepáticos, ginecológicos y óseos, y se ha iniciado su uso en la terapia para las neoplasias renales con buenos resultados. Presentamos una revisión bibliográfica (búsqueda estructurada en la base electrónica MEDLINE online) de los principios físicos de este tratamiento y su acción biológica. Describimos la metodología de tratamiento de los primeros casos de carcinoma renal tratados en nuestro hospital con éxito mediante HIFU. Resultados: Esta terapia ha sido empleada con éxito para tratar tumores sólidos en varios centros de Europa, América y Asia. En nuestro centro tenemos una amplia experiencia en el tratamiento mediante HIFU extracorpóreo de tumores ginecológicos, y ya hemos tratado tumores renales sin complicaciones, si bien el seguimiento es todavía corto. Conclusiones: El uso de esta energía de forma extracorpórea aparece como una nueva opción dentro de las terapias no invasivas del cáncer renal en casos seleccionados, con un escaso índice de complicaciones, aunque hace falta mucho más tiempo de seguimiento para valorar sus resultados desde el punto de vista oncológico (AU)

Objectives: High intensity focused ultrasound (HIFU) is known to be used for the treatment of solid tumors in minimally invasive procedures. Transducers allowing for application of ultrasound from an extracorporeal focus have recently been developed. A review is provided of the development, physical principles, and current status of this therapy, and our early experience with it for the treatment of renal tumors is reported. Materials and methods: Extracorporeal HIFU is currently being used for the treatment of tumors (mainly hepatic, gynecological, and bone tumors), and has been started to be used for renal tumors with good results. A literature review (structured search in the online MEDLINE electronic base) of the physical principles of this treatment and its biological action is provided. The therapeutic procedure used in the first few patients with renal carcinoma successfully treated with HIFU at our hospital is reported. Results: This therapy has been successfully used to treat solid tumors at several centers in Europe, America, and Asia. Our center has a wide experience in treatment of gynecological tumors using extracorporeal HIFU, and has already treated renal tumors with no complications, although follow-up is still short. Conclusions: Extracorporeal use of this energy appears as a new option among non-invasive therapies for renal cancer in selected cases. A low complication rate has been noted, but much longer follow-up times are required for assessment of oncological results (AU)

Satisfacción de los Usuarios de la Unidades de Gestión Clínica / No disponible

No disponible

Patología Forense y Geriatría: una visión de futuro / Forensic Pathology and Geriatrics: a vision of future

Actualmente asistimos a un aumento progresivode la población anciana en países occidentalesque lleva asociado consigo, obviamente, unaumento tanto de las patologías propias de laedad como los fallecimientos que interesan aámbitos sanitarios no exclusivamente asistenciales,sino periciales que auxilian a la administraciónde justicia. Nos estamos refiriendo a los Institutosde Medicina Legal, y dentro de ellos losServicios de Clínica y Patología Forense.El presente trabajo es únicamente una reflexiónen voz alta sobre como la población ancianaconstituye un sector de mucho interés en MedicinaLegal y Patología Forense por el volumende trabajo que origina y el gran número de casosque deben ser estudiados por el Médico Forense,tendencia que, por los motivos anteriormenteexpuestos, es ascendente. Así mismo, y de formailustrativa, se exponen algunos resultados deun estudio realizado (tesis doctoral de próximaaparición) sobre 843 casos de muertes judiciales,donde se puede objetivar lo expuesto

At present we are witnessing a progressive increasein the population of the elderly in Westerncountries.This obviously implies a rise in the pathologiesof elderly people as well as deaths thatnot only interest the area of care in the field ofhealth, but also the experts that assist the administrationof justice. We are referring to the Institutesof Legal Medicine and to be more specific,the Services of Clinics and Forensic Pathology.The present study is simply some reflectionsmade out aloud on how the elderly populationconstitutes an area of great interest in Legal Medicineand Forensic Pathology as due to thequantity of work that arises from this situation andthe great number of cases that must be studiedby the Forensic doctor. This tendency, as a resultof the reasons mentioned above, is on the rise.Thus, by way of illustration, some results of astudy carried out (doctoral thesis to be publishedshortly) on some 843 cases of judicial deaths arepresented where the above can be seen

Factors Affecting Pseudomonas savastanoi pv. savastanoi Plant Inoculations and Their Use for Evaluation of Olive Cultivar Susceptibility.

ABSTRACT Pseudomonas savastanoi pv. savastanoi causes olive knot disease, which is present in most countries where olive trees are grown. Although the use of cultivars with low susceptibility may be one of the most appropriate methods of disease control, little information is available from inoculation assays, and cultivar susceptibility assessments have been limited to few cultivars. We have evaluated the effects of pathogen virulence, plant age, the dose/response relationship, and the induction of secondary tumors in olive inoculation assays. Most P. savastanoi pv. savastanoi strains evaluated were highly virulent to olive plants, but interactions between cultivars and strains were found. The severity of the disease in a given cultivar was strongly dependent of the pathogen dose applied at the wound sites. Secondary tumors developed in noninoculated wounds following inoculation at another position on the stem, suggesting the migration of the pathogen within olive plants. Proportion and weight of primary knots and the presence of secondary knots were evaluated in 29 olive cultivars inoculated with two pathogen strains at two inoculum doses, allowing us to rate most of the cultivars as having either high, medium, or low susceptibility to olive knot disease. None of the cultivars were immune to the disease.

Evidencias científicas de electroterapia y termoterapia en lumbalgia y lumbociatalgia / Scientific evidence of electrotherapy and thermotherapy in low back pain and sciatica

El tratamiento de la lumbalgia y lumbociatalgia suele ser multidisciplinar y es común que incluya terapia física. Dentro de ésta y como medida analgésica se emplea la electroterapia. Sin embargo, no existe una pauta de actuación bien definida respecto a qué aparatos utilizar y con qué parámetros. Propósito. Buscar la evidencia científica para la electroterapia que se emplea con mayor frecuencia en el tratamiento de estas patologías y proponer pautas de tratamiento con la mayor eficacia conocida. Método. Se buscaron los estudios más relevantes (aleatorios, con grupo placebo y/o control y a ciego) en las bases de datos PEDro y MEDLINE, desde el año 1983 hasta 2003 inclusive. Resultados. La Estimulación Eléctrica Trancutánea (TENS), a pesar de su efecto placebo, demuestra ser eficaz a corto-medio plazo cuando se emplea con una frecuencia elevada (100 Hz) y un tiempo de pulso de 125 μseg. Los ultrasonidos son eficaces en patología discal al utilizarlos durante 10 min con una intensidad entre 1-2 W/cm2. El láser de arseniuro de galio demuestra su efectividad cuando se aplica con dosis de 4 J/cm2. La técnica que obtiene mejores reducciones del dolor a corto plazo, tanto en la lumbalgia como en la ciatalgia, es la Terapia de Neouromodulación PercutáneaEl tratamiento de la lumbalgia y lumbociatalgia suele ser multidisciplinar y es común que incluya terapia física. Dentro de ésta y como medida analgésica se emplea la electroterapia. Sin embargo, no existe una pauta de actuación bien definida respecto a qué aparatos utilizar y con qué parámetros. Propósito. Buscar la evidencia científica para la electroterapia que se emplea con mayor frecuencia en el tratamiento de estas patologías y proponer pautas de tratamiento con la mayor eficacia conocida. Método. Se buscaron los estudios más relevantes (aleatorios, con grupo placebo y/o control y a ciego) en las bases de datos PEDro y MEDLINE, desde el año 1983 hasta 2003 inclusive. Resultados. La Estimulación Eléctrica Trancutánea (TENS), a pesar de su efecto placebo, demuestra ser eficaz a corto-medio plazo cuando se emplea con una frecuencia elevada (100 Hz) y un tiempo de pulso de 125 μseg. Los ultrasonidos son eficaces en patología discal al utilizarlos durante 10 min con una intensidad entre 1-2 W/cm2. El láser de arseniuro de galio demuestra su efectividad cuando se aplica con dosis de 4 J/cm2. La técnica que obtiene mejores reducciones del dolor a corto plazo, tanto en la lumbalgia como en la ciatalgia, es la Terapia de Neouromodulación Percutánea (PNT o PENS), que demuestra ser eficaz cuando se utiliza una frecuencia alternante de 15/30 Hz, un tiempo de pulso entre 0,5-0,7 mseg, intensidad máxima sin contracción muscular y una duración de 30 minutos por sesión. Conclusiones. Existe evidencia científica para incluir la electroterapia en el tratamiento de la lumbalgia y ciatalgia

The treatment of low back pain and sciatica is usually multidisciplinary and it often includes physical therapy. Electrotherapy is used as part of the latter as an analgesic measure. However, there is no well defined therapy regimen with regards to which equipment and parameters to use. Purpose. To find scientific evidence for electrotherapy, which is used more and more often in the treatment of these pathologies and to propose treatment regimens with the best know efficacy. Methods. We searched for the most relevant studies (randomized, with a placebo and/or control group and blind) in the PEDro and MEDLINE databases from 1983 to 2003 inclusive. Results. TENS, despite its placebo effect, proves to be effective in the short-medium term when it is used with a high frequency (100 Hz) and a pulse width of 125 μs. Ultrasound is effective in disc disease when used for 10 minutes with an intensity between 1-2 W/cm2. The gallium arsenide laser proves its effectiveness in chronic low back pain when it is applied with a dose of 4 J/cm2. The technique with the best short-term pain relief results in both low back pain and sciatica is Percutaneous Neuromodulation Therapy (PNT or PENS), which proves to be effective when it is used with an alternating frequency of 15/30 Hz, a pulse width between 0.5-0.7 ms, maximum intensity without muscular contraction and an application of 30 minutes at each treatment session. Conclusions. There is scientific evidence for including electrotherapy in the treatment of low back pain and sciatica

[Prevalence of atopic dermatitis in schoolchildren from Cartagena (Spain) and relationship with sex and pollution]. / Prevalencia de la dermatitis atópica en escolares de Cartagena y su relación con el sexo y la contaminación.

BACKGROUND: Atopic dermatitis is favored by exogenous factors, such as air pollution interacting with a genetic predisposition. OBJECTIVE: The aim of the present study was to evaluate the influence of sex and air pollution in the city of Cartagena on the prevalence of atopic dermatitis. DESIGN AND METHODS: We performed a cross-sectional study using the ISAAC questionnaire in schoolchildren aged 13 and 14 years old from Cartagena (Murcia). The influence of sex and the schools' location in two distinct areas (polluted and unpolluted) on the prevalence of atopic dermatitis and its severity (described as being awakened by nocturnal itching) was analyzed. RESULTS: The prevalence of atopic eczema was 6.3 %. Atopic eczema was severe in 19 % of the cases. Risk factors for atopic eczema were female sex (OR 2.19 95 % CI: 1.59-3. 02) and attending school in a polluted area (OR: 1.83, 95 % CI 1.01-1.87) but these factors were not associated with greater severity. CONCLUSIONS: Air pollution is associated with a higher prevalence of atopic eczema and there is a trend that this eczema is more severe. The condition was more prevalent among girls.

Prevalencia de la dermatitis atópica en escolares de Cartagena y su relación con el sexo y la contaminación / PRevalence of atopic dermatitis in schoolchildren from Cartagena (Spain) and relationship with sex and pollution

Objetivo El objetivo del presente trabajo es estudiar la prevalencia de la dermatitis atópica y la influencia del sexo y la contaminación atmosférica de la ciudad de Cartagena. Métodos y diseño Estudio transversal, mediante encuesta de investigación del Estudio ISAAC (International Study of Asthma and Allergies in Childhood), en los escolares de 13 y 14 años de Cartagena (Murcia), analizando el sexo y la ubicación de los colegios a los que acuden estos escolares según dos zonas (contaminada y no), establecidas previamente; y la prevalencia y gravedad del eccema (manifestado por despertar por la noche a causa del prurito), según el sexo y según cada zona analizada. Resultados Los resultados muestran una prevalencia del eccema atópico del 6,3 por ciento, y es grave en una quinta parte de los casos, con mayor prevalencia significativa (odds ratio [OR], 2,19; intervalo de confianza del 95 por ciento [IC 95 por ciento], 1,59-3,02), pero no mayor gravedad, en el sexo femenino, y con mayor prevalencia (OR, 1,83; IC 95 por ciento, 1,01-1,87), pero tampoco mayor gravedad significativas en los escolares que asisten a los colegios en la zona contaminada. Conclusiones La contaminación atmosférica se asocia con una mayor prevalencia de eccema atópico y existe una tendencia de que éste sea más grave. El eccema fue más prevalente entre las niñas (AU)

Asociación entre dermatitis atópica, rinitis alérgica y asma en escolares de 13 y 14 años / Association between atopic dermatitis, allergic rhinitis and asthma in schoolchildren aged 13-14 years old

Antecedentes La dermatitis atópica está en íntima relación con otras enfermedades atópicas, particularmente con asma y rinitis alérgica. A pesar de haber cierto acuerdo en que el padecimiento de eccema atópico predispone al padecimiento de asma y rinitis, es preciso cuantificar el riesgo en las poblaciones, siguiendo un método de estudio estandarizado, que es el objetivo del presente trabajo.Método Siguiendo una metodología de encuesta de investigación del estudio ISAAC, en un estudio transversal, hemos analizado, y cuantificado, en la población de escolares de 13 y 14 años de la ciudad de Cartagena (Murcia), la asociación del padecimiento y gravedad de eccema atópico con el de la rinitis alérgica, el asma y el asma alérgica.Resultados Los resultados han mostrado, cuantificando el riesgo, que los escolares con eccema atópico, respecto a los que no lo padecen, tienen un riesgo triple de tener rinitis alérgica (odds ratio [OR], 3,33; intervalo de confianza del 95 por ciento [IC 95 por ciento], 2,45-4,54), cuádruple de tener asma (OR, 3,85; IC 95 por ciento, 2,74-5,42) y quíntuple de tener asma alérgica (OR, 4,91; IC 95 por ciento, 3,17-7,59), estando en relación directa las gravedades respectivas (AU)