Soil properties determine the impact of nZVI on Lactuca sativa L and its rhizosphere.

Nanoscale zero-valent iron (nZVI) is a promising material tool for the remediation of metal(loid)-contaminated soils since it reduces metal(loid) availability and plant uptake, thereby enhancing the development of the plants. However, the effects of nZVI as nanoparticles on soil properties, plants, and the microbial rhizosphere in unpolluted soils are poorly understood. Here we tested the impact of nZVI at different doses (0.5 and 5% of commercial suspension) on soil properties, lettuce plants, and their microbial rhizosphere in two non-contaminated soils with distinct physico-chemical properties (alkaline versus acidic soil). To this end, a pot experiment was performed with lettuce plants in a growth chamber for a month. Both soils showed an increase in of pH and available Fe after nZVI application. However, these effects were more marked in the acidic soil. In this regard, the plants in this soil showed increased biomass and Fe content. TEM analysis revealed that although the roots and leaves of plants grown in the alkaline soil showed better cell integrity than those in acidic soil-an observation that was consistent with the visual appearance of the plants-the former were more affected by the nZVI treatment. Regarding the microbial rhizosphere, in general, nZVI enhanced enzyme activity regardless of the soil type. Microbial functional diversity showed a significant decline in response to nZVI in alkaline soil. In contrast, the 0.5% nZVI treatment had a positive effect on this parameter in acidic soil. Bacterial genetic diversity was less affected by the presence of nZVI than fungal diversity, which was higher in nZVI-treated acidic soils. In addition, alterations of bacterial and fungal communities were associated with available Fe in acidic soil. In conclusion, soil properties play a key role in determining the effects of nZVI on lettuce plants and their rhizosphere.

Iron nanoparticles to recover a co-contaminated soil with Cr and PCBs.

Little attention has been given to the development of remediation strategies for soils polluted with mixture of pollution (metal(loid)s and organic compounds). The present study evaluates the effectiveness of different types of commercial iron nanoparticles (nanoscale zero valent iron (nZVI), bimetallic nZVI-Pd, and nano-magnetite (nFe3O4)), for the remediation of an industrial soil co-contaminated with Cr and PCBs. Soil samples were mixed with nZVI, nZVI-Pd, or nFe3O4 at doses selected according to their reactivity with PCBs, homogenized, saturated with water and incubated at controlled conditions for 15, 45 and 70 days. For each sampling time, PCBs and chromium were analyzed in aqueous and soil fractions. Cr(VI) and Cr leachability (TCLP test) were determined in the soil samples. The treatment with the three types of iron nanoparticles showed significant reduction in Cr concentration in aqueous extracts at the three sampling times (> 98%), compared to the control samples. The leachability of Cr in treated soil samples also decreased and was stable throughout the experiment. Results suggested that nZVI and nZVI-Pd immobilized Cr through adsorption of Cr(VI) on the shell and reduction to Cr(III). The mechanism of interaction of nFe3O4 and Cr(VI) included adsorption and reduction although its reducing character was lower than those of ZVI nanoparticles. PCBs significantly decreased in soil samples (up to 68%), after 15 days of treatment with the three types of nanoparticles. However, nFe3O4 evidenced reversible adsorption of PCBs after 45 days. In general, nZVI-Pd reduced PCB concentration in soil faster than nZVI. Control soils showed a similar reduction in PCBs concentration as those obtained with nZVI and nZVI-Pd after a longer time (45 days). This is likely due to natural bioremediation, although it was not effective for Cr remediation. Results suggest that the addition of nZVI or nZVI-Pd and pseudo-anaerobic conditions could be used for the recovery of soil co-contaminated with Cr and PCBs.

Selecting efficient methodologies for estimation of As and Hg availability in a brownfield.

The determination of soil metal(loid) availability presents controversy and there is no consensus or uniformity on used analytical methods. In this study nine single extraction methods (H2O, CaCl2, NaNO3, NH4NO3, DTPA, EDTA, HCl, LMWOA, TCLP) and four sequential extraction procedures (Tessier, BCR, Wenzel and Fernández-Martínez) have been compared to estimate the availability of As and Hg in two soils from a highly polluted brownfield, especially with As. The metal(loid) concentrations were also determined in three native plant species (Lotus corniculatus, Betula celtiberica and Dactylis glomerata) collected in the habitat under study. Each single extractant showed a particular capacity of As/Hg extraction because they do not extract the same forms of each element. The availability of As and Hg depended on the element characteristics, soil properties, type of extractant and degree of pollution, thus the use of a single extraction procedure provides limited information of metal(loid) availability and to reach general conclusions is difficult. Regarding the sequential extractions, each procedure showed a specific pattern for As and Hg regardless of the soil. Thus, the choice of one or other method depends on the environmental conditions, metal(loid) and soil properties. In risk assessment studies it would be recommendable to select one of the more aggressive extractants, so as not to underestimate the environmental risk. In this regard, the sequential extraction procedures render more detailed information about metal(loid) potential availability in relation to soil properties. The analysis of native plant species showed higher metal(loid) concentrations in roots than in aerial parts and differences were observed depending on the metal(loid) and the species. In general, plants showed a higher BCFs for Hg than As even though the total and available As concentrations were higher than those found for Hg, which highlights the influence of plant species on the metal(loid) uptake.

Effectiveness of nanoscale zero-valent iron for the immobilization of Cu and/or Ni in water and soil samples.

In the last few years, the effectiveness of nanoscale zero-valent iron (nZVI) as a treatment for polluted waters and soils has been widely studied. However, little data are available on its efficacy for metal immobilization at low and moderate doses. In this study, the effectiveness of two doses of commercial nZVI (1 and 5%) to immobilize Cu and/or Ni in water and acidic soil samples was evaluated. The influence of the nanoremediation technology on iron availability, physico-chemical soil properties and soil phytotoxicity was also assessed. The results show that the effectiveness of nZVI to immobilize Cu and Ni in water and soil samples was determined by the dose of the nanomaterial and the presence of both metals. Nickel immobilization was significantly decreased by the presence of Cu but the opposite effect was not observed. nZVI showed better immobilization capacity in water than in soil samples. In water, the dose of 5% completely removed both metals, whereas at a lower dose (1%) the percentage of immobilized metal decreased, especially for Ni in Cu + Ni samples. In soil samples, 5% nZVI was more effective in immobilizing Ni than Cu, with a 54% and 21% reduction of leachability, respectively, in single contaminated samples. In Cu + Ni soil samples, nZVI treatment led to a significant decrease in Ni immobilization, similar to that observed in water samples. The application of nZVI induced a dose-dependent increase in available Fe-a relevant effect in the context of soil rehabilitation. Germination assays of Medicago sativa and Vicia sativa seeds revealed that treatment with nZVI did not induce phytotoxicity under the experimental conditions tested, and that the phytotoxicity induced by Ni decreased significantly after the treatment. Thus, the use of nZVI emerges as an interesting option for Cu and/or Ni immobilization in water samples. The effectiveness of nZVI to remove Cu from acidic soil samples was moderate, while for Ni it was strongly dependent on the presence of Cu. These observations therefore indicate that the results in water samples cannot be extrapolated to soil samples.

Zero valent iron and goethite nanoparticles as new promising remediation techniques for As-polluted soils.

The capacity of two iron-based nanomaterials, namely goethite nanospheres (nGoethite) and zero valent iron nanoparticles (nZVI), to immobilize As in a polluted soil was evaluated and compared. The composition and morphology of the products were studied by energy dispersive X-ray analysis and transmission electron microscopy, while zeta potential and average sizes were determined by dynamic light scattering. To assess As immobilization, soil subsamples were treated with nGoethite or nZVI at a range of Fe doses (0.5%, 2%, 5% and 10%) and then studied by the TCLP test and the Tessier sequential extraction procedure. The influence of both nanoparticles on As speciation was determined, as was impact on soil pH, electrical conductivity, Fe availability and phytotoxicity (watercress germination). For nZVI, notable results were achieved at a dose of 2% (89.5% decrease in As, TCLP test), and no negative effects on soil parameters were detected. Indeed, even soil phytotoxicity was reduced and only at the highest dose was a slight increase in As3+ detected. In contrast, excellent results were obtained for nGoethite at the lowest dose (0.2%) (82.5% decrease in As, TCLP test); however, soil phytotoxicity was increased at higher doses, probably due to a marked enhancement of electrical conductivity. For both types of nanoparticle, slight increases in Fe availability were observed. Thus, our results show that both nZVI and nGoethite have the capacity to effectively immobilize As in this brownfield. The use of lower doses of nGoethite emerges as a promising soil remediation strategy for soils affected by As pollution.

The impact of active dry yeasts in commercial wineries from the Denomination of Origen "Vinos de Madrid", Spain.

This paper has studied the success of implantation for 16 commercial active dry yeasts (ADYs) during industrial fermentation (30) and the impact of these yeasts during spontaneous fermentations (19) in 10 wineries from the Denomination of Origin "Vinos de Madrid" over two consecutive years. Yeasts strains were identified by molecular techniques, pulsed field electrophoresis and microsatellite analysis. According to these techniques, all the ADYs were different with the exceptions of two strains, L2056 and Rh, which showed the same karyotype and loci size. The results showed that inoculating fermentations with ADYs did not ensure their dominance throughout the fermentation; the implantation level of ADYs was above 80% in only 9 of the 30 commercial fermentations studied; while in 16 fermentations, the dominance of the inoculated ADYs was below 50%. The type of vinification with the best implantation results overall were those associated with red wine fermentations. ADYs affected spontaneous fermentations, although their impact was observed to decrease in the second year of the study. Therefore, specific adaptation studies are necessary before using commercial yeasts during the fermentation process. At the same time, a study was carried out on the frequency of commercial strains in IMIDRA's yeast collection, made up of strains isolated from spontaneous fermentations of the different areas and cellars since the beginning of the Denomination of Origin "Vinos de Madrid" in 1990. Six different ADYs were found with a frequency of less than 5%.

Nanoremediation and long-term monitoring of brownfield soil highly polluted with As and Hg.

In the last decade, several laboratory-scale experiments have shown the use of nanoscale zero-valent iron (nZVI) to be effective in reducing metal(loid) availability in polluted soils. The present study evaluates the capacity of nZVI for reducing the availability of As and Hg in brownfield soils at a pilot scale, and monitors the stability of the immobilization of these contaminants over a 32 month period. To the best of our knowledge, this is the first study to apply nZVI to metal(loid)-polluted soils under field conditions. Two sub-areas (A and B) that differed in pollution load were selected, and a 5 m2 plot was treated with 2.5% nZVI (by weight) in each case (Nanofer 25S, NanoIron). In sub-area A, which had a greater degree of pollution, a second application was performed eight months after the first application. Overall, the treatment significantly reduced the availability of both As and Hg, after only 72 h, although the effectiveness of the treatment was highly dependent on the degree of initial contamination. Sub-area B (with a lower level of pollution) showed the best and most stable immobilization results, with As and Hg in toxicity characteristics leaching procedure (TCLP) extracts decreasing by 70% and 80%, respectively. In comparison, the concentrations of As and Hg in sub-area A decreased by 65% and 50%, respectively. Based on our findings, the use of nZVI at a dose of 2.5% appears to be an effective approach for the remediation of soils at this brownfield site, especially in sub-area B. For sub-area A, a higher dose of nZVI-or its use in combination with other remediation strategies-should be tested.

Comparing different commercial zero valent iron nanoparticles to immobilize As and Hg in brownfield soil.

Nanoscale zero valent iron (nZVI) particles obtained by different methods differ in their structure, which lead to different reactivity, and therefore a likely difference in the remediation efficiency. The present study compares the effectiveness of three commercial ZVI nanoparticles to immobilize As and Hg in two soils (A and B) collected from a brownfield highly contaminated by mining and metallurgy activities. Scarce data are available on the effectiveness of nZVI for Hg immobilization in soil. Two commercial nZVI slurries from Toda (RNIP and RNIP-D) and one from Nano Iron (25S) were used at different doses (1, 5 and 10%). The metal(loid) availability and mobility was evaluated with the TCLP test and Tessier extraction procedure. The influence of nZVI application on As and Hg speciation was also evaluated as well as its impact on soil pH, electrical conductivity and soil phytotoxicity to vetch germination. The three commercial nZVI particles significantly reduced As and Hg availability in the two soils studied, which led to a decrease in soil phytotoxicity. At the dose of 5% of nZVI a decrease of exchangeable-As higher than 70% was observed for both soils, whereas in the case of Hg, a higher dose of nZVI (10%) was necessary to achieve reductions of exchangeable-Hg between 63 and 90% depending on the type of nZVI and soil. No impact on soil pH and electrical conductivity was observed. The effectiveness of metal(loid) immobilization depended on type of nZVI, soil properties and metal(loid) characteristics. Nanoparticles from Nano Iron showed better results for As immobilization whereas RNIP nanoparticles were more effective for Hg. Overall, 25S at the dose of 5% resulted more effective than RNIP nanoparticles for the reduction of exchangeable-As (in the range of 6-14%), whereas RNIP and RNIP-D were 10 and 13% more effective, respectively, for the reduction of exchangeable-Hg at the dose of 10% in soil B. Thus, nZVI can be used for the remediation of highly As and Hg polluted soils, although previous experiments at lab scale are necessary to determine the most viable type of nZVI and its dose.

Viability of a nanoremediation process in single or multi-metal(loid) contaminated soils.

The effectiveness of single- and multi-metal(loid) immobilization of As, Cd, Cr, Pb and Zn using different doses of nanoscale zero-valent iron (nZVI) was evaluated and compared in two different soils, a calcareous and an acidic one. The effectiveness of nZVI to immobilize metal(loid)s in soil strongly depended on the metal characteristics, soil properties, dose of nZVI and presence of other metal(loid)s. In the case of single contamination, this nanoremediation strategy was effective for all of the metal(loid)s studied except for Cd. When comparing the two soils, anionic metal(loid)s (As and Cr) were more easily retained in acidic soil, whereas cationic metal(loid)s (Cd, Pb and Zn), were immobilized more in calcareous soil. In multi-metal(loid) contaminated soils, the presence of several metal(loid)s affected their immobilization, which was probably due to the competitive phenomenon between metal(loid) ions, which can reduce their sorption or produce synergistic effects. At 10% of nZVI, As, Cr and Pb availability decreased more than 82%, for Zn it ranged between 31 and 75% and for Cd between 13 and 42%. Thus, the application of nZVI can be a useful strategy to immobilize As, Cr, Pb and Zn in calcareous or acidic soils in both single- or multi-metal(loid) contamination conditions.

A nanoremediation strategy for the recovery of an As-polluted soil.

The present study investigates the impact of the nanoremediation treatment on soil recovery as evaluated by the development of barley plants. Highly As-polluted brownfield soil was treated with nanoscale zero-valent iron (nZVI) commercial suspension at two doses (1% and 10%). Barley plants were cultivated in treated and untreated soils in a growth chamber, and the As, Fe, and nutrients uptake were determined. The efficacy of As immobilization was evaluated according to the toxicity characteristics leaching procedure (TCLP) as well as using a sequential extraction procedure. The application of nZVI reduced the amount of As in the more available fractions and increased the amount of As in the residual fraction. The best immobilization results were obtained for the highest dose of nZVI (10%). In turn, the lower availability of As in nZVI-treated soils, particularly at the dose of 10%, stimulated the development of the barley plants and decreased the As uptake. Neither an important increase of available Fe nor negative impact on soil physico-chemical and biological properties were observed. Thus, our results show that the use of nZVI could be an adequate strategy to recover the land use in As polluted soils.

Evaluation of the stability of a nanoremediation strategy using barley plants.

This study evaluated the effectiveness of nZVI in reducing the availability of Cd, Cr or Zn in polluted soils. The influence of this nanoremediation process on the development of barley plants as well as its impact on soil properties and the stability of the metal immobilization afterwards were also evaluated in a greenhouse experiment. The application of nZVI reduced the availability of these metals in the soil, but the effectiveness of the immobilization and its stability depended on the metal chemical characteristics. Cadmium distribution in soil fractions showed an important change after the barley crop, favoring the immobilization of Cd in RS fraction for both nZVI-treated and untreated soils. The Cr immobilization was stable over the time studied and the doses of Cr were lethal for the barley plants. In contrast, the decrease of Cr availability reached after the nZVI treatment induced a reduction of soil phytotoxicity and an improvement in the development of the plants, which were able to complete their growing period. The Zn immobilization with nZVI was stable over time, but its effectiveness was moderate, and the growth of barley plants was poorer than that observed in the cases of Cd and Cr. Thus the best results of metal immobilization with nZVI were obtained for Cr-polluted soils. There was no overall increase of Fe in barley plants from nZVI-treated soils. In relation to the soil, no negative effects on its physico-chemical properties were observed after the time exposure with nZVI. Taking into account these results we can conclude that the use of nZVI is a promising remediation strategy, and its effectiveness would be conditioned to the soil properties and the bioavailable metal concentration.

ECO-physiological response of S. vulgaris to CR(VI): Influence of concentration and genotype.

The objective of this work is to study the response of Silene vulgaris to a range of environmentally relevant concentrations of Cr(VI) in order to evaluate its potential use in the phytomanagement of Cr polluted sites. Cuttings of six homogenous genotypes from Madrid (Spain) have been used as plant material. The eco-physiological response of S. vulgaris to Cr(VI) changed with the genotype. The yield dose-response curve was characterized by stimulation at low doses of Cr(VI). The effects of metal concentration were quantified on root dry weight, water content and chlorophyll content, determined by SPAD index. The response was not homogeneous for all studied genotypes. At high doses of Cr(VI), plants increased micronutrient concentration in dry tissues which suggested that nutrient balance could be implicated in the alleviation of Cr toxicity. This work highlights the importance of studying the eco-physiological response of metallophytes under a range of pollutant concentrations to determine the most favorable traits to be employed in the phytomanagement process.

Residual impact of aged nZVI on heavy metal-polluted soils.

In the present study, the residual toxicity and impact of aged nZVI after a leaching experiment on heavy metal (Pb, Zn) polluted soils was evaluated. No negative effects on physico-chemical soil properties were observed after aged nZVI exposure. The application of nZVI to soil produced a significant increase in Fe availability. The impact on soil biodiversity was assessed by fluorescence in situ hybridization (FISH). A significant effect of nZVI application on microbial structure has been recorded in the Pb-polluted soil nZVI-treated. Soil bacteria molecular response, evaluated by RT-qPCR using exposure biomarkers (pykA, katB) showed a decrease in the cellular activity (pykA) due to enhanced intracellular oxidative stress (katB). Moreover, ecotoxicological standardised test on Caenorhabditis elegans (C. elegans) showed a decrease in the growth endpoint in the Pb-polluted soil, and particularly in the nZVI-treated. A different pattern has been observed in Zn-polluted soils: no changes in soil biodiversity, an increase in biological activity and a significant decrease of Zn toxicity on C. elegans growth were observed after aged nZVI exposure. The results reported indicated that the pollutant and its nZVI interaction should be considered to design soil nanoremediation strategies to immobilise heavy metals.

Response of two barley cultivars to increasing concentrations of cadmium or chromium in soil during the growing period.

The heavy metal contamination of soils is a serious environmental issue because excessive metal concentrations pose risks to the health of humans, animals, and plants. For this reason, the interest in understanding the toxic effects of metals on crop growth and physiology has increased in the last decades. A pot trial was performed in a greenhouse to evaluate the effects of contaminated soil with different concentrations of cadmium (Cd) or chromium (Cr) on barley growth and development. Two cultivars of barley were studied, Pedrezuela and CB502. Growth, chlorophyll content, chlorophyll fluorescence, and relative water content (RWC) were analyzed during the plant-growing period. After harvesting, the Cd and Cr contents in plant were analyzed. No significant differences were observed for chlorophyll content and chlorophyll fluorescence between control plants and those treated with Cd. In the case of Cr, a significant decrease of plant growth, chlorophyll content, chlorophyll fluorescence, and RWC was detected with respect to the control. The tolerance index (TI) and translocation factor (TF) were calculated. Data indicated that both varieties are tolerant to these metals; CB502 showed higher tolerance to Cr and Pedrezuela to Cd. The effect of Cd or Cr addition on nutrient concentrations in plants varied among elements and organs of the plant analyzed. The correlations between the physiological and agronomic studied traits were significant (p < 0.01, p < 0.001), so the stress induced by these metals affected the physiology and water relations of the plant, which provoked a decrease of plant biomass, especially in the plants treated with Cr.

Actualización en vacunas. Teoría, realidades y mitos (II) Actualización de calendarios vacunales españoles / An update on vaccines. Theory, realities and myths (and II) Update in the Spanish vaccine schedule

En España existen 19 calendarios diferentes que no se justifica desde un punto de vista sanitario, epidemiológico, social o económico. La Asociación Española de Pediatría recomienda vacunar: frente rotavirus a partir de las sexta semana, frente a papilomavirus en niñas preadolescentes, universalizar la vacuna antineumocócica, administrar una segunda dosis de varicela a los 3-4 años, cambiar indicaciones de la vacuna de la tos ferina y vacunar de gripe y hepatitis A en situaciones de riesgo. Repasaremos más detenidamente las vacunas que han sido recientemente introducidas: rotavirus, neumococo, papiloma y mentaremos los principales cambios en las ya existentes. Los criterios para introducir modificaciones en el calendario de vacunación dependen de la enfermedad (carga, frecuencia, morbimortalidad, potencial de eliminación), de la vacuna (inmunogenicidad, eficacia, efectividad, eficiencia, compatibilidad, seguridad y garantía de suministro) y de la sociedad (impacto sobre la población y el sistema sanitario, percepción de la enfermedad por la población) (AU)

The criteria for modifying the immunization schedule depends on the disease (load, frequency, morbidity and mortality, killing potential) of the vaccine (immunogenicity, efficacy, effectiveness, efficiency, compatibility, safety and assurance of supply) and society (impact on the population and the health system, perception of disease in the population). In Spain there are 19 different vaccine schedules that are not justified from a health, epidemiological, social or economic perspective. The Spanish Association of Paediatrics recommends: vaccinating against rotavirus from the sixth week, against papillomavirus in preadolescent girls, achieving universal pneumococcal protection, administering a second dose of varicella at 3-4 years, changing the indications of the pertussis vaccine and flu vaccine and hepatitis A risk. We will review further the vaccines that have recently been introduced: rotavirus, pneumococcus and papillomavirus and mention the major changes in existing ones (AU)

Actualización en vacunas. Teoría, realidades y mitos (I) / An update on vaccines. Theory, realities and myths (I)

Las vacunas son productos biológicos utilizados para conseguir una inmunización activa artificial. Actualmente hay vacunas cada vez más potentes, eficaces y seguras. Se está ampliando la lista de enfermedades prevenibles con vacunas, que, junto a la cada vez mayor población susceptible de ser vacunada, hace previsible que aumenten los productos vacunales en este siglo. Este artículo pretende ser un breve pero práctico, resumen del concepto y tipos de vacunas, los avances acontecidos en las últimas décadas sobre fundamentos de la respuesta inmunitaria y componentes de las vacunas (destacando el papel de los adyuvantes). Estos conceptos acarrean los criterios de cuándo, cómo vacunar, a quiénes y por qué no hacerlo. Con la ambición de que este texto sea útil finalizará con un somero repaso al porqué hay personas que rechazan las vacunas (AU)

Vaccines are biological products used to achieve active artificial immunization. Nowadays, vaccines are increasingly powerful, effective and safe. The list of vaccine-preventable diseases is expanding, which together with the increasing population likely to be vaccinated, it is expected that vaccine products will increase this century. This article is a brief but practical overview of the concept and types of vaccines, advances that have taken place recent decades on the fundamentals of the immune response and vaccine components (including the role of adjuvants). These concepts give rise to the criteria for when and how to vaccinate, to whom and why not to do it. With the hope that this text is useful, it ends with a brief overview as to why there are people who refuse vaccinations (AU)

[An update on vaccines. Theory, realities and myths (I)]. / Actualización en vacunas. Teoría, realidades y mitos (I).

Vaccines are biological products used to achieve active artificial immunization. Nowadays, vaccines are increasingly powerful, effective and safe. The list of vaccine-preventable diseases is expanding, which together with the increasing population likely to be vaccinated, it is expected that vaccine products will increase this century. This article is a brief but practical overview of the concept and types of vaccines, advances that have taken place recent decades on the fundamentals of the immune response and vaccine components (including the role of adjuvants). These concepts give rise to the criteria for when and how to vaccinate, to whom and why not to do it. With the hope that this text is useful, it ends with a brief overview as to why there are people who refuse vaccinations.

[An update on vaccines. Theory, realities and myths (and II) update in the Spanish vaccine schedule]. / Actualización en vacunas. Teoría, realidades y mitos (II) Actualización de calendarios vacunales españoles.

The criteria for modifying the immunization schedule depends on the disease (load, frequency, morbidity and mortality, killing potential) of the vaccine (immunogenicity, efficacy, effectiveness, efficiency, compatibility, safety and assurance of supply) and society (impact on the population and the health system, perception of disease in the population). In Spain there are 19 different vaccine schedules that are not justified from a health, epidemiological, social or economic perspective. The Spanish Association of Paediatrics recommends: vaccinating against rotavirus from the sixth week, against papillomavirus in preadolescent girls, achieving universal pneumococcal protection, administering a second dose of varicella at 3-4 years, changing the indications of the pertussis vaccine and flu vaccine and hepatitis A risk. We will review further the vaccines that have recently been introduced: rotavirus, pneumococcus and papillomavirus and mention the major changes in existing ones.

Signo y síndrome de Chilaiditi: entidades a tener en cuenta / Chilaiditi's sign and syndrome: conditions to be aware of

El signo de Chilaiditi fue descrito en 1910 por el radiólogo vienés Dimitrius Chilaiditi y consiste en la interposición de intestino entre el hígado y el hemidiafragma derecho. En la mayor parte de los casos se trata del ángulo hepático del colon. Se trata de un hallazgo radiológico, generalmente casual, sin que provoque en el paciente sintomatología alguna. Se define como síndrome de Chilaiditi a la asociación del signo radiológico con manifestaciones clínicas, que usualmente serán digestivas. Es importante que el médico sepa reconocer la imagen radiológica y realizar un correcto diagnóstico diferencial, así como conocer los síntomas que puede provocar el síndrome (AU)

Chilaiditi's sign was described in 1910 due to the radiology by Dimitrius Chilaiditi and consists of the overlapping of the intestine between the liver and the right diaphragm. In the majority of cases it involves the hepatic angle of the colon. It is a, generally, casual radiological finding without there being any patient symptomatology. Chilaiditi's syndrome is defined as the combination of the sign with other clinical manifestations, which are usually gastrointestinal. It is important that the physician knows how to recognise the radiological image and make the correct differential diagnosis, as well as knowing the symptoms that may trigger the syndrome (AU)

Rosácea: revisión y nuevas alternativas terapéuticas / Rosacea: a review and new treatment alternatives

La rosácea es una dermatosis crónica que afecta a un 10% de la población. No es una enfermedad con graves repercusiones en la salud del paciente pero tiene un componente estético que puede suponer una importante carga emocional. Por todo ello el médico de familia debe estar familiarizado con esta entidad y con los diferentes tratamientos disponibles, así como conocer la posibilidad de derivar a los pacientes con determinadas características al dermatólogo para beneficiarse de la aplicación de técnicas con láser (AU)

Rosacea is a chronic skin disease that affects 10% of the population. It is a disease with serious implications for patient's health but has an aesthetic component that can cause significant emotional damage. Therefore the practitioner should be familiar with this entity and the different treatments available, as well as the possibility of referring patients with certain characteristics to the dermatologist to benefit from the application of laser techniques (AU)