Pesticides in water and sediments from natural protected areas of Spain and their associated ecological risk.

In the last years, issues related to intensive agriculture have been found in protected areas potentially harming wildlife. This study aimed to analyze a wide range of pesticides in water and sediments of two protected areas namely Doñana Natural Park (DNP) and Tablas de Daimiel National Park (TDNP) performing an environmental risk assessment in order to highlight potential risks to living organisms derived from pesticide burden. Higher pesticide load was found in DNP than TDNP with similar distribution profiles, with pyrethroid insecticides (PYRs) the main detected class. Particularly problematic are two PYRs, cyhalothrin and fenvalerate, which were detected at high concentrations that can pose a high risk to aquatic organisms. In addition, despite being detected at lower concentrations, the presence of chlorpyrifos, cypermethrin, and permethrin in water, and of chlorpyrifos, dicofol, and diflufenican in sediments, must be taken into account due to their potential risks for aquatic organisms. Moreover, some banned pesticides such as dimethoate, terbutryn, diazinon, and tricyclazol were detected in water at levels which deserve further investigation to assess their potential sources, including potential illegal practices.

Trasplante hepático ortotópico: visión global / No disponible

El trasplante hepático ortotópico (THO) es el tratamiento de elección y en muchos casos definitivo de la patología hepática terminal. Desde la introducción de la técnica en España, en 1984, hasta la actualidad la supervivencia en el primer año posterior al THO ha aumentado aproximadamente un 10 %, situándose en el 85,9 % (1). Dicho aumento de la supervivencia se asocia a mejoras en la técnica quirúrgica, en el tratamiento inmunosupresor y en los cuidados perioperatorios. Es por tanto crucial, para asegurar la supervivencia y la calidad de vida de los pacientes sometidos a THO el conocimiento de todos los factores que pueden interferir en la evolución del injerto. Entre ellos se encuentran la indicación del THO, el estado basal de los pacientes antes del THO, la técnica quirúrgica y las distintas fases del THO, el tratamiento inmunosupresor y las probables complicaciones posoperatorias tanto precoces como tardías (AU)

Orthotopic liver transplantation (OLT) is the treatment of choice and in most cases the definitive treatment in end-stage liver disease. Since the introduction of the technique in Spain, in 1984, to the present day survival in the first year after OLT has increased approximately 10 %, reaching 85.9 % (1). This increase in survival is associated with improvements in the surgical technique, immunosuppressive therapy and perioperative care. In order to ensure the survival and quality of life of patients undergoing OLT it is crucial to know all factors that may interfere with the graft outcome. These include indication for OLT, preoperative state of patients, surgical technique and phases of OLT, immunosuppressive therapy and postoperative complications (AU)

Documento de consenso sobre el tratamiento antimicrobiano de las infecciones bacterianas odontogénicas / Consensus statement on antimicrobial treatment of odontogenic bacterial infections

Las infecciones de la cavidad bucal son un problema de salud pública frecuente y motivo constante de prescripción antibiótica; el 10% de los antibióticos se emplean para tratar este problema. Sin embargo, hasta la fecha son pocos los estudios realizados para determinar su incidencia. Asimismo, su relación con ciertas enfermedades sistémicas (cardiacas, endocrinas, etc...) confiere a estas patologías una importancia vital. A pesar de la reconocida frecuencia e importancia de las infecciones odontogénicas, llama la atención la actual dispersión de criterio en varios aspectos referentes a su clasificación, terminología y recomendaciones terapéuticas. El objetivo principal de este documento, realizado con el consenso de especialistas en microbiología y odontología, es establecer unas recomendaciones útiles para todos los profesionales implicados en el manejo clínico de estas patologías. Recibe especial atención el aumento de la prevalencia de resistencias bacterianas observado durante los últimos años y, en concreto, la proliferación de cepas productoras de betalactamasas. Otro factor causal importante de la aparición de resistencias es la falta de cumplimiento terapéutico, en especial en lo que respecta a la dosis y a la duración del tratamiento. Así pues, estas patologías constituyen un problema complejo cuyo abordaje requiere la instauración de antimicrobianos de amplio espectro, con adecuados parámetros farmacocinéticos, con buena tolerancia y una posología cómoda que permita que el paciente reciba la dosis adecuada durante el tiempo necesario. Amoxicilina/ácido clavulánico a dosis altas (2000mg/ 125mg) ha demostrado buenos resultados y capacidad para superar resistencias. Otros agentes como metronidazol y clindamicina, seguidos de claritromicina y azitromicina han demostrado también ser activos frente a la mayoría de los microorganismos responsables de las infecciones odontogénicas (AU)

The infection of the oral cavity is a common public health problem and constant cause for antibiotic prescription, with 10% of antibiotics used to treat this problem. However, few studies have so far aimed to determine its incidence. Added to this, its relationship with certain sytemic diseases (cardiac, endocrine, etc…) confers this pathology vital importance. In spite of the frequency and importance of odontogenic infection, the current dispersion in criteria regarding key aspects in classification, terminology and therapeutic recommendations is noticeable. The main objective of this document, compiled as a consensus statement by specialists in microbiology and odontology, is to establish useful recommendations for all of those involved in the clinical management of this pathology. Special attention has been placed on the rise in bacterial resistance observed over the last years, specifically the proliferation of betalactamase producing strains. Another important factor causing the resistance to appear is lack of therapeutic compliance, specially what regards dosage and treatment duration. Therefore, this pathology constitutes a complex problem which requires the instauration of broad spectrum antimicrobials, well tolerated and a convenient posology so that patients receive the adequate dose over the necessary period. High doses of amoxicillin/clavulanate (2000 mg / 125 mg) have showed good results and power to overcome resistance. Other agents such as metronidazole and clindamycin, followed by de claritromycin and azithromycin have also proved to be active against most of microorganisms responsible for odontogenic infection (AU)

[Cowden syndrome: clinical case presentation with oral lesions]. / Síndrome de Cowden: presentación de un caso clínico con lesiones orales.

Cowden syndrome is an autosomal-dominant inheritance disease, characterized by the presence of skin and oral mucosa multiple hamartomas and nodules, together with thyroid and breast anomalies and polyposis of the gastrointestinal tract, which tend to undergo malignant transformation, especially in breast and thyroids. Therefore, the oral lesions early diagnosis facilitates the identification of asintomatic lesions, in other parts of the body. This is the case in the report we are to present, in which the patient, probably with the Cowden Syndrome, because of the presence of multiple hamartomas in the oral mucose diagnosed a breast carcinoma, and other alterations such as thyroid calcifications and polyposis of the gastrointestinal tract.

Síndrome de Cowden: presentación de un caso clínico con lesiones orales / Cowden syndrome: a clinical case with oral lesions

El síndrome de Cowden es una enfermedad hereditaria, de transmisión autosómica dominante, caracterizada por la presencia de múltiples hamartomas y nódulos en piel y mucosa oral, junto con anomalías en mama, tiroides y pólipos en el tracto gastrointestinal, tendiendo a malignizarse sobre todo en mama y tiroides. El diagnóstico precoz a partir de las lesiones orales puede dar lugar a que se descubran otras tumoraciones, asintomáticas, en otras partes del organismo. Así ocurrió en el caso clínico que a continuación expondremos, en el que a la paciente, tras la sospecha de un síndrome de Cowden por la presencia de múltiples fibro mas en la mucosa oral, se le diagnosticó un carcinoma de mama, y otras alteraciones como calcificaciones a nivel tiroideo y pólipos intestinales (AU)

No disponible

Hiperplasia epitelial focal. A propósito de dos casos clínicos / Focal epithelial hyperplasia

La hiperplasia epitelial local o enfermedad de Heck es una afección asintomática, benigna y proliferativa que aparece como pápulas en la mucosa labial inferior, aunque también se pueden encontrar en otras localizaciones. Presentamos dos casos clínicos de pacientes con lesiones papulares en número variable irregularmente distribuidas, circunscritas, blandas al tacto, redondas u ovoideas y de unos milímetros de diámetro. Histológicamente la lesiones corresponden a una hiperplasia papilomatosa asociada a infección con HPV y existe una displasia celular leve. Los pacientes padecen inmunodepresión asociada a la infección por HIV, lo cual supone un factor predisponente para la infección oral con HPV inusuales tales como 13 y 32 (AU)

Tratamiento de la fasciolasis hepática humana con triclabendazole / Treatment of human hepatic fasciolasis with triclabendazole

El presente estudio pretende valorar el efecto del triclabendazole sobre la distomatosis hepática en humanos, producida por la Fasciola hepática. Para ello se trató 70 pacientes con fasciolasis demostrada por exámenes seriados de heces, con triclabendazole a 12 mg/Kg. de peso diarios por dos días. El control parasitológico se realizó a los 15 y 45 días de administrado el tratamiento. Se encontró curación parasitológica en 83 por ciento de la población estudiada y tratada una sola vez, el 14 por ciento necesitó un segundo tratamiento y el 3 por ciento un tercero, y no se reportó efectos colaterales importantes atribuibles al tratamiento. Se concluye en consecuencia que el triclabendazole tiene una eficacia alta y buena tolerancia en el tratamiento de la fasciolasis hepática en humanos.

[TREATMENT OF HUMAN HEPATIC FASCIOLASIS WITH TRICLABENDAZOLE] / Tratamiento de la Fasciolasis Hepática Humanacon Triclabendazole.

This study has the purpose to evaluate the effect of triclabendazole over human fasciolasis produced by Fasciola hepatica. 70 patients with positive stools studies for fasciolasis were treated with 12 mg/kg/ day of triclabendazole for 2 days.The control stools tests were performed 15 and 45 days after the treatment was finished. Parasitologic negativitation of stools was found in 83% of those patients who recieved 1 cycle of treatment. 14% needed 2 cycles and 3% a third one.No important side effects were reported because of treatment. We conclude that triclabendazole is highly efficient and good against liver fasciolasis in humans.

[Oral lichen planus plaques and homogeneous leukoplasia: comparative results of treatment with CO2 laser]. / Liquen plano oral en placas y leucoplasia oral homogénea: resultados comparativos tras el tratamiento de estas lesiones con láser CO2.

OBJECTIVE: To determine the efficacy of CO2 laser therapy in plaque-like oral lichen planus and homogeneous oral leukoplakia. MATERIAL AND METHODS: We studied two groups of patients; one comprised 29 cases of plaque-like oral lichen planus (group 1) and the other one included 34 cases of homogeneous oral leukoplasia (group 2). After histological study, all the lesions were treated by CO2 laser evaporation at 10 W. We analyzed the results following one month, three months and one year after the treatment. RESULTS: In group 1, 19 lesions (65.5%) were revoluted enterally in one month. Patients reported a slight to moderate pain in 16 cases (55.2%), while 4 (13.8%) showed recurrences after three months and 12 (41.4%) at the end of the following time (one year). In group 2 we found a complete healing after one month in 28 cases (82.4%), with a slight to moderate pain in 22 cases (64.7%). Three months after the treatment we found 7 recurrences (20.6%) and 8 (25.8%) one year after. CONCLUSIONS: We found lower rate of recurrences in homogeneous oral leukoplakias than in plaque-like oral lichen planus after treatment with carbon dioxide laser therapy.

[Sinus aspergillosis after an endodontic treatment. Presentation of a clinical case]. / Aspergilosis sinusal a partir de un tratamiento odontológico. Presentación de un caso clínico.

Aspergillosis is an opportunistic deep mycosis that occurs in immunocompromised patients, often in the paranasal sinuses. However, it sometimes occurs in healthy subjects, producing symptoms similar to those of a chronic sinusitis that is unresponsive to conventional treatment. A possible entry point for Aspergillus is the oroantral communication originated by perforation of the dental root cavity during root canal of a molar with penetration of material. We report the clinical case of a patient with symptoms of chronic sinusitis who was diagnosed as sinus aspergillosis after radiological and histological study. The origin may have been a third upper molar in which a root canal was performed.

[Oral histiocytosis X with severe upper maxillary destruction]. / Histiocitosis X oral con severa destrucción del maxilar superior.

Histiocytosis X is a group of disorders of the reticuloendothelial system that have different clinical features and common histological characteristics, including abnormal proliferation of Langerhans cells. Eosinophilic granuloma is a localized form of histiocytosis affecting one or more bones. A case report is made of a patient diagnosed as histiocytosis X whose first manifestation was the appearance of an orosinusal communication. The lesions were located in the maxillary bones and produced large osteolytic lesions. No other bones were affected. In spite of surgery and radiotherapy, the disease recurred at 12 months.

Membrane regulation of liver and lung microsomes under low oxygen tension.

A highly monitorized animal model has been developed for the study of the influence of low oxygen tension on lipid composition, microviscosity and regulation of enzyme activities involved in the phospholipid synthesis of hepatic and pulmonary microsomes. Microviscosity decreased in liver microsomes whereas no difference was shown in that of microsomal membrane core of hypoxemic lung. Nevertheless, phospholipid and cholesterol content of both liver and lung membranes changed significantly. Microsomal membranes of hypoxemic liver increased the unsaturation degree of fatty acids, whereas hypoxemic lung membranes become more saturated, mainly due to the increase of palmitic acid. The adaptive response of lung was confirmed by the high increase of the deacylation-reacylation mechanism.