Search

Resumen Introduccion La diabetes es una de las principales pandemias en los ultimos anos. Su asociacion con depresion incrementa el riesgo de mortalidad y morbilidad. La coexistencia de ambas patologias produce un mal manejo de la diabetes, lo que conlleva a una peor calidad de vida. Objetivo Determinar la frecuencia de depresion en pacientes con diabetes mellitus y el efecto que tienen ambas patologias sobre la calidad de vida en pacientes que acuden de forma ambulatoria a establecimientos de salud publicos de Lima y Callao. Metodos Analisis secundario de la base de datos del Estudio Epidemiologico de Salud Mental de depresion en adultos diabeticos. El instrumento empleado para determinar el episodio depresivo fue el MINI (Entrevista Neuropsiquiatrica Internacional) mientras que la calidad de vida fue medida empleando el Indice de Calidad de Vida de Mezzich. Se obtuvo informacion de diagnostico de diabetes tipo 1 o 2 del registro medico diario (HIS) de atencion. Resultados La frecuencia de depresion en los 471 pacientes con diabetes fue 5,8% en las ultimas dos semanas. Mientras que la frecuencia anual fue 8,6% y en algun momento de la vida 31,8%. Ser mujer se asocio con mayor frecuencia de depresion. La calidad de vida fue menor en los pacientes con diabetes y depresion (p Conclusiones La frecuencia de depresion en pacientes con diabetes que son atendidos en forma ambulatoria en centros de salud publicos es mayor a la poblacion general y su calidad de vida se ve reducida significativamente, lo que plantea la necesidad de considerar la depresion como un factor aditivo a la carga de morbilidad de esta condicion.

Introduction Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life. Objective To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao. Methodology Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care. Results The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p Conclusions The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition.

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.

Objective To standardize clinical evaluation of patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA) using a checklist. Methods Qualitative study that included: (1) nominal group (18 experts); (2) literature reviews of measures used in the assessment of patients with axial SpA or PsA; and (3) focus groups, one with rheumatologists and another with patients, organized to become familiar with their opinion on medical assistance. Taking this into account, the experts selected the measures to be included in the checklist based on their relevance, feasibility, and the outcome type. Results The checklist includes measures for the evaluation of personal history, physical examination, activity and function, laboratory tests, imaging studies and treatments. It also defines risk factors of radiographic progression, predictors of the response to biological therapies, and comprises measures of excellence. Conclusions This checklist for patients with axial SpA and PsA could help standardize daily clinical practice and improve clinical management and patient prognosis.

Resumen Objetivo Estandarizar la evaluacion clinica de pacientes con espondiloartritis (EspA) axial y artritis psoriasica (APs). Metodos Estudio cualitativo que incluyo: 1) grupo nominal (18 expertos); 2) revision de la literatura sobre variables empleadas en la evaluacion de los pacientes con EspA axial o APs, y 3) grupo focal con reumatologos y otro con pacientes con EspA axial o APs para analizar la evaluacion de las EspA en las consultas de reumatologia. Los expertos seleccionaron las variables a incluir en el cuadro de actuacion con base en su relevancia, factibilidad en consulta y metodo/s de medicion. Resultados El cuadro de actuacion incluye las variables para valorar antecedentes personales, exploracion fisica, actividad y funcion, pruebas complementarias y tratamientos. Detalla factores de riesgo de progresion radiografica, factores predictores de respuesta a terapia biologica, e incluye variables de excelencia. Conclusiones Este cuadro de actuacion para pacientes con EspA axial y APs podra ayudar a homogeneizar la practica clinica diaria y a mejorar el manejo y el pronostico de estos pacientes.

Over 3 billion people use solid fuels as a means of energy and heating source, and ~ 50% of households burn them in inefficient, poorly ventilated stoves. In 2010, ~ 43% of the 640 million preschool children in 220 countries suffered from a certain degree of anemia, with iron deficiency as the main cause in developed countries whereas its causes remained multifactorial in the undeveloped group. In this study, we explore the relations of country-wide variables that might affect the people's health status (from socioeconomic status to more specific variables such as water access). We found independent relationship between solid fuel use and anemia in children under five years old (p < 0.0001), taking into account the prevalence of anemia in pregnant woman and the access to improved water sources. Countries in which the population uses solid fuel the most have over three times higher anemia rates in children than countries with the lowest prevalence of solid fuels use. There is still a complex relationship between solid fuels use and anemia, as reflected in its worldwide significance (p < 0.05) controlled for measles immunization, tobacco consumption, anemia in pregnant mothers, girl's primary education, life expectancy and improved water access but not (p > 0.05) when weighing for sanitation access or income per capita.

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.

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.

Objective To validate oral exfoliative cytology in the analysis of the microRNA expression profile in oral lichenoid disease (OLD). Study Design The expression of 13 microRNAs was analyzed in 26 cases, 16 diagnosed as OLD and 10 controls with no oral mucosal pathology. Cytologic samples from the oral mucosa obtained using an Orcellex toothbrush were analyzed using reverse transcription-quantitative polymerase chain reaction and TaqMan microRNA assays. Results The aberrant expression was validated for 2 microRNAs (miR-146 a-5 P and miR-7-1-3 P) of those previously recognized in the biopsy study. Conclusion This is the first time that oral exfoliative cytology is validated in a microRNA study in OLD. The microRNAs validated in this study are associated with both inflammatory and carcinogenic phenomena that are involved in the etiopathogenesis of this potentially malignant oral disorder.

Tree architecture has evolved to support a top-heavy above-ground biomass, but this integral feature poses a weight-induced challenge to trunk stability. Maintaining an upright stem is expected to require vertical proprioception through feedback between sensing stem weight and modulating radial growth. Despite its apparent importance, the principle by which plant stems respond to vertical loading forces remains largely unknown. Here, by manipulating the stem weight of downy birch (Betula pubescens) trees, we show that cambial development is modulated systemically along the stem. We carried out a genetic study on the underlying regulation by combining an accelerated birch flowering program with a recessive mutation at the ELIMAKI locus (EKI), which causes a mechanically defective response to weight stimulus resulting in stem collapse after just three months. We observed delayed wood morphogenesis in eki compared with WT, along with a more mechanically elastic cambial zone and radial compression of xylem cell size, indicating that timely tissue differentiation is critical for cambial growth under mechanical stress. Furthermore, the touch-induced mechanosensory pathway was transcriptionally misregulated in eki, indicating that the ELIMAKI locus is required to integrate the weight-growth feedback regulation. By studying this birch mutant, we were able to dissect vertical proprioception from the gravitropic response associated with reaction wood formation. Taken together, our study provides evidence for both local and systemic responses to mechanical stimuli during secondary plant development.

Commercial magnetite nanoparticles (NPs) were used to immobilize As and organic pollutants, mainly PAHs, in a polluted soil. The composition, structure and morphology of the NPs were examined by means of electron microscopy, X-ray analysis, infrared spectroscopy, dynamic light scattering, thermogravimetric analysis, and magnetic property determination. To evaluate the immobilization of As and organic pollutants, soil subsamples were treated with the magnetite NPs at different doses (0.2%, 1%, 2% and 5%). The availability of As was then examined by the TCLP test and the Tessier sequential extraction procedure, whereas TPH and PAHs were measured by GC–MS. Notable results for As immobilization were achieved at a dose of 1% NPs (42.5% decrease in As, TCLP test), although the best result was obtained at the highest dose of 5% (92.3% decrease in As, TCLP test) without significant variations in As speciation. Regarding organic pollutants, a decrease in TPH and PAHs content was detected even at the lowest dose of NPs tested (49% and 89% respectively). The treatments had no negative effects on soil parameters such as soil pH and electrical conductivity. In turn, the increase in Fe availability after application of NPs was insignificant whereas soil phytotoxicity assessed by germination test was reduced. In conclusion, the use of magnetite NPs opens up new nanoremediation options to treat soils affected by both organic and metal(loid) pollution.

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.

This paper presents a simplified method for the study of the soil-structure interaction problem for isolated footings on soils subjected to water content-related volume changes. The method is based on the 2D modelling of thermo-hydro-mechanical processes occurring in the soil and the soil–atmosphere interface, the calculation of the soil-footing system stiffness and the modelling of the structure. The idealization of soil-structure interaction from an equivalent springs model, obtained from the above characteristics, allows the movements changes in time of the foundations to be obtained. These in turn can be used for evaluation of building damage related to angular distortion among foundations.

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 Precambrian metamorphic basement exposed in the eroded core of the Huizachal-Peregrina Anticlinorium (Cd. Victoria, Mexico) is described in this contribution as Novillo Metamorphic Complex (NMC). Based on field relations, modal content, whole rock geochemistry and Nd-isotopic ratios is possible to recognize two major units: (a) Metaigneous Unit (MIU) and (b) Metasedimentary Unit (MSU). The MIU is subdivided into the Old Suite, constituted by (a) felsic gneisses from Novillo canyon, (b) felsic gneisses from Peregrina canyon, (c) metagranites, (d) mafic gneisses, and (d) migmatites; and the AMCG Suite, composed by (a) meta-anorthosites, (b) metagranite-gabbro intercalations, (c) metacharnockites, (d) garnet-rich metaferrodiorite dykes, and (e) metanelsonites. The MSU is represented by (a) meta-arkose – amphibolite intercalations and (b) calcsilicate marbles. Tectonic discrimination diagrams based on linear discriminant analysis of natural logarithm transformed ratios of elements show an island arc tectonic setting for the MIU. Nd isotopic ratios show crustal residence TDM ages of 1.49–1.44 Ga for the Old Suite (2 samples) and 1.63–1.33 Ga for the AMCG Suite (7 samples). The MSU have TDM between 1.39 a 1.25 Ga (3 samples) that support the interpretation that the protoliths were possibly deposited in a basin with sediment input from the younger MIU members. These deposits were later thrusted over MIU rather than intruded, and together metamorphosed under granulite facies conditions by the ca. 1.0 Ga Zapotecan orogeny. However, since the metaferrodioritic bodies cut discordantly the meta-anorthosites fabric, they represent a younger tectonothermal event, not yet described for the NMC.

This article proposes a new plastification mechanism to model bentonite free swelling processes by using an elastoplastic approach. The formulation is based on an interaction function that defines the plastic macrostructural strains induced by microstructural effects. This term is defined as a function of the microstructural void ratio, and it establishes a direct connection between the destructuration of the micro- and macrostructures of the bentonite during the free swelling processes. The formulation proposed also includes a new approach to the calculation of the microstructural void ratio as well as a new method to describe the kinetic mass exchange between micro- and macrostructural water, considering that there may not be equilibrium between the two types of water. The model was used to analyse several free swelling tests and was found to yield satisfactory results.

In this work, the scale up of the flushing-fluid-assisted electrokinetic remediation of kaolin soil polluted with phenanthrene has been studied. Three different scales have been used: lab (25 cm3), bench (28 × 103 cm3) and pilot scale (175 × 103 cm3) plants. Results show that electrokinetic fluxes, removals of PHE and pollutant distribution in soil were very different in the three setups in spite of being the same soil, pollutant and operation conditions. Electro-osmotic fluxes were much bigger in the case of the lab scale setup and very similar in the bench scale plant and in the pilot mock up, just as expected according to the PHE fluxes and to the distribution of PHE removal. Moreover, in the pilot scale plant used, hydraulic flux produced by gravity and evaporation flux by electric heating of the soil should be taken considered. This variety of results suggests a very complex process with many factors influencing on results. In the lab scale plant, the main mechanisms involved in the removal of PHE are dragging with electro-osmotic flow in the cathodic wells and electrophoresis after interaction of surfactant with phenanthrene in the anodic wells. Just on the contrary, desorption of PHE promoted by the electric heating seems to be a very significant removal mechanism in the bench scale plant and in the pilot mock-up.

Using multiphysics computer codes has become a useful tool to solve systems of partial differential equations. However, these codes do not always allow for the free introduction of implicitly defined state functions when automatic differentiation is used to compute the iteration matrix. This makes it considerably more difficult to solve geomechanical problems using non-linear constitutive models. This paper proposes a method for overcoming this difficulty based on multiphysics capabilities. The implementation of the well-known Barcelona basic model is described to illustrate the application of the method. For this purpose, without including formulation details addressed by other authors, the fundamentals of its implementation in a finite element code are described. Examples that demonstrate the scope of the proposed methodology are also presented.

In this work, a pilot plant with two rows of three electrodes in semipermeable electrolyte wells was used to study the electrokinetic treatment of a natural soil polluted with phenanthrene (PHE). The electrokinetic pilot plant was an open system, i.e., there was direct contact between the soil and air. To increase the solubility of phenanthrene, thereby enhancing its transport through the soil, an aqueous solution of the anionic surfactant dodecyl sulfate was used as a flushing fluid. The results show that at the pilot scale considered, gravity and evaporation fluxes are more relevant than electrokinetic fluxes. Contrary to observations at the laboratory scale, desorption of PHE promoted by electric heating appears to be a significant removal mechanism at the pilot scale. In addition, PHE is dragged by the electroosmotic flow in the cathodic wells and by electrophoresis after interaction of the surfactant with phenanthrene in the anodic wells. In spite of the long treatment time (corresponding to an energy consumption over 500 kWh m−3), the average removal attained was only 25%.

A constitutive model of the volumetric behaviour of bentonite aggregates is proposed. The model is based on a state function to define the inter-aggregate (microstructural) void ratio and on a mass transfer function to calculate the mass exchange between macrostructural and microstructural water. Although both functions have been used previously for clay soils, their application beyond the range for which they were derived is proposed. To evaluate whether this extrapolation is valid, data on the swelling of individual bentonite aggregates are analysed. This novel aspect of this study is significant because it is not common to analyse microstructural data directly without introducing any hypothesis about the behaviour of the macrostructure. Despite the lack of a more intensive validation, which will be conducted when more experimental data become available, the results obtained have been satisfactory.

This paper presents a methodology that allows the identification of optimum geosynthetic mitigation designs and the assessment of their cost-effectiveness taking into account the spatial-temporal probability of occurrence of sinkholes of different diameters and the characteristics and mechanical strength of the road. The procedure is illustrated using a specific case study of a road built in a sinkhole-prone area near Zaragoza city, Spain. The most cost-effective geosynthetic distribution is identified integrating in the cost-benefit analyses a sinkhole hazard model that includes an empirical magnitude and frequency relationship. A sensitivity analysis reveals the parameters whose uncertainty has a higher impact on the profitability of the mitigation measure. The impact of the actual temporal and spatial distribution of damaging sinkholes on the cost-effectiveness of the optimum geosynthetic design has been evaluated by means of Monte Carlo simulations. The proposed approach could be applied, with some modifications, to other mitigation measures (e.g. slabs), different structures (e.g. railways), as well as other processes (e.g. landslides, piping).

A numerical model is presented to simulate the hydro-mechanical behaviour of the porous rocks that form the deep saline aquifers which are currently being considered as potential CO 2 storage reservoirs. The model has taken into account the equations of state regulating the behaviour of CO 2 , in both the supercritical state in which will be injected, and under atmospheric conditions. Whilst the flow model is founded on a “conventional” advective/diffusive formulation, the geomechanical constitutive model used is a critical state model that includes a non-linear hypoelastic law, and a brittle/ductile yield which takes into account mechanical degradation and the effect of partial saturation caused by the CO 2 flow. With this model, it will be possible to analyse the localisation of the deformation which may occur when a dilatant brittle yield is reached, and thus to analyse the role played by the preferential flow paths associated with this localisation. A partial differential equation solver based on the finite element method, which adopts a multiphysics simulation environment, has been used. After some examples of validation, the simulation of a synthetic example that highlights the capacities of the model is presented.

Sinkholes in karst areas disrupt transportation route serviceability causing significant direct and indirect economic losses and may lead to accidents involving fatalities. A quantitative procedure has been developed to identify the most suitable mitigation designs for a road recently built in an area with a very high probability of sinkhole occurrence. Installation of geogrids with different resistances to a variable number of road sections has been simulated taking into account the occurrence probability of sinkholes with different diameters in each section. The proposed methodology includes the following phases: (1) Development of a sinkhole hazard model that predicts the occurrence probability of sinkholes with different diameters in each 5 × 5 m pixel of the road. (2) Vulnerability appraisal of the road by means of stability analyses. (3) Risk assessment for the “without geogrid” and multiple “with geogrid” scenarios including direct and indirect economic losses, as well as expected number of fatalities. (4) Cost–benefit analysis to estimate the net benefit of the mitigation designs. (5) Acceptability analysis considering geogrid solutions based on cost-effectiveness, conventional (maximum acceptable rate of fatalities) and utility-based (maximum acceptable investment in mitigation to prevent fatalities) criteria. (6) Sensitivity analysis to evaluate the impact of the uncertainty of a set of parameters on the most critical results from the risk management perspective. The presented method could be easily adapted to other geohazards (e.g. shallow landslides, rock-falls, piping), different infrastructures (e.g. railways), as well as to other corrective measures (e.g. concrete slabs, catch fences, armoured roofs, steel meshes, barrier systems).

This article proposes a synthetic model to explain the cracking process observed in Santos Morcillo Lake, Ruidera Lakes Natural Park, central Spain. The model was obtained by means of a comprehensive review of the available data, supplemented with an electrical tomography survey and a field and laboratory investigation. The system’s structure has been condensed into a microscale model based on a sediment column connecting the crust of the lake bottom with the Mesozoic substrate. The deformation of both this column and the crust covering it allows for a consistent explanation of the behaviors observed. It also provides a simple reproduction of the crack opening data. Hence the model has been used to define guidelines for the safe use and management of this protected space.

Resumen Introduccion Actualmente, el factor masculino es el responsable de forma aislada del 40% de los casos de infertilidad de pareja, compartiendo este protagonismo de forma adicional en un 20% junto al factor femenino, por lo que de forma conjunta, representa el 50% de todos los casos. A pesar de la falta de evidencia cientifica, el tratamiento empirico se ha utilizado ampliamente y continua haciendose en la actualidad, basicamente a expensa de compuesto de vitaminas y otros oligoelementos, que debido a su poder antioxidante, permitiria mejorar parametros seminales como movilidad o morfologia. Objetivos Estudiar los cambios en parametros seminales en un grupo de pacientes con oligoastenoteratozoospermia idiopatica, a quienes se les pauto tratamiento con el complejo antioxidante. Material y metodos 40 pacientes con oligoastenoteratozoospermia idiopatica fueron tratados con el complejo antioxidante Androferti® (Laboratorio Q-Pharma). Conclusiones El estudio demostro mejoria de los parametros seminales concentracion, movilidad progresiva y morfologia a los 3 y 6 meses de tratamiento, presentando significacion estadistica el analisis de los datos, lo cual, dada la mejoria sobre el recuento de espermatozoides moviles (REM), permite a estos pacientes acudir a tecnicas de reproduccion asistida (TRA) como fecundacion in vitro (FIV) o inyeccion intracitoplasmatica de espermatozoides (ICSI) con mayor garantia, o incluso, parejas que debido al REM inicial necesariamente tenian que recurrir a dicha tecnica de reproduccion, pueden finalmente recurrir a inseminacion artificial (IAC) ante la mejoria experimentada.

Objetivo Dada la gran cantidad de informacion actual sobre el uso de terapias biologicas (TB) en la artritis psoriasica (APs), y la variabilidad de la misma en cuanto a su calidad, desde la Sociedad Espanola de Reumatologia (SER) se ha impulsado la generacion de recomendaciones basadas en la mejor evidencia posible. Estas deben de servir de referencia para reumatologos e implicados en el tratamiento de APs que vayan a utilizar o consideren la utilizacion de TB. Metodos Las recomendaciones se emitieron siguiendo la metodologia de grupos nominales y basadas en revisiones sistematicas. El nivel de evidencia y el grado de recomendacion se clasificaron segun el modelo del Center for Evidence Based Medicine de Oxford y el grado de acuerdo se extrajo por tecnica Delphi. Resultados Se realizan recomendaciones sobre el uso de las TB disponibles en la actualidad en nuestro pais para el tratamiento de la APs. Estas recomendaciones incluyen la evaluacion de la enfermedad, objetivos del tratamiento, esquema terapeutico y cambios en el mismo. Conclusiones Se presentan las actualizaciones a las recomendaciones SER para el uso de TB en pacientes con APs

Objective Due to the amount and quality variability regarding the use of biologic therapy (BT) in psoriatic arthritis (PsA) patients, the Spanish Society of Rheumatology (SER) has promoted the generation of recommendations based on the best evidence available. These recommendations should serve as reference to rheumatologists and those involved in the treatment of patients with PsA, who are using, or about to use BT. Methods Recommendations were developed following a nominal group methodology and based on systematic reviews. The level of evidence and degree of recommendation was classified according to the model proposed by the Center for Evidence Based Medicine at Oxford. The level of agreement was established through Delphi technique. Results We have produced recommendations for the use of TB currently available for PsA in our country. These recommendations include disease assessment, treatment objectives, therapeutic scheme and switching. Conclusions We present an update on the SER recommendations for the use of BT in patients with PsA.