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Old Borders along with New Horizons in Multimodality Imaging of Dangerous Pleural Mesothelioma cancer.
Introduction given the lack of historical documentary sources about the beginning of potato effective consumption in Vitoria (Alava, Spain), its introduction in the urban diet is estimated from cultivation and production data. This only allows asserting the introduction of the cultivation at the end of the 18th century, the recognition of two quantitative jumps during the Independence and First Carlist Wars, and that it was the second cultivation in quantity by 1857. Objective/method from the hypothesis of a good correspondence between hospital diet and ordinary urban diet, evidenced in other studies for Vitoria, it is proposed to document the chronology of potato introduction in the urban diet from its analysis in the city hospital, as well as to contextualize concurrent historical events, through the review and analysis of primary and secondary documentary sources. Results the hospital keeps a record of food acquisitions since 1743. The first purchase of potatoes was paid on September 17, 1834. Acquisitioespondence between hospital diet and ordinary urban diet, evidenced in other studies for Vitoria, it is proposed to document the chronology of potato introduction in the urban diet from its analysis in the city hospital, as well as to contextualize concurrent historical events, through the review and analysis of primary and secondary documentary sources. Results the hospital keeps a record of food acquisitions since 1743. The first purchase of potatoes was paid on September 17, 1834. Acquisitions continue in very variable quantities and dates, which are normalized from 1844. Contextually, there is a major subsistence crisis with cholera as the most immediate and necessary cause in synergy with the first carlist war and the devastation of crops in a summer storm. Dorsomorphin AMPK inhibitor In 1854 the potato was established in the urban diet. Conclusions the first acquisition of potatoes was made in September 1834 in the immediate context of cholera together with the carlist war and catastrophic weather effects.Duodenum is the second most common location of intestinal diverticula. It is extremely rare that periampullary duodenal diverticulum causes obstructive jaundice. This rare condition was first described by German surgeon Gerhard Lemmel in 1934.(1) Lemmel's syndrome is defined as obstructive jaundice due to a periampullary duodenal diverticulum in the absence of choledocholithiasis or neoplasm. We present a case of a 69-year-old male patient admitted to our hospital for painless obstructive icterus. Diagnostic workup by use of MSCT revealed periampullary duodenal diverticulum (Figure 1) while MRCP and endoscopy confirmed duodenal diverticulum causing a focal short-segment stenosis in the distal segment of the choledochus with dilatation of intrahepatic and extrahepatic bile ducts proximally (Figure 2). Surgery was indicated and intraoperatively we detected markedly dilated choledochus in the segment thus exposed (Figure 3) so internal bile drainage was ensured by creating termino-lateral hepaticojejunal Roux-en-Y anastomosis. Although a number of treatment modalities such as diverticulectomy or endobiliary stent placement have been proposed, we consider that internal biliary drainage by creating hepaticojejunal Roux-en-Y anastomosis is the only appropriate and long-term option for these patients.(2,3).Nintedanib is a multikinase inhibitor used for the treatment of Pulmonary Idiopathic Fibrosis. We present the first report published until now about severe hepatotoxicity and jaundice secondary to Nintedanib. A 88-year-old male with a 1-month history of weakness, weight loss, jaundice and pruritus without abdominal pain. Laboratory findings showed progressive cholestatic liver injury in the past months, whereas hyperbilirrubinemia and mild coagulopathy at admission (TABLE 1). Once dismissed other causes of liver injury (drugs, toxics, viral and autoimmunity tests), abdominal ultrasound and MRI were performed due to the suspicion of neoplastic origin, resulting both normal. The patient was diagnosed 2 years ago with Pulmonary Idiopathic Fibrosis, treated with Nintedanib, and dose-reduced months ago because of worsening of chronic diarrhea as a side effect (1). Since organic lesions were dismissed by imaging findings, and suspecting toxicity caused by Nintedanib, it was finally withdrawn and progressive clinical and laboratory tests improvement were achieved during the follow-up. Nintedanib is associated to mixed liver injury (cholestasic and/or cytolytic) in 4,9-5,7% (2) of patients treated. This side effect is also described with other multikinase inhibitors, as Lenvatinib used for Hepatocellular Carcinoma. For this reason, we need to make liver function tests before and during the whole treatment (2, 3). Although no cases have been reported, Nintedanib should be withdrawn in cases of severe hepatotoxicity with jaundice (4). In mild cases a full recovery of the liver function has been reported, although it is uncertain the time necessary to achieve this goal.
Ensuring health and well-being during this pandemic is essential according to the United Nations Sustainable Development Goals. Physical exercise has an important role in the preservation of the immune system, which is vital to prevent infections. To promote physical exercise and maintain a healthy status, recent studies have suggested general exercise routines to be implemented during the quarantine period. However, to improve the health-related physical fitness components, any specific prescription should include intensity, volume, duration, and mode. Controversy persists about which is the best intensity of physical activity, while performing exercise at a moderate intensity could bring important benefits to asymptomatic people. High intensity or unaccustomed exercise should be restricted for older people, and for people of all ages with chronic diseases or compromised immune system, obesity, or upper respiratory tract infection with limited symptoms. Besides, physical activity guidelines should be parti High intensity or unaccustomed exercise should be restricted for older people, and for people of all ages with chronic diseases or compromised immune system, obesity, or upper respiratory tract infection with limited symptoms. Besides, physical activity guidelines should be particular to each population group, giving special consideration to those vulnerable to COVID-19 who are much more likely to suffer more self-isolation. Therefore, the present study is to provide specific physical activity recommendations for different populations during this pandemic.
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