Hypercalcemia due to hyperparathyroidism is a rare etiology for acute pancreatitis, oscillating between 1.5 and 7% in the different series. Although the cause-effect relationship and the pathophysiology of the condition are not clear, it seems that the association among them is not incidental, and serum calcium could be a major risk factor, so that pancreatitis would come to occur during severe hypercalcemia attacks. Mutations in different genes have been proposed as well to justify why only some patients with primary hyperparathyroidism and hypercalcemia develop acute pancreatitis.References to cases like these ones are rare in the literature. We report two patients with acute pancreatitis associated with hyperparathyroidism and hypercalcemia, one of them with a fatal outcome.

All four giant planets, far from the Earth and sun and having deep gravitational wells, present propulsion and power mission issues, but they also have an ambient plasma and magnetic field that allows for a common mission concept Electrodynamic tethers can provide propellantless drag for planetary capture and operation down the gravitational well, and they can generate power to use along with or be stored for inverting tether current The design for an alternative to NASA's proposed Europa mission is presented here. The operation requires the spacecraft to pass repeatedly near Jupiter, for greater plasma density and magnetic field, raising a radiation-dose issue that past analyses did take into account; tape tethers tens of kilometers long and tens of micrometers thick, for greater operation efficiency, are considered. This might result, however, in attracted electrons reaching the tape with a penetration range that exceeds tape thickness, thereby escaping collection. The mission design requires keeping the range below thickness throughout, resulting in an orbit perijove only hundreds of kilometers above Jupiter and tapes a few kilometers long. A somewhat similar mission design might apply to other giant outer planets. Copies of this paper may be made for personal and internal use, on condition that the copier pay the per-copy fee to the Copyright Clearance Center (CCC). All requests for copying and permission to reprint should be submitted to CCC at www.copyright.com; employ the ISSN 0748-4658 (print) or 1533-3876 (online) to initiate your request.*

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Una mujer ecuatoriana de 28 años residente en España tres meses consulta por presentar, desde 8 meses antes, dolor abdominal difuso recurrente tipo retortijón en relación con la ingesta. El día previo al ingreso el dolor aumenta de intensidad y se acompaña de vómitos, por lo que consulta en Urgencias de nuestro centro.En el estudio inicial se realizó bioquímica y hemograma, en la que únicamente destacaba una discreta anemia microcítica (Hb: 9,9 g/dl; VCM: 72; HCM; 29). Las radiografías de tórax y abdomen simple no presentaron alteraciones. La endoscopia digestiva alta también resultó ser normal, con biopsias negativas para Helicobacter pylori. Fue igualmente negativo el estudio de parásitos en heces.Al continuar la paciente con dolor importante e intensificarse los vómitos se realizó una nueva placa de abdomen en bipedestación, en la que se apreciaban algunos niveles hidroaéreos en yeyuno. Se comentó con cirugía. Al no haber un cuadro oclusivo completo, se colocó sonda nasogástrica y se decidió una actitud expectante, y entretanto se realizó un tránsito intestinal. En dicho estudio se pusieron de manifiesto imágenes negativas, ahusadas y entrelazadas desde tercera porción duodenal hasta yeyuno (Figs. 1 y 2). Juicio diagnóstico: infestación por Ascaris lumbricoides.Se instauró tratamiento con mebendazol, evolucionando la paciente favorablemente, con desaparición del dolor y normalización de la tolerancia oral. A los dos meses, en consultas, se constató la recuperación también del cuadro anémico. Fig. 1. Presencia de cuerpos de Ascaris lumbricoides en el interior del intestino delgado. Fig. 2. Detalle de duodeno distal con los helmintos en su interior. IMÁGENES EN PATOLOGÍA DIGESTIVA