Determination of nicotine in mushrooms by various GC/MS- and LC/MS-based methods.

Due to the basic properties of nicotine, it is not easily integrated into commonly used multiresidue methods. The present work investigates the application of two commonly employed multiresidue methods-the QuEChERS method and the ethyl acetate method-for determining nicotine in mushrooms. Both methods are employed in a modified form and an unmodified form: the former to address the special properties of nicotine and the latter, combined with the use of isotopically labelled nicotine, to compensate for poor recoveries. The QuEChERS-based methods were followed by liquid chromatography-time-of-flight mass spectrometry and those based on ethyl acetate extraction were followed by gas chromatography-triple quadrupole-mass spectrometry. All methods were validated according to European guidelines (document no. SANCO/10684/2009). Recovery studies performed on mushroom spiked at 10 and 100 µg kg(-1) yielded average recoveries in the range 80-110% with relative standard deviation (RSD) values below 9%. The linearity of the response over two orders of magnitude was demonstrated (r(2) > 0.995) for all of the determination techniques employed. The limits of detection and quantification obtained were in the 0.7 and 10 µg kg(-1) range, depending on the technique, and thus below the maximum residue level established for this toxic alkaloid by current EU legislation. Good repeatability and reproducibility were obtained in terms of the RSD of the analytical methods (0.4-13.2%). The modified QuEChERS method was tested in a proficiency test on nicotine in dried mushrooms obtaining good results. The methods were successfully applied to 20 real samples.

Harmonizing analytical chemistry and clinical epidemiology for human biomonitoring studies. A case-study of plastic product chemicals in urine.

There is an interdisciplinary interface between analytical chemistry and epidemiology studies with respect to the design, execution, and analysis of environmental epidemiology cohorts and studies. Extracting meaningful results linking chemical exposure to human health outcomes begins at study design and spans the entire workflow. Here we discuss analytical experimental design from an exposure science perspective, and propose a reporting checklist for the design of human biomonitoring studies. We explain key analytical chemistry concepts of blanks and limits of reporting and present a case series of plastic product chemical exposure in prenatal urine specimens from the Barwon Infant Study.

Integrated chemical exposure assessment of coastal green turtle foraging grounds on the Great Barrier Reef.

The Great Barrier Reef receives run-off from 424,000 km2 catchment area across coastal Queensland, incorporating diffuse agricultural run-off, and run-off point sources of land-based chemical pollutants from urban and industrial development. Marine biota, such as green turtles (Chelonia mydas), are exposed to these diverse chemical mixtures in their natural environments, and the long term effects on turtle and ecosystem health remain unknown. This study was part of a larger multi-disciplinary project characterising anthropogenic chemical exposures from the marine environment and turtle health. The aim of this study was to screen for a wide range of anthropogenic chemical pollutants present in the external and internal environment of green turtles, using a combination of traditional targeted chemical analyses, non-target suspect screening, and effect-based bioassay methods, while employing a case-control study design. A combination of passive (water) and grab (water, sediment) samples were investigated. Three known green turtle foraging sites were selected for sampling: two coastal 'case' sites influenced primarily by urban/industrial and agricultural activities, respectively; and a remote, offshore 'control' site. Water and sediment samples from each of the three sampling locations showed differences in chemical pollutant profiles that reflected the dominant land uses in the adjacent catchment. Targeted mass spectrometric analysis for a range of pesticides, industrial chemicals, pharmaceuticals and personal care products found the greatest detection frequency and highest concentrations in coastal samples, compared to the control. Non-target screening analysis of water showed clear differentiation in chemical profile of the urban/industrial site. In-vitro assays of sediment samples from the control site had lowest induction, compared to coastal locations, as expected. Here we present evidence that turtles foraging in coastal areas are exposed to a range of anthropogenic pollutants derived from the adjacent coastal catchment areas.

Extrinsic ileal occlusion secondary to appendiceal mucocele of unusual size.

Appendiceal mucocele due to papilar cystadenoma is a rare condition, characterized by a diffuse swelling, a distension of the lumen secondary to accumulation of mucoid substance and occasional mucinous intraperitoneal deposits. It is often asymptomatic (approximately 25%) and is found incidentally during abdominal imaging studies or surgical exploration. Pre-operative recognition is difficult but very important because of the possibility of rupture during surgery with the development of pseudomyxoma peritonei. A case of benign mucocele presenting acutely as an occlusive syndrome is reported. The surgical treatment consisted of an appendicectomy with partial caecectomy. The clinicopathological and imaging diagnostic features of this pathological entity, as well as the main therapeutic approaches suggested in the literature, are commented on.

Concentrations of phthalates and DINCH metabolites in pooled urine from Queensland, Australia.

Dialkyl phthalate esters (phthalates) are ubiquitous chemicals used extensively as plasticizers, solvents and adhesives in a range of industrial and consumer products. 1,2-Cyclohexane dicarboxylic acid, diisononyl ester (DINCH) is a phthalate alternative introduced due to a more favourable toxicological profile, but exposure is largely uncharacterised. The aim of this study was to provide the first assessment of exposure to phthalates and DINCH in the general Australian population. De-identified urine specimens stratified by age and sex were obtained from a community-based pathology laboratory and pooled (n=24 pools of 100). Concentrations of free and total species were measured using online solid phase extraction isotope dilution high performance liquid chromatography tandem mass spectrometry. Concentrations ranged from 2.4 to 71.9ng/mL for metabolites of di(2-ethylhexyl)phthalate, and from <0.5 to 775ng/mL for all other metabolites. Our data suggest that phthalate metabolites concentrations in Australia were at least two times higher than in the United States and Germany; and may be related to legislative differences among countries. DINCH metabolite concentrations were comparatively low and consistent with the limited data available. Ongoing biomonitoring among the general Australian population may help assess temporal trends in exposure and assess the effectiveness of actions aimed at reducing exposures.

Pericardial tamponade as initial presentation of papillary thyroid carcinoma.

We herein describe a 19-year-old woman who presented with pericardial effusion that resulted in heart tamponade. The clinicopathological study revealed papillary carcinoma of the thyroid metastasized to the heart. Although malignant pericardial effusion is a known complication of thyroid cancer, it is rarely the first manifestation and shows a relatively favourable prognosis despite widespread metastases if adequate treatment is given.

Sipple's syndrome presenting acutely as severe heart failure.

We describe the case of a 56-year-old man who developed acute hypertension leading to cardiac insufficiency, arrhythmia, severe heart failure and death. The autopsy revealed Sipple's syndrome (multiple endocrine neoplasia syndrome type IIa) and catecholamine-induced cardiomyopathy. This man had received a false diagnosis of primary hypertension 1 year before. The prime objective of this report is to call attention to the necessity of an in depth diagnosis of labile and paroxysmal hypertension. The clinical diagnostic features of phaeochromocytoma as well as the main therapeutic approaches suggested in the literature are commented on.

[Evolution of the nutritional status of patients with HIV-AIDS. Effects of socioeconomic situation and dietetic counseling]. / Evolución del estado nutricional de pacientes VIH-SIDA. Efecto de su situación socio-económica y del consejo dietético.

OBJECTIVES: To know HIV-AIDS patient's nutritional status in different infection's condition and their relation with the socioeconomic situation and, in that case, the nutritional condition improvement through the dietetic advice appropriated for each patient. METHODS: Prospective study of 79 patients with HIV-AIDS diagnostic in any illness's condition and recopilation of anthropometrics and biochemical variables. At the beginning of the study we got data about socioeconomic situation of patient with a scale of 1 to 5 points each variable and an score top of 35. In the survivors we checked, after dietetic advice, the variables at 6 and 12 months by sanitary personal (physician and nurse) who weren't implicated in direct assistance. The study was analyzed by Student "T" for matched data and the simple correlation test. RESULTS: We have objectivated a lost of initial weight over their habitual's with a progressive impairment in different stage of evolution that weren't modified by dietetic advice. We didn't observed significant variations in the biochemical variables included in advances states and in parameters which are usually affected in malnutrition. In the analysis of relation between nutritional condition and socioeconomic factors, it was estimated a lesser score, that was statistically significative, in patients who had a work, family situation and an affective upset positive. CONCLUSIONS: The results obtained induce to think that the nutritional advices appropriated for each patient are not related, in our series, with progressive deterioration of anthropometrics variables, neither biochemical parameters fluctuations at 6, 12 months of follow-up. The patient's socioeconomic situation is not influenced by nutritional condition except for the work, affectivity and family environment.

[Comparative study of two enteral feeding formulas in hospitalized elders: casein versus soybean protein]. / Estudio comparativo de dos dietas enterales en ancianos hospitalizados: proteína de soja frente a proteína caseína.

OBJECTIVES: To compare the incidence of gastrointestinal side effects of two enteral feeding formulas with changes in the origin of protein (casein and isolated soy protein) in hospitalised elderly patients. METHOD: A cross sectional survey was done among a sample of elderly patients carrying nasogastric tube admitted to the Reina Sofia General Hospital (Murcia) during a period of 6 months. A formula based on casein or soybean protein was randomly assigned. The variables studied were: age, sex, cause for indication of EN, duration of the EN and maximum amount of EN administered per day. Nutritional status at admission and discharge, mortality and gastrointestinal side effects (diarrhoea, constipation, vomits or regurgitation) were also collected. Statistical analyses were performed with the Student's T and chi 2 tests, with a significance of 95%. RESULTS: Sample conformed by 50 patients over 65 years (48% casein, 52% soybean) without statistically significant differences in age nor cause of indication of the EN. Either there were no differences in the nutritional status at the admission and discharge in both groups. Significant differences were observed in the incidence of diarrhoea (C: 45.83%, S: 7.69%, p = 0.009) and vomits (C: 41.66%, S: 15.38%, p = 0.05). CONCLUSIONS: A significant reduction in the incidence of gastrointestinal complications, a reduction in the incidence of ulcers by pressure and less mortality occurred on the group that took formula based on the soybean protein. The individualized nutritional evaluation must be performed routinely when the patient is admitted to the hospital for detection and treatment of early signs of malnutrition.

Spontaneous retroperitoneal hemorrhage from adrenal artery aneurysm.

Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture.