Risk assessment for uptake and accumulation of pharmaceuticals by baby leaf lettuce irrigated with reclaimed water under commercial agricultural activities.

The use of reclaimed water to irrigate agricultural crops has increased in recent years as a consequence of water shortage constituting a potential risk for human health. The main objective of this study was to evaluate the impact on the soil-plant system and determining the accumulation of carbamazepine (CBZ), diclofenac (DCF), ketoprofen (KTP) and naproxen (NPX) in the edible part of lettuce under commonly used agricultural practices in commercial production. For this purpose, red oak baby lettuce (Lactuca sativa L.) was irrigated with reclaimed water fortified with different concentrations of pharmaceuticals. The study was carried out in two different scenarios: soil and tray. The tray experiments were conducted with substrate and took place at three different seasons of the year. Lettuce tissue sampled from these experiments were analysed 3 times during the lettuce growing cycle (first, second and third harvest). The practices of first harvest regrowth were also evaluated. For all experiments, CBZ showed the highest accumulation in lettuce leaves of the pharmaceuticals tested, showing a correlation between irrigation exposure time and pharmaceutical uptake. Unexpectedly, DCF was the compound with the highest uptake levels after regrowth practices. Results suggested that pharmaceuticals uptake could be directly associated with the irrigation method and possible accumulation in soil and substrates, while concentration of pharmaceuticals in substrates were 10 times higher. Based on the concentration values detected in lettuce leaves, the risk assessment suggests that no compounds imply any risk to human health, except CBZ for those on vegetarian diets in the tray scenario. Although commercial agricultural practices are usually not considered with regards to risk reduction, in this experiment we demonstrated that climatic conditions are a key factor in pharmaceuticals uptake and different agricultural practices (soil cropping and drip irrigation) can limit the presence of pharmaceutical compounds in crops.

Assessment of saliva and oral candidiasis levels 12, 24 and 36 months after radiotherapy in patients with head and neck cancer.

INTRODUCTION: Hyposalivation is a serious complication during radiotherapy (RT) and it is one of the major risk factors for the presence of candidiasis. The aim of this study was to evaluate the salivary hypofunction during the different stages of RT, analysing its connection with the presence of candidiasis. MATERIAL AND METHODS: A retrospective study was performed in 83 patients who had been diagnosed with head and neck tumours and who were undergoing RT treatment. Their salivary function was clinically analysed throughout the course of the RT treatment (before, during and after treatment) by means of the whole saliva test (WST), both unstimulated (WST-I) and stimulated (WST-II), and its relationship with candidiasis was evaluated using culture-based methods. RESULTS: The WST-I before RT was 37.24±17.36mm and the WST-II was 60.70±30.98mm, with 47% of patients testing positive for candidiasis. The prevalence of candidiasis increased up to 55.8% during RT and it returned to similar pre-RT levels at the end of treatment (45.2%). A statistical significant relationship was found between low WST-I and candidiasis in the 1st (13.58 vs 20.78mm), 3rd (18.06 vs 24.36mm), 6th (16.83 vs 24.5) and 12th (16 vs 28.74mm) months after RT; and this relationship was also detected for WST-II in the 1st (24.73 vs 41.26mm) and 3rd (27.71 vs 39.91mm) months after RT. Female sex was identified as an independent associated risk factor for mild hyposalivation before RT (OR=6.50, CI: 95% 1.77-23.93, p=0.005) and glandular hypofunction (OR=3.01, CI: 95% 1.12-8.10, p=0.029). DISCUSSION: There is a clear relation between hyposalivation and the presence of candidiasis during and after RT. Larger studies must be performed in order to further elucidate this effect.

[Intraoperative neurophysiological monitoring in Spain: its beginnings, current situation and future prospects]. / Monitorizacion neurofisiologica intraoperatoria en España: inicios, situacion actual y perspectivas de futuro.

Intraoperative neurophysiological monitoring (IONM) is nowadays another tool within the operating room that seeks to avoid neurological sequels derived from the surgical act. The Spanish Neurophysiological Intra-Surgical Monitoring Association (AMINE) in collaboration with the Spanish Society of Clinical Neurophysiology (SENFC), and the IONM Working Group of the SENFC has been collecting data in order to know the current situation of the IONM in Spain by hospitals, autonomous communities including the autonomous cities of Ceuta and Melilla, the opinions of the specialists in clinical neurophysiology involved in this topic and further forecasts regarding IONM. The data was gathered from November 2015 to May 2016 through telephone contact and/or email with specialists in clinical neurophysiology of the public National Health System, and through a computerized survey that also includes private healthcare centers. With the data obtained, from the perspective of AMINE and the SENFC we consider that nowadays the field of medicine covered by IONM is considerably large and it is foreseen that it will continue to grow. Therefore, a greater number of specialists in Clinical Neurophysiology will be required, as well as the need for specific training within the specialty that involves increasing the training period of MIRs based on competencies due to the increase in techniques/procedures, as well as its complexity.

TITLE: Monitorizacion neurofisiologica intraoperatoria en España: inicios, situacion actual y perspectivas de futuro.La monitorizacion neurofisiologica intraoperatoria (MNIO) es hoy en dia una herramienta mas dentro del quirofano que busca evitar secuelas neurologicas derivadas del acto quirurgico. Nuestro objetivo, desde la Asociacion de Monitorizacion Intraquirurgica Neurofisiologica Española (AMINE), en colaboracion con la Sociedad Española de Neurofisiologia Clinica (SENFC) y el Grupo de Trabajo de MNIO de la SENFC, ha sido recopilar datos para conocer la situacion actual de la MNIO en España por hospitales, comunidades autonomas y ciudades autonomas de Ceuta y Melilla, las opiniones de los especialistas en neurofisiologia clinica involucrados en este tema y las perspectivas de futuro. La recopilacion de los datos se ha realizado durante el periodo de noviembre de 2015 a mayo de 2016 mediante contacto telefonico o correo electronico con especialistas de neurofisiologia clinica del Sistema Nacional de Salud, y mediante una encuesta via informatica en la que tambien participaron algunos centros sanitarios privados. Con los datos obtenidos consideramos desde la perspectiva de la AMINE y la SENFC que el campo de la medicina que abarca la MNIO en estos momentos es muy amplio y seguira creciendo. Por eso, se precisa un mayor numero de especialistas en neurofisiologia clinica, asi como una mayor formacion especifica dentro de la especialidad, que implica incrementar el periodo formativo actual de los medicos internos residentes en funcion a competencias debido al incremento de las tecnicas/procedimientos, asi como su complejidad.

Quantitative determination of c-myc facilitates the assessment of prognosis of OSCC patients.

Myc genes are a family of proto-oncogenes whose proteins are implicated in the regulation of cell proliferation, differentiation and apoptosis, and in regulating the activity of genes involved in cell division. The aim of the present study was to establish a quantitative description of the expression of c-myc and evaluate its relationship with other clinical and prognostic factors, as well as to establish a multivariate survival prediction model. This is a retrospective study of 68 patients diagnosed with oral squamous cell carcinoma (OSCC). We constructed a tissue microarray for investigating the expression of c-myc by immunohistochemistry. Statistical analyses were carried out, and a multivariate model that predicts survival was established. The average expression of c-myc was 50.32 (SD, 26.05) with a range from 6.60 to 99.48; similar for initial and advanced tumor stages. Non-smoking patients had higher levels of c-myc, showing statistically significant differences (Kruskal-Wallis χ2=5.975; p=0.05). We found no statistically significant relationship between the quantitative expression of c-myc and any other clinical or pathological parameters. For each unit of increase of c-myc, the risk increased by 1.15 (p<0.001; HR, 1.150; 95% CI, 1062-1245). Further study of this protein, which may have a significant diagnostic, prognostic and therapeutic value is warranted. Its determination can be valuable when used together with other markers to assess the prognosis of OSCC patients.

Comparison of three sampling instruments, Cytobrush, Curette and OralCDx, for liquid-based cytology of the oral mucosa.

Exfoliative cytology of the oral cavity is a simple and noninvasive technique that permits the study of epithelial cells. Liquid-based cytology is an auxiliary diagnostic tool for improving the specificity and sensitivity of conventional cytology. The objective of our study was to compare the quality of normal oral mucosa cytology samples obtained using three different instruments, Cytobrush®, dermatological curette and Oral CDx® for liquid-based cytology. One hundred four cytological samples of oral cavity were analyzed. Samples were obtained from healthy volunteer subjects using all three instruments. The clinical and demographic variables were age, sex and smoking habits. We analyzed cellularity, quality of the preparation and types of cells in the samples. All preparations showed appropriate preparation quality. In all smears analyzed, cells were distributed uniformly and showed no mucus, bleeding, inflammatory exudate or artifacts. We found no correlation between the average number of cells and the type of instrument. The samples generally consisted of two types of cells: superficial and intermediate. No differences were found among the cytological preparations of these three instruments. We did not observe basal cells in any of the samples analyzed.

Subjective annoyance caused by environmental noise.

We developed an acoustic study implemented throughout a neighborhood of Valencia (Spain). Acoustic recordings were made during the months of November and December 1989, on workdays between 9 a.m. and 1 p.m., and between 5 p.m. and 8 p.m. We also directly interviewed individuals living in this city area to determine their perception of noise and to evaluate the discomfort caused by it in daily life. A personal interview in the form of a questionnaire was employed to poll the neighborhood inhabitants on the magnitude of environmental noise and the distress it caused. The results showed that 40% of those interviewed considered environmental noise to cause considerable distress. On a 1 to 10 scale, over half of those interviewed rated noise in the neighborhood of 5 or higher. Traffic was considered the major source of noise, followed by noise from neighbors and factories. Of those interviewed, 9% changed the location of their bedroom as a result of noise, whereas 11% were forced to sleep with the windows closed for the same reason.

[The defecation habits in a normal working population]. / Hábitos defecatorios en población laboral normal.

We have studied the bowel habits of a theoretically normal working population to know the range defecation patterns, characteristics and main factors that may influence it. We have designed a questionnaire composed of 80 questions and distributed to 837 people. Answers, were evaluated in 414 cases (187 men and 227 women), with a median age of 33 years (range 20-64 years). The average number of stools was 7.1 +/- 3.3 per week and in 62.4% of subjects they were between the range of 5 and 8. Bowel movements were less frequent in women than in men, and the same finding was seen about self-reported constipation; nevertheless there were no differences in regard to age. Laxatives were used regularly by 11.3%, and 36% referred straining at stool at least 25% of the time and 8.3% referred straining for loose stools. Alternating bowel function presented in 19.4% and functional abdominal pain in 28% with a female predominance. Faecal incontinence occurred in 6.8% of population; an important prevalence. We also analyse variables such as diet influence, physical activity, obstetrical, gynaecological and psychosocial factors. Although this survey has revealed that a normal bowel function is very variable, only a 7.5% of the subjects, consulted a doctor for bowel complaints.