A Methodological Approach for Spatiotemporally Analyzing Water-Polluting Effluents in Agricultural Landscapes Using Partial Triadic Analysis.

Multivariate techniques for two-dimensional data matrices are normally used in water quality studies. However, if the temporal dimension is included in the analysis, other statistical techniques are recommended. In this study, partial triadic analysis was used to investigate the spatial and temporal variability in water quality variables sampled in a northeastern Spain river basin. The results highlight the spatiality of the physical and chemical properties of water at different sites along a river over 1 yr. Partial triadic analysis allowed us to clearly identify the presence of a stable spatial structure that was common to all sampling dates across the entire catchment. Variables such as electrical conductivity and Na and Cl ions were associated with agricultural sources, whereas total dissolved nitrogen, NH-N concentrations, and NO-N concentrations were linked to polluted urban sites; differences were observed between irrigated and nonirrigated periods. The concentration of NO-N was associated with both agricultural and urban land uses. Variables associated with urban and agricultural pollution sources were highly influenced by the seasonality of different activities conducted in the study area. In analyzing the impact of land use and fertilization management on water runoff and effluents, powerful statistical tools that can properly identify the causes of pollution in watersheds are important. Partial triadic analysis can efficiently summarize site-specific water chemistry patterns in an applied setting for land- and water-monitoring schemes at the landscape level. The method is recommended for land-use decision-making processes to reduce harmful environmental effects and promote sustainable watershed management.

Use of non-invasive positive pressure ventilation in emergency departments of hospitals in Spain.

A survey was undertaken of the use of non-invasive ventilation (NIV) in Spain. 45.7% of emergency departments use NIV. The average time it has been in use is 4 years. Public hospitals use NIV more frequently (89.5%) as well as teaching hospitals (78.1%). Emergency physicians are the professionals who most frequently use NIV (68.8%). High flux continuous positive airway pressure (58.4%) and facial masks (63.5%) are most commonly used. Only 18.9% of hospitals have quality registration in NIV and 35.6% have protocols for using NIV. The method is underused by technicians working in hospital emergency services and there is a lack of uniform protocols with other departments involved.

Water resources and nitrate discharges in relation to agricultural land uses in an intensively irrigated watershed.

Application of integrated hydrological models to manage water resources and non-point agricultural pollutants are increasingly used in decision-making processes. In this study SWAT (Soil and Water Assessment Tool) was used to simulate the water balance and nitrate pollution in an intensively irrigated agricultural catchment (Flumen River in Monegros, Aragon, NE Spain). Rainfall comprised only 45% of the inputs of water in the Flumen watershed and the rest is contributed through irrigation canals from two other rivers outside the Flumen watershed. Green water storage and green water flow are the dominant components of the water balance in the watershed, which is related to the important contribution of water for irrigation. In general, green water storage and green water flow are quite similar in the subwatersheds dominated by irrigation agriculture that are located in the central part of the watershed. A similar pattern was observed for blue water, with high amounts in the central irrigated subwatersheds compared to the non-irrigated subwatersheds. Consequently, nitrate infiltration in the aquifer was higher in the inner irrigated subwatersheds (100-250 kg N ha-1 year-1) but much lower than the lateral flow rates estimated in the non-irrigated subwatersheds (1400-2000 kg N ha-1 year-1). Two scenarios simulating the effects of expected climate change factors in this zone were performed. A reduction in the availability of water for irrigation will transform the area from irrigated crops to cereal. In this case the water flow of River Flumen at the outlet of the watershed is reduced by 15%. If a reduction of 40% nitrate fertilization is applied, the nitrate exported to Flumen River would decreased by 28%. These results suggest that dosing irrigation water and fertilizers in accordance with crop requirements would contribute to buffer peaks of water and nitrate discharges and to a more efficient agricultural use of the resources.

[Quality of the publication of adverse drug reactions in the letters to the editor section of four Spanish internal medicine and general medicine journals]. / Calidad de la publicación de reacciones adversas a medicamentos en la sección de Cartas al Director de cuatro revistas españolas de medicina interna y medicina general.

OBJECTIVE: To assess the quality and relevance of adverse drug reactions (ADRs) published as Letters to the Editor (LE) in Spanish medical journals. DESIGN: Observational study. PARTICIPANTS: LE on adverse drug reactions published over 5 years (1994-98). SETTING: Four Spanish medical journals (Medicina Clínica, Revista Clínica Española, Atención Primaria and Anales de Medicina Interna). MAIN MEASUREMENTS: Patient characteristics, drugs, ADR, causality algorithm, minimum criteria, and publication relevance. RESULTS: Out of 2244 LE, 204 (9.1%) reported ADRs, which included 235 cases. The therapeutic subgroups most commonly implicated were anticoagulants and antiplatelet drugs, antibiotics, and antineoplastic agents; 20.4% of the drugs were recently marketed. ADRs most commonly involved the nervous system (13.6%), liver (10.2%), skin and appendages (9.8%), general reactions (9.8%), and the digestive system (8.1%). The reactions were moderate in 50.2% of cases and severe/fatal in 34%. The mean causality algorithm value (5.9+/-2.2) was similar among journals. Of the ADRs, 28 (11.9%) were definitive, 182 (77%) possible or probable, and 26 (11.1%) improbable or conditional; 10.2% were unknown. There were no differences in the mean minimum publication criteria (9.5+/-1.2). Publication relevance was 3.2+/-1.6 points, and higher in Medicina Clínica. CONCLUSIONS: ADRs constitute an important part of LE in the journals studied. The causal relationship is acceptable, the documentation quality is high, with few unknown reactions and ADRs to recently marketed drugs. Relevance is generally low, although greater in Medicina Clínica.

Calidad de la publicación de reacciones adversas a medicamentos en la sección de Cartas al Director / Quality of the publication of adverse drug reactions in the letters to the editor section

Objetivo. Conocer la calidad y la relevancia de las reacciones adversas a medicamentos (RAM) publicadas como Cartas al Director en las revistas médicas españolas. Diseño. Estudio descriptivo. Participantes. Cartas al director sobre RAM aparecidas durante 5 años (1994-98). Emplazamiento. Cuatro revistas españolas (Medicina Clínica, Revista Clínica Española, Atención Primaria y Anales de Medicina Interna). Mediciones principales. Las características de los pacientes, de los medicamentos, de las reacciones adversas, el algoritmo de causalidad, los criterios mínimos y la relevancia de la publicación. Resultados. De 2.244 cartas, 204 (9,1%) se referían a RAM e incluían 235 casos. Los subgrupos terapéuticos más implicados fueron: anticoagulantes y antiplaquetarios, antibióticos y antineoplásicos. El 20,4% de los medicamentos era reciente. Las RAM más frecuentes afectaron al sistema nervioso (13,6%), el hígado (10,2%), la piel y anejos (9,8%), reacciones generales (9,8%) y aparato digestivo (8,1%). El 50,2% fueron moderadas y el 34%, graves/mortales. El valor medio (5,9 ± 2,2) del algoritmo de causalidad fue similar entre revistas; las RAM fueron: 28 (11,9%) definidas, 182 (77%) posibles o probables y 26 (11,1%) improbables o condicionales; el 10,2% eran desconocidas. No se detectaron diferencias en la media (9,5 ± 1,2) de criterios mínimos de publicación. La relevancia de la publicación fue de 3,2 ± 1,6 puntos, superior en Medicina Clínica. Conclusiones. La publicación de RAM supone una parte importante de la sección de Cartas al Director en las revistas estudiadas. La relación de causalidad es aceptable y la calidad documental elevada, con pocas reacciones desconocidas y a medicamentos recientes. La relevancia ha sido escasa, aunque superior en Medicina Clínica

Objective. To assess the quality and relevance of adverse drug reactions (ADRs) published as Letters to the Editor (LE) in Spanish medical journals. Design. Observational study. Participants. LE on adverse drug reactions published over 5 years (1994-98). Setting. Four Spanish medical journals (Medicina Clínica, Revista Clínica Española, Atención Primaria, and Anales de Medicina Interna). Main measurements. Patient characteristics, drugs, ADR, causality algorithm, minimum criteria, and publication relevance. Results. Out of 2,244 LE, 204 (9.1%) reported ADRs, which included 235 cases. The therapeutic subgroups most commonly implicated were anticoagulants and antiplatelet drugs, antibiotics, and antineoplastic agents; 20.4% of the drugs were recently marketed. ADRs most commonly involved the nervous system (13.6%), liver (10.2%), skin and appendages (9.8%), general reactions (9.8%), and the digestive system (8.1%). The reactions were moderate in 50.2% of cases and severe/fatal in 34%. The mean causality algorithm value (5.9±2.2) was similar among journals. Of the ADRs, 28 (11.9%) were definitive, 182 (77%) possible or probable, and 26 (11.1%) improbable or conditional; 10.2% were unknown. There were no differences in the mean minimum publication criteria (9.5±1.2). Publication relevance was 3.2±1.6 points, and higher in Medicina Clínica. Conclusions. ADRs constitute an important part of LE in the journals studied. The causal relationship is acceptable, the documentation quality is high, with few unknown reactions and ADRs to recently marketed drugs. Relevance is generally low, although greater in Medicina Clínica