Caffeinated coffee consumption and risk of atrial fibrillation in two Spanish cohorts.

AIMS: The association between caffeinated coffee consumption and atrial fibrillation remains unclear. Recent studies suggest an inverse association only between a moderate caffeinated coffee consumption and atrial fibrillation, but others have reported no association. The aim of our study was to prospectively assess the association between caffeinated coffee consumption and atrial fibrillation in two Spanish cohorts, one of adults from a general population and another of elderly participants at high cardiovascular risk. METHODS AND RESULTS: We included 18,983 and 6479 participants from the 'Seguimiento Universidad de Navarra' (SUN) and 'Prevención con Dieta Mediterránea' (PREDIMED) cohorts, respectively. Participants were classified according to their caffeinated coffee consumption in three groups: ≤3 cups/month, 1-7 cups/week, and >1 cup/day. We identified 97 atrial fibrillation cases after a median follow-up of 10.3 years (interquartile range 6.5-13.5), in the SUN cohort and 250 cases after 4.4 years median follow-up (interquartile range 2.8-5.8) in the PREDIMED study. No significant associations were observed in the SUN cohort although a J-shaped association was suggested. A significant inverse association between the intermediate category of caffeinated coffee consumption (1-7 cups/week) and atrial fibrillation was observed in PREDIMED participants with a multivariable-adjusted hazard ratio = 0.53 (95% confidence interval 0.36-0.79) when compared with participants who did not consume caffeinated coffee or did it only occasionally. No association was found for higher levels of caffeinated coffee consumption (>1 cup per day), hazard ratio = 0.79 (95% confidence interval 0.49-1.28). In the meta-analysis of both PREDIMED and SUN studies, the hazard ratio for intermediate consumption of caffeinated coffee was 0.60 (95% confidence interval 0.44-0.82) without evidence of heterogeneity. Similar findings were found for the association between caffeine intake and atrial fibrillation risk. CONCLUSION: Intermediate levels of caffeinated coffee consumption (1-7 cups/week) were associated with a reduction in atrial fibrillation risk in two prospective Mediterranean cohorts.

Dietary intake and major food sources of polyphenols in a Spanish population at high cardiovascular risk: the PREDIMED study.

BACKGROUND AND AIMS: Epidemiological data have shown an inverse association between the consumption of polyphenol-rich foods and the risk of cardiovascular disease or overall mortality. A comprehensive estimation of individual polyphenol intake in nutritional cohorts is needed to gain a better understanding of this association. The aim of this study was to estimate the quantitative intake of polyphenols and the major dietary sources in the PREDIMED (PREvención con DIeta MEDiterránea) cohort using individual food consumption records. METHODS AND RESULTS: The PREDIMED study is a large, parallel-group, multicentre, randomised, controlled 5-year feeding trial aimed at assessing the effects of the Mediterranean diet on the primary prevention of cardiovascular disease. A total of 7200 participants, aged 55-80 years, completed a validated 1-year food frequency questionnaire (FFQ) at baseline. Polyphenol consumption was calculated by matching food consumption data from the FFQ with the recently developed Phenol-Explorer database on polyphenol content in foods. The mean total polyphenol intake was 820 ± 323 mg day⁻¹ (443 ± 218 mg day⁻¹ of flavonoids and 304 ± 156 mg day⁻¹ of phenolic acids). Hydroxycinnamic acids were the phenolic group with the highest consumption and 5-caffeoylquinic acid was the most abundantly ingested individual polyphenol. The consumption of olives and olive oil was a differentiating factor in the phenolic profile of this Spanish population compared with other countries. CONCLUSION: In Mediterranean countries, such as Spain, the main dietary source of polyphenols is coffee and fruits, but the most important differentiating factor with respect to other countries is the consumption of polyphenols from olives and olive oil.

Distribution and temporal evolution of pharmaceutically active compounds alongside sewage sludge treatment. Risk assessment of sludge application onto soils.

In this work, the distribution and the ecotoxicological risk of sixteen pharmaceutically active compounds belonging to seven different therapeutic groups (five anti-inflammatory drugs, two antibiotics, an anti-epileptic drug, a ß-blocker, a nervous stimulant, four estrogens and two lipid regulators) have been studied in sewage sludge from wastewater treatment plants. Only three of the sixteen pharmaceutical compounds were never detected in sludge while eleven of the studied pharmaceuticals were still detected in compost. Mean concentration levels of the pharmaceutically active compounds ranged between 24.9 and 4105 µg/kg dm, 14.5-944 µg/kg dm, 3.29-636 µg/kg dm and 9.19-974 µg/kg dm in primary, secondary, digested sludge and compost, respectively. An increase in the concentration levels of most of the pharmaceuticals was observed from summer to winter (mean values in primary and secondary sludge were 304 and 85.1 µg/kg dm in summer and 435 and 175 µg/kg dm in winter, respectively) probably due to an increase of their consumption during the coldest season and a reduction of the microbial activity under colder temperatures. The highest ecotoxicological risk, in digested sludge and compost, was due to the estrogenic compound 17ß-estradiol. The ecotoxicological risk significantly decreased after the application of digested sludge or compost to the soils (risk quotient values ranged between 0.04 and 252 in digested sludge and 0.002-37.8 in compost and decreased to 8·10(-4)-1.92 in digested sludge-amended soil and 1·10(-4)-0.23 in compost-amended soil).

Normal values for serum, ultrafilterable and intraerythrocytic magnesium in children.

Serum magnesium (MgS), levels were determined in 137 children age range 2 months to 16 years. Ultrafilterable magnesium (MgU) and intraerythrocytic magnesium (MgI) concentrations were determined in 37 of these children. MgS was 0.83 +/- 0.1 mmol/L (range 0.66-1.36 mmol/L), with no differences between sexes. Children under 2 years had higher MgS levels (0.92 +/- 0.13 mmol/L) than children over 2 years (0.81 +/- 0.08 mmol/L; p < .001). Mean MgU was 0.60 +/- 0.07 mmol/L (range 0.50-0.87 mmol/L), with no differences between sexes. Mean MgI in children was 2.58 +/- 0.33 mmol/L (range 2.06-3.6 mmol/L), with no differences between sexes. MgS correlated with MgU, age, theoretical growth rate, and serum calcium, phosphorus and alkaline phosphatase; MgU correlated with MgI, age, theoretical growth rate, and serum phosphorus. MgS concentration was higher in children under 2 years than in children over 2 years. In healthy children, MgS concentration correlated with MgU, and MgU correlated with MgI, but MgS and MgI showed no correlation.

[Combined treatment of gaseous gangrene with hyperbaric oxygen therapy, surgery and antibiotics. A national cooperative multicenter study]. / Tratamiento combinado de la gangrena gaseosa con oxigenoterapia hiperbárica, cirugía y antibióticos. Estudio colaborativo multicéntrico nacional.

85 confirmed gas gangrene cases from general hospitals where hyperbaric oxygen chambers with single or multiple places are available were reviewed. The diagnosis was made on the basic of muscle necrosis with the characteristic color and odor of the wound, and suggestive clinical and bacteriological findings. The treatment consisted on surgical excision, multiple antibiotic therapy, and hyperbaric oxygen at 3 absolute atmospheres. There was a male predominance (76.5%); 49.4% of them had previous risk factors; the origin of the disease was spontaneous in 18.8% of cases, after trauma in 37.6%, and after surgery in 43.5%. The surgery had been orthopedic in 18.8%, vascular in 16.5% and other in 1.2%. The lesion was in the lower limbs in 71.8%, with abdominal origin of propagation in 18.8% and perineal propagation in 8.2%. 44.7% of patients had shock on admission. The outcome was good in 50.6% of patients, who had a full recovery, and fair in 16.5%, who had minor sequelae or small re-amputations; this amounts to 67.1% of satisfactory evolutions. Outcome was poor in 20% in whom amputation or other major surgical procedures were required (p less than 0.05). Overall mortality rate was 20%, although only in 12.9% death directly related with gas gangrene. Mortality was significantly higher in women, in abdominal localization, and in patients with shock. It was 37.5% in spontaneous and 29.7% in postsurgical cases. There was no death in traumatic cases (p less than 0.005). Death directly related with the disease occurred in the first three days and nonrelated death after two weeks. More severe cases could be cared for in hospitals where multiple place hyperbaric oxygen chambers were available than in those with single place chambers, with a definite outcome towards cure or death with less intermediate situations. The relevant literature is reviewed. It is concluded that this combined therapeutic schedule has the best efficacy to treat gas gangrene, particularly in the more severe forms.