Ecotoxicological risk assessment in soils contaminated by Pb and As 20 years after a mining spill.

This study evaluates the potential toxicity of the soils of the Guadiamar Green Corridor (GGC) affected by the Aznalcóllar mine spill (Andalusia, Spain), one of the most important mining accidents in Europe in recent decades. Twenty years after the accident, although the area is considered to be recovered, residual contamination in soils persists, and the bioavailability of some contaminants, such as As, is showing trends of increasing. Therefore, the potential residual toxicity in 84 soil samples was evaluated by bioassays with lettuce (Latuca sativa L.), earthworms (Eisenia andrei) and determining the microbial activity by basal respiration and metabolic quotient. The selected soils sampled along the GGC were divided into 4 types according to their physicochemical properties. In the closest part of the mine two soil types appear (SS1 and SS2), originally decarbonated and loamy, with a reduction in lettuce root elongation of 57% and 34% compared to the control, as well as a the highest metabolic quotient (23.9 and 18.1 ng CcO2 µg Cmicrob-1 h-1, respectively) with the highest risk of Pb and As toxicity. While, located in the middle and final part of the affected area of the spill (SS3 and SS4), soils presented alkaline pH, finer textures and the lowest metabolic quotient (<9.5 ng CcO2 µg Cmicrob-1 h-1). In addition, due to Pb and As exceeded the Guideline values established in the studied area, the human toxicity risk was determined according to US-EPA methodology. Although the total contents were higher than the Guidelines established, the obtained hazard quotients for both contaminants were less than one, so the risk for human health was discarded. However, monitoring over time of the toxicity risks of the GGC soils would be advisable, especially due to the existence of areas where residual contamination persist, and soil hazard quotient obtained for As in children was higher and close to unity.

Detection and Characterization of TiO2 Nanomaterials in Sludge from Wastewater Treatment Plants of Chihuahua State, Mexico.

TiO2 nanoparticles (TiO2-NPs) have a wide range of industrial applications (paintings, sunscreens, food and cosmetics) and is one of the most intensively used nanomaterials worldwide. Leaching from commercial products TiO2-NPs are predicted to significantly accumulate in wastewater sludges, which are then often used as soil amendment. In this work, sludge samples from four wastewater treatment plants of the Chihuahua State in Mexico were obtained during spring and summer (2017). A comprehensive characterization study was performed by X-ray based (laboratory and synchrotron) techniques and electron microscopy. Ti was detected in all sludge samples (1810-2760 mg/kg) mainly as TiO2 particles ranging from 40 nm up to hundreds of nm. Micro-XANES data was analyzed by principal component analysis and linear combination fitting enabling the identification of three predominant Ti species: anatase, rutile and ilmenite. Micro-XANES from the smaller Ti particles was predominantly anatase (68% + 32% rutile), suggesting these TiO2-NPs originate from paintings and cosmetics. TEM imaging confirmed the presence of nanoscale Ti with smooth surface morphologies resembling engineered TiO2-NPs. The size and crystalline phase of TiO2-NPs in the sludge from this region suggest increased reactivity and potential toxicity to agro-systems. Further studies should be dedicated to evaluating this.

Arsenic Distribution Assessment in a Residential Area Polluted with Mining Residues.

Mining is a major source for metals and metalloids pollution, which could pose a risk for human health. In San Guillermo, Chihuahua, Mexico mining wastes are found adjacent to a residential area. A soil-surface sampling was performed, collecting 88 samples for arsenic determination by atomic absorption. Arsenic concentration data set was interpolated using the ArcGis models: inverse distance weighting (IDW), ordinary kriging (OK), and radial basis function (RBF). For method validation purposes, a set of the data was selected and two tests were performed (P1 and P2). In P1 the models were processed without the validation data; in P2 the validation data were removed one by one, models were processed every time that a data point was removed. An arsenic concentration range of 22.7 to 2190 mg/kg was reported. The 39% of data set was classified as contaminated soil and 61% as industrial land use. In P1 the method of interpolation with the lowest RMSE was RBF (0.80), the highest coefficient of E was RBF (46.25), and the highest Ceff value was with RBF (0.48). In P2 the method with the lowest RMSE was OK (0.76), the highest E value was 50.65 with OK, and the Ceff reported the highest value with OK (0.52). The high arsenic contamination in soil of the site indicates an abundant dispersion of this metalloid. Furthermore, the difference between the models was not very wide. The incorporation of more parameters would be of interest to observe the behavior of interpolation methods.

Simulation of arsenic retention in constructed wetlands.

The software RCB-arsenic was developed previously to simulate the metalloid behavior in a constructed wetland (CW). The model simulates water flow and reactive transport by contemplating the major processes of arsenic (As) retention inside of CW. The objective of this study was to validate the RCB-arsenic model by simulating the behavior of horizontal flow CW for As removal from water. The model validation was made using data from a 122-day experiment. Two CWs prototypes were used: one planted with Eleocharis macrostachya (CW_planted) and another one unplanted (CW_unplanted) as a control. The prototypes were fed with synthetic water prepared using well water and sodium arsenite (NaAsO2). In the RCB-arsenic model, a CW prototype was represented using a 2D mesh sized in accordance with the experiment. For simulation of As retention in CW, data addition was established in two stages that considered the mechanisms in the system: (1) aqueous complexation, precipitation/dissolution, and adsorption on granular media and (2) retention by plants: uptake (absorption) and rhizofiltration (adsorption). Simulation of As outlet (µg/L) in stage_1 was compared with CW_unplanted; the experimental mean was 40.79 ± 7.76 and the simulated 39.96 ± 6.32. As concentration (µg/L) in stage_2 was compared with CW_planted, the experimental mean was 9.34 ± 4.80 and the simulated 5.14 ± 0.72. The mass-balance simulation and experiment at 122 days of operation had a similar As retention rate (94 and 91%). The calibrated model RCB-arsenic adequately simulated the As retention in a CW; therefore, it constitutes a powerful tool of design.

Effects of repeated electroejaculations on kinematic sperm subpopulations and quality markers of Mexican creole goats.

Here we show the effects of repeated electroejaculation (EE) on mean values of motility, mitochondrial functionality, and expression of active caspases on goat sperm obtained by EE. Evaluations were done using CASA and flow cytometry. A strategy for identification of kinematic sperm subpopulations, when individual data of sperm are not provided by the CASA system, is provided. Fifty semen samples, five of each of ten adult creole goats, were obtained by electroejaculation. Mean values of total motility, progressive motility and flow cytometry evaluations were compared among EEs. Relationships among mean values of variables were investigated using Spearman correlation and principal component analysis (PCA). For identification of kinematic sperm subpopulations, PCA followed by hierarchical clustering was applied on data of the intervals provided automatically by the CASA system. Total motility does no change after repeated EE. Mean values of motility parameters and molecular markers were unrelated in multivariate space, but bivariate correlations were found. Values in upper and lower intervals defined clearly the sperm subpopulations, which had motility parameters changing over time. Taken together, our results show that repeated EE does not affect mean values of total motility, that molecular markers are not related with motility parameters, and that it is possible to identify kinematic sperm subpopulations when individual data, of motility parameters, are not provided by the CASA system.

Psychosocial factors influencing the frequency of fast-food consumption among urban and rural Costa Rican adolescents.

OBJECTIVE: The aim of this study was to identify psychosocial factors that influence fast-food consumption in urban and rural Costa Rican adolescents. METHODS: A self-administered questionnaire designed for the study asked about sociodemographic information, frequency of fast-food consumption, meaning of "fast food," location of purchase, and psychosocial correlates. Five psychosocial factors were extracted by using principal components analysis with Varimax rotation method and eigenvalues. Descriptive statistics and a hierarchical linear regression model were used to predict the frequency of fast-food consumption. RESULTS: Responses from 400 adolescents (ages 12-17 y) reveal that daily consumption of fast food was 1.8 times more frequently mentioned by rural adolescents compared with urban youth. Urban and rural differences were found in the way adolescents classified fast foods (rural adolescents included more traditional foods like chips, sandwiches, and Casado-a dish consisting of rice, black beans, plantains, salad, and a meat), and in purchasing locations (rural adolescents identified neighborhood convenience stores as fast-food restaurants). Living in rural areas, convenience and availability of foods, and the presence of external loci of control were predictors of a higher frequency of fast-food consumption, whereas health awareness predicted a lower frequency. CONCLUSIONS: The development of interventions to reduce fast-food consumption in Costa Rican adolescents should consider not only convenience, but also the availability of these foods where adolescents are more exposed, particularly in rural areas. Interventions such as improving the convenience of healthy fast foods available in school canteens and neighborhood stores, policies to increase the price of unhealthy fast food, and activities to provide adolescents with the skills to increase self-efficacy and reduce the effect of external loci of control are recommended.

Changes in dietary intake and food sources of saturated and cis and trans unsaturated fatty acids in Costa Rican adolescents: 1996 versus 2006.

OBJECTIVE: To identify how dietary intake and food sources of saturated (SFA) and cis (PUFA) and trans (TFA) unsaturated fatty acids in the diet of Costa Rican adolescents changed from 1996 to 2006--a period with several public health nutrition changes. METHODS: Cross-sectional comparisons used data from measured food records of 133 adolescents (ages 12-17 y) surveyed in 1996 and a similar group of adolescents surveyed in 2006. Values obtained in 1996 and 2006 were compared with the current World Health Organization guidelines for chronic disease prevention. RESULTS: Adolescents surveyed in 2006 reported a significantly higher mean daily energy intake from linoleic acid (LA) and alpha-linolenic acid (ALA) (0.9% and 7.8%, respectively) compared with the 1996 cohort, whereas SFA and TFA were significantly lower (9.5% and 1.3%, respectively). Food sources of fat also changed. In 2006, 2% of SFA in the diet came from palm shortening (compared with 34% in 1996); 39% of TFA came from ruminant-derived foods (in 1996, soybean oil was the main contributor of TFA, 34%), and bakery products (mainly pre-packaged cookies) provided 25% of the source of TFA, compared with only 11% in 1996. Dietary fatty intake of Costa Rican adolescents in 2006 is closer to WHO guidelines compared with 1996. CONCLUSIONS: After public health initiatives that changed fatty acid profile of most foods, intakes of TFA, SFA, and food sources of fatty acids in adolescents' diets improved. Public health nutrition efforts should continue to strengthen diets that are low in SFA and TFA and higher in ALA content among Costa Rican adolescents.

Salud(es) y nacimiento(s): sentidos y prácticas sobre el embarazo, parto y posparto en mujeres que asisten a un hospital público bonaerense / Health (s) and birth (s): senses and practices on pregnancy, childbirth and postpartum in women attended in a public hospital in buenos aires province

INTRODUCCIÓN La medicalización de los procesos sexuales y reproductivos ha naturalizado su consideración como procesos médicos. Hablar de salud(es) y nacimiento(s) implica asumir la posibilidad de coexistencia de diversidad de sentidos y prácticas relacionadas con esos procesos, OBJETIVOS Observar, describir e interpretar los sentidos y prácticas de salud en torno a los procesos de embarazo, parto y posparto en el sistema público y su relación con los distintos modelos de atención de la salud. MÉTODOS El estudio se llevó a cabo en el Hospital Zonal de Agudos Dr. Ricardo Gutiérrez (La Plata, Provincia de Buenos Aires); con una perspectiva etnográfica basada en observación participante y entrevistas no directivas realizadas en diversos ámbitos hospitalarios y extrahospitalarios, a mujeres, sin restricción etaria, ni de adscripción étnica, ni de clase social, residentes en la Ciudad de La Plata durante la investigación, que cursasen los procesos de embarazo, parto y posparto. RESULTADOS La preponderancia del discurso del Modelo Médico Hegemónico en el ámbito hospitalario limitó la posibilidad de aprehender sentidos y prácticas relativas a la salud reproductiva de las mujeres; sin embargo, estos fueron puestos de manifiesto durante las entrevistas y charlas informales. DISCUSIÓN en el espacio institucional los sentidos y prácticas de las mujeres sobre el embarazo, parto y posparto son invisibilizados y supeditados a los del Modelo Médico Hegemónico. De modo que los enfoques interculturales tienen aún mucho que aportar para recuperar saberes y poner en diálogo distintos modelos de atención de la salud.

Retinoic acid reduces chemotherapy-induced neuropathy in an animal model and patients with lung cancer.

OBJECTIVE: To evaluate the effect of all-trans retinoic acid (ATRA) as treatment for chemotherapy-induced peripheral neuropathy in an experimental animal model and in a randomized, double-blinded, controlled trial in patients with non-small-cell lung cancer (NSCLC). METHODS: Forty male Wistar rats were randomized in 5 groups: group A, control; groups B and C, treated with cisplatin; and groups D and E, treated with paclitaxel. ATRA (20 mg/kg PO) was administered for 15 days in groups C and E. We evaluated neuropathy and nerve regeneration-related morphologic changes in sciatic nerve, the concentration of nerve growth factor (NGF), and retinoic acid receptor (RAR)-α and RAR-ß expression. In addition, 95 patients with NSCLC under chemotherapy treatment were randomized to either ATRA (20 mg/m(2)/d) or placebo. Serum NGF, neurophysiologic tests, and clinical neurotoxicity were assessed. RESULTS: The experimental animals developed neuropathy and axonal degeneration, associated with decreased NGF levels in peripheral nerves. Treatment with ATRA reversed sensorial changes and nerve morphology; this was associated with increased NGF levels and RAR-ß expression. Patients treated with chemotherapy had clinical neuropathy and axonal loss assessed by neurophysiology, which was related to decreased NGF levels. ATRA reduced axonal degeneration demonstrated by nerve conduction velocity and clinical manifestations of neuropathy grades ≥2. CONCLUSIONS: ATRA reduced chemotherapy-induced experimental neuropathy, increased NGF levels, and induced RAR-ß expression in nerve. In patients, reduction of NGF in serum was associated with the severity of neuropathy; ATRA treatment reduced the electrophysiologic alterations. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that ATRA improves nerve conduction in patients with chemotherapy-induced peripheral neuropathy.

Nutritional status and associated factors in children aged 0-23 months in Granada, Nicaragua.

OBJECTIVES: Nicaragua is one of two low-income countries in the Latin Americas. The objectives of this study were to clarify the nutritional status of children aged 0-23 months and to identify the associated factors in rural Nicaragua. STUDY DESIGN AND METHODS: This was a cross-sectional study; a questionnaire survey was performed and anthropometric measurements were taken in Granada province, Nicaragua. RESULTS: Seven hundred and fifty-six mothers with at least one child aged 0-23 months took part in this study. The proportion of underweight children [weight-for-age Z-score <-2 standard deviations (SD)] was 10.3%, while 30.1% of children exhibited stunted growth (height-for-age Z-score <-2 SD) and 5.0% were wasted (weight-for-height Z-score <-2 SD). Mothers' illiteracy or lack of formal education [odds ratio (OR)=3.476, P<0.01], a history of respiratory infection (OR=1.821, P<0.05) and a birth weight below the median (<3000 g; OR=1.704, P<0.05) were identified as risk factors for stunted growth. Breastfeeding for more than 12 months (OR=2.031, P<0.01), absence of participation in child growth monitoring (OR=1.956, P<0.05) and female gender of the child (OR=1.884, P<0.05) were identified as risk factors for underweight. DISCUSSION: Despite the steady economic development in Nicaragua since 1990, child nutritional status has not improved as much as might be expected. The present study revealed that a mother's favourable sociodemographic characteristics and her active participation in health activities, such as child growth monitoring, can protect against child malnutrition, particularly against underweight. More attractive health education or antenatal care programmes might lead to substantial improvements in maternal and child health in this small, poor community.

Waterborne outbreak among Spanish tourists in a holiday resort in the Dominican Republic, August 2002.

On 3 September 2002, the Spanish national centre of epidemiology (Centro Nacional de Epidemiologia--CNE) was alerted to a high number of gastroenteritis cases in Spanish tourists who had travelled to a hotel in Punta Cana on different days during august 2002. Entamoeba hystolitica cysts have been visualised by microscopy in the stools of several patients that sought medical attention in the Dominican Republic. The CNE informed the health authorities in the Dominican Republic and conducted in conjunction an epidemiological investigation. A descriptive study of the 76 initial cases estimated a mean illness duration of 5.1+2.9 days and a exposure period of 3.6+2.2 days. Following a retrospective cohort study, the attack rate was found to be 32.4%. Consequently, 216 (95% CI=114.75-317.25) spanish tourists had probably developed the illness. Stool samples were collected in Spain from untreated patients who still felt unwell. None of the samples were positive for E.hystolitica. On 10 September, a hygiene inspection was undertaken at the hotel. Samples of the ice and meals served at the buffet that day, yielded coliform bacteria. Consumption of water from the resort water system was the only risk factor associated with the symptoms (RR= 3.55; 95% CI =1.13-10.99). To avoid similar outbreaks occurring again at the hotel, it is essential to regularly monitor the water quality and to improve food handling hygiene standards. Basic food hygiene training for food handlers should be mandatory. An international guideline for the management foodborne and waterborne outbreaks among tourists in holiday resorts should be drawn up, involving all competent authorities of both destination and tourist origin countries.

[Non-convulsive epileptic status associated with Lafora disease: two case reports]. / Estado epiléptico no convulsivo asociado a enfermedad de Lafora: presentación de dos casos.

INTRODUCTION: Lafora s disease is a type of progressive myoclonic epilepsy with poor prognosis, is characterized by myoclonic crisis, tonic clonic seizures, absence or partial complex seizures and other neurological manifestations with a progressive course and a poor response to the treatment. It has not been considered as a cause of epileptic status. CASE REPORTS: Two women without important past medical history with normal psychomotor development before their suffering, with manifestations of 2 years of evolution the first one and 8 years on the second case characterized by myoclonic generalized, partial complex seizures and progressive deterioration of the mental functions that joined to our institution in a non convulsive epileptic status and they featured with a different evolution. The first patient with favorable control of the event with a single medication and functionality recover later, the second one with torpid evolution complicated with an epileptic status convulsive widespread condition and a prolonged permanency in the unit of intensive therapy. In both patients the diagnosis of Lafora s disease was established based in the findings of the skin axilar biopsy. DISCUSSION AND CONCLUSION: We believe that Lafora s disease must be suspected as a probable cause of non convulsive epileptic status in patients with myoclonic epilepsy associated with other neurological manifestations and a refractary response to the medical treatment. The evolution and clinical response will depend on the evolutionary stage of the disease.

Tratamiento de la disfonía espástica con inyección de toxina botulínica / Botilinum toxin management of spastic dysphonia

La disfonía espástica se caracteriza por movimientos involuntarios y espasmos hiperfuncionales de la laringe. Aronson la clasifica en dos tipos: de abducción y de aducción, siendo la última más frecuente. El diagnóstico se realiza clínicamente y con estudios como nasofibrolaringoscopia, análisis acústico, videolaringoestroboscopia, electromiografía y estudios aerodinámicos. Se han utilizado múltiples tratamientos incluyendo psicoterapia, farmacoterapia, terapia de voz y diversos procedimientos quirúrgicos sin obtener resultados alentadores. Alan Scott introduce en 1980 el uso de Toxina Botulínica tipo A para el manejo de movimientos distónicos y desde 1984 se ha utilizado para el manejo de la disfonía espástica. Se realizó un estudio prospectivo entre enero del 2000 y febrero del 2002 en el Hospital Militar Central en 12 pacientes con disfonía espástica de aducción a quienes se les realizó inyección de 1.25 a 2.5 U de Toxina Botulínica tipo A en el músculo tiroaritenoideo de manera bilateral con guía electromiográfica. En los 12 pacientes se encontró algún grado de mejoría subjetiva dado por una mejor calidad de la voz y disminución del componente espástico, al igual que se observaron cambios objetivos en el análisis fonoaudiológico y en la videolaringoestroboscopia. La duración del efecto fue entre 10 y 16 semanas, momento en el cual se realizó una nueva inyección. Sólo cinco pacientes presentaron efectos secundarios leves y transitorios. Para realizar el procedimiento es necesario contar con un equipo multidisciplinario formado por los servicios de otorrinolarin gología, fonoaudiología, psicología y neurología. A pesar de que la duración del efecto es corta, sigue siendo una terapia útil ya que produce satisfacción en el paciente y tiene mínimos efectos secundarios. Con este estudio se corrobora la efectividad de este tipo de terapia constituyendo el tratamiento de elección para el control sintomático de la disfonía espástica

Mediastinitis necrotizante descendente / Descendant necrotic mediastinitis

Se presentan dos casos de mediastinitis necrotizante descendente, posteriores a absceso retrofaríngeo que fueron manejados por los autores en la Clínica Vascular Navarra y en la Clínica San Rafael. Se revisa esta patología infrecuente con el fin de que sea reconocida como una posible complicación mortal de faringoamigdalitis logrando un tratamiento temprano apropiado con el fin de evitar un desenlace fatal

[Increasing decayed, missing and filled teeth index among school children in Loja, Spain]. / Incremento del índice de dientes permanentes cariados, perdidos por caries y obturados, entre escolares de Loja, España.

OBJECTIVE: To identify the clinical, socioeconomic, dietary, and hygienic predictors of the increasing Decayed, Missing, and Filled Teeth (DMFT) index, in a cohort of school children in Loja, Granada, Spain, during a three-year period (1994-1997). MATERIAL AND METHODS: A retrospective cohort study was conducted in 812 students to measure the DMFT index, using the methods recommended by the World Health Organization. Statistical analysis was conducted using logistic regression models. RESULTS: During the study period, the DMFT index increased from 1.86 to 4.5 for the study cohort as a whole, and from 3.71 to 4.47 among twelve-year olds. The DMFT at mid-period was associated to an increase in the final DMFT. The relative risk for attending school no. 3 was 0.69 (95% CI 0.60-0.8) vs. school no. 4, and 0.78 (95% CI 0.67-0.90) vs. school no. 5. CONCLUSIONS: The final model showed that the DMFT at mid-period was a risk factor for an increase in the DMFT index and that attending school number 3 was a protective factor.

Síndrome de mobius unilateral / Unilateral mobius syndrome

El síndrome de Mobius es una entidad caracterizada por parálisis del VI y VII par, pudiendo existir compromiso de otros pares craneanos o asociación a alteraciones de la pared torácica, retardo mental y alteraciones de las extremidades. Normalmente es de presentación bilateral, pero puede presentarse en forma unilateral. El presente reporte muestra el caso de una paciente de 15 años de edad quién consulta por presentar parálisis facial congénita unilateral y VI par ipsilateral; siendo estas sus únicas manifestaciones clínicas

[Cholera epidemiology in Mozambique: 1973-1992]. / Epidemiologia da cólera em Moçambique no período de 1973-1992.

The results of an epidemiological analysis of cholera in Mozambique from 1973 to 1992 are described. The project sought to assess the influence of socio-economic and ecological factors the spread of cholera in a country at war. Information about the incidence of cholera and the fatality rate were related to the rainfall and the annual average growth rate of the population in the main cities. Water supply, sanitation and food hygiene were also studied. The high annual average growth rate of the population was found to have a direct linear correlation to the incidence of cholera. The drought of 1991-1992 also played an important role in the increased number of cases of the disease. Cholera has presented an endemic-epidemic pattern determined by: a) the uncontrolled growth of urban population, b) the deterioration of sanitation in urban centers, c) the unhygienic commercialization of food and d) the drought.

[Clinical, echocardiographic and hemodynamic sequence in cerebral arteriovenous fistula]. / La secuencia clínica, ecocardiográfica y hemodinámica en la fístula arteriovenosa cerebral.

It is presented a fatal case of cerebral arteriovenous tube in which it was obtained clinical, radiological, electric, echocardiographic and haemodinamic sequencial information since the birth. Data suggested biventricular overcharge's existence initially without cardiac insufficiency. Finally appeared right ventricular expansion's data and biventricular hypertrophy, with left ventricular fluxe's diminution and cardiac insufficiency's data and shock.