Association between environmental predisposing risk factors and leg disorders in broiler chickens.

Footpad dermatitis and lameness are a major welfare concern in broiler chicken farming. In general, footpad lesions are linked to poor environmental conditions. Ulcers that arise from advanced lesions can negatively affect the gait of the birds, with effects on the animal welfare, including, in the worst cases, inability to reach the feed or water. In this study, the degree of footpad dermatitis and lameness was manually scored on 4 broiler farms across Europe, as part of an EU-wide welfare assessment program. The welfare of the chickens was assessed 3 times per production cycle (at wk 3, 4, and 5), scoring footpad dermatitis, lameness, and litter quality. In the same broiler farms, variables such as air temperature and relative humidity were automatically measured over the same period. These variables were combined into a widely accepted thermal comfort index and associated to upper and lower thresholds, which made it possible to quantify the percentage of time the birds spent out of the thermal comfort zone (POOC). The data was analyzed by combining data from the welfare assessments with environmental data collected by the automated monitoring systems. Considering the comparison between POOC classes, the highest probabilities of footpad dermatitis and lameness were obtained when POOC values exceeded the 70% threshold. Therefore, the analysis showed that footpad dermatitis and lameness were more frequent when the flock was exposed to poor environmental conditions for prolonged periods ( < 0.001). Since environmental conditions can be continuously measured, and the risk factor for footpad dermatitis and lameness increases with poor environmental conditions, there is the possibility to develop a detection and control system of severe lesions.

Monitorización de la presencia y distribución de platino y rodio en suelos urbanos de Alcalá de Henares (Madrid, España) / Monitoring the presence and distribution of platinum and rhodium in urban soils of Alcala de Henares (Madrid, Spain)

El constante desarrollo urbanístico y demográfico ha conllevado la aparición de nuevos riesgos para la salud humana en el medioambiente urbano. En los últimos años, se ha observado un fuerte incremento de la presencia de metales y metaloides en suelos urbanos, incluido la presencia de metales poco estudiados como los elementos del grupo del platino (PGE): platino (Pt), paladio (Pd) y rodio (Rh). Dada la creciente preocupación sobre los efectos nocivos de estos nuevos contaminantes para la salud humana, se han determinado los niveles de estos metales en los suelos de distintas zonas de Alcalá de Henares (Madrid). La acumulación de Pt y Rh ha sido significativamente inferior a las observadas en suelos de otras ciudades del mundo. La zona industrial y el centro urbano de la ciudad contienen significativamente niveles más elevados de PGEs debido al mayor volumen de tráfico, el tipo de conducción de parada/arranque, la actividad industrial y la cercanía del hospital Príncipe de Asturias. No obstante, los niveles encontrados parecerían implicar un riesgo mínimo para la salud de la población alcalaína, aunque son necesarios más estudios. Así, se hace necesario el establecimiento de dosis de referencia oral e inhalatoria (RfDo y RfCi) para PGEs, con el fin de establecer protocolos para proteger la salud humana en el medio urbano

The constant urban and demographic development has led to the emergence of new risks to human health in the urban environment. In recent years, there has been a sharp increase in the presence of metals and metalloids in urban soils, including the presence of metals little studied as the elements of the platinum group (PGE): platinum (Pt), palladium (Pd) and rhodium (Rh). Given the growing concern about the harmful effects of these new pollutants to human health, have determined the levels of these metals in the soils of different areas of Alcalá de Henares (Madrid). The accumulation of Pt and Rh has been significantly lower than those observed in soils from other cities. The industrial area and the center of the city contain significantly higher levels of PGEs due to the higher volume of traffic, type of driving stop / start, industrial activity and the proximity of Prince of Asturias hospital. However, the levels found appear to involve minimal risk to the health of the population alcalaína, although more studies are needed. Thus, the establishment of dose oral and inhalation reference (RfDo and RFCI) for PGEs is necessary, in order to establish protocols to protect human health in urban areas. although more studies are needed. Thus, the establishment of dose oral and inhalation reference (RfDo and RFCI) for PGEs is necessary, in order to establish protocols to protect human health in urban areas. although more studies are needed. Thus, the establishment of dose oral and inhalation reference (RfDo and RFCI) for PGEs is necessary, in order to establish protocols to protect human health in urban areas

Annual and seasonal variability of metals and metalloids in urban and industrial soils in Alcalá de Henares (Spain).

Contamination of urban and industrial soils with trace metals has been recognized as a major concern at local, regional and global levels due to their implication on human health. In this study, concentrations of aluminum (Al), arsenic (As), beryllium (Be), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), lead (Pb), tin (Sn), thallium (Tl), vanadium (V) and zinc (Zn) were determined in soil samples collected in Alcalá de Henares (Madrid, Spain) in order to evaluate the annual and seasonal variation in their levels. The results show that the soils of the industrial area have higher metals concentrations than the urban area. Principal component analysis (PCA) revealed that the two principal sources of trace metal contamination, especially Cd, Cu, Pb, and Zn in the urban soils of Alcalá can be attributed to traffic emissions, while As, Ni and Be primarily originated from industrial discharges. The seasonal variation analysis has revealed that the emission sources in the industrial area remain constant with time. However, in urban areas, both emissions and emission pathways significantly increase over time due to ongoing development. Currently, there is no hypothesis that explains the small seasonal fluctuations of trace metals in soils, since there are many factors affecting this. Owing to the fact that urban environments are becoming the human habitat, it would therefore be advisable to monitor metals and metalloids in urban soils because of the potential risks to human health.

"Reference values" of trace elements in the hair of a sample group of Spanish children (aged 6-9 years) - are urban topsoils a source of contamination?

Human hair is used as a biomonitor to evaluate the environmental exposure to contaminants in the individual. However, the use of human hair is controversial, mainly because reference levels for pollutants in hair have not yet been set. In the case of Spain, few biomonitoring studies have involved infants and children. A biomonitoring study was conducted to investigate the possible normal values of trace elements of toxicological concern in children aged 6-9 years from the city of Alcalá de Henares, Community of Madrid (Spain), following the methodology and strict inclusion criteria previously developed by our group. Levels of Al, As, Be, Cd, Cr, Cu, Hg, Mn, Ni, Pb, Sn, Ti, Tl, V and Zn were monitored in scalp-hair from 117 healthy children (47 boys and 70 girls) between April and May of 2001. The levels of trace elements here described could be considered as possible "reference values" for children aged 6-9 years resident in the Community of Madrid. These values might also be selected as a preliminary screening tool to evaluate if a Spanish child has been exposed to any of the contaminants studied here. This study also investigated whether local urban topsoils were a source of metals for this population.

Establishing the importance of human health risk assessment for metals and metalloids in urban environments.

Rapid development, industrialisation, and urbanisation have resulted in serious contamination of soil by metals and metalloids from anthropogenic sources in many areas of the world, either directly or indirectly. Exponential urban and economic development has resulted in human populations settling in urban areas and as a result being exposed to these pollutants. Depending on the nature of the contaminant, contaminated urban soils can have a deleterious effect on the health of exposed populations and may require decontamination, recovery, remediation and restoration. Therefore, human health risk assessments in urban environments are very important. In the case of Spain, there are few studies regarding risk assessment of trace elements in urban soils, and those that exist have been derived mainly from areas potentially exposed to industrial contamination or in the vicinity of point pollution. The present study analysed Al, As, Be, Cd, Cr, Cu, Hg, Mn, Ni, Pb, Sn, Ti, Tl, V and Zn soil concentrations in and around the city of Alcalá de Henares (35 km NE of Madrid). Soil samples were collected in public parks and recreation areas within the city and in an industrial area on the periphery of the city. From these results, an assessment of the health risk for the population was performed following the methodology described by the US EPA (1989). In general, it was observed that there could be a potential increased risk of developing cancer over a lifetime from exposure to arsenic (As) through ingestion of the soils studied (oral intake), as well as an increased risk of cancer due to inhalation of chromium (Cr) present in re-suspended soils from the industrial area. Our group has previously reported (Granero and Domingo, 2002; Peña-Fernández et al., 2003) that there was an increased risk of developing cancer following exposure to As in the same soils in a previous study. Therefore, it is necessary to reduce the levels of contaminants in these soils, especially As and Cr as these have been found to exceed safe levels for human health.

The importance of evaluating the physicochemical and toxicological properties of a contaminant for remediating environments affected by chemical incidents.

In the event of a major chemical incident or accident, appropriate tools and technical guidance need to be available to ensure that a robust approach can be adopted for developing a remediation strategy. Remediation and restoration strategies implemented in the aftermath of a chemical incident are a particular concern for public health. As a result an innovative methodology has been developed to help design an effective recovery strategy in the aftermath of a chemical incident that has been developed; the UK Recovery Handbook for Chemical Incidents (UKRHCI). The handbook consists of a six-step decision framework and the use of decision trees specifically designed for three different environments: food production systems, inhabited areas and water environments. It also provides a compendium of evidence-based recovery options (techniques or methods for remediation) that should be selected in relation to their efficacy for removing contaminants from the environment. Selection of effective recovery options in this decision framework involves evaluating the physicochemical and toxicological properties of the chemical(s) involved. Thus, the chemical handbook includes a series of tables with relevant physicochemical and toxicological properties that should be assessed in function of the environment affected. It is essential that the physicochemical properties of a chemical are evaluated and interpreted correctly during the development of a remedial plan in the aftermath of a chemical incident to ensure an effective remedial response. This paper presents a general overview of the key physicochemical and toxicological properties of chemicals that should be evaluated when developing a recovery strategy. Information on how physicochemical properties have impacted on previous remedial responses reported in the literature is also discussed and a number of challenges for remediation are highlighted to include the need to develop novel approaches to remediate sites contaminated by mixtures of chemicals as well as methods for interpreting chemical reactions in different environmental matrices to include how climate change may affect the speciation and mobility of chemicals in the environment.

Factors influencing recovery and restoration following a chemical incident.

Chemicals are an important part of our society. A wide range of chemicals are discharged into the environment every day from residential, commercial and industrial sources. Many of these discharges do not pose a threat to public health or the environment. However, global events have shown that chemical incidents or accidents can have severe consequences on human health, the environment and society. It is important that appropriate tools and technical guidance are available to ensure that a robust and efficient approach to developing a remediation strategy is adopted. The purpose of remediation is to protect human health from future exposure and to return the affected area back to normal as soon as possible. There are a range of recovery options (techniques or methods for remediation) that are applicable to a broad range of chemicals and incidents. Recovery options should be evaluated according to their appropriateness and efficacy for removing contaminants from the environment; however economic drivers and social and political considerations often influence decision makers on which remedial actions are implemented during the recovery phase of a chemical incident. To date, there is limited information in the literature on remediation strategies and recovery options that have been implemented following a chemical incident, or how successful they have been. Additional factors that can affect the approach taken for recovery are not well assessed or understood by decision makers involved in the remediation and restoration of the environment following a chemical incident. The identification of this gap has led to the development of the UK Recovery Handbook for Chemical Incidents to provide a framework for choosing an effective recovery strategy. A compendium of practical evidence-based recovery options (techniques or methods for remediation) for inhabited areas, food production systems and water environments has also been developed and is included in the chemical handbook. This paper presents the key factors that should be considered when developing a recovery strategy with respect to how these may impact on its effectiveness. The paper also highlights the importance of these factors through an evaluation of recovery strategies implemented following real chemical incidents that have been reported in the literature.

Monitoring lead in hair of children and adolescents of Alcalá de Henares, Spain. A study by gender and residential areas.

In recent years there has been an increased interest from the European Union (EU) in the development of large Human Bio-monitoring (HBM) studies across Europe, especially biomonitoring toxic metals. In Spain, most studies using hair as a biomarker have been conducted to determine occupational or industrial exposures, and have involved adult populations. Few studies have involved adolescents and children, despite these groups being sensitive to environmental contamination and pollutants. Therefore, the objective of the present study was to determine the degree of lead exposure in children and adolescents residing in Alcalá de Henares, Spain. Lead poisoning is the number one toxicological threat in the environment. So, lead (Pb) was selected as it is a persistent environmental contaminant, is measureable and is also a neurotoxin that can affect brain development. The city of Alcalá de Henares was divided into four zones to determine the influence of residence area on Pb levels. A range of other variables including age and gender were also considered within the study. The study comprised 115 children (6-9 years old) and 96 adolescents (13-16 years old). There was a significant difference between the levels of Pb in the hair of adolescents, for different gender and area of residence (p<0.001 and p<0.01 respectively). There was no significant difference in the Pb levels in hair of children, for different gender or area of the city. The levels of Pb were significantly (p<0.001) elevated in children compared to adolescents (1.48 vs. 0.70 µg/g), and there was a significant difference in Pb levels in male and female adolescent hair (0.53 vs. 0.77 µg/g) (p<0.001). The association observed between areas of residence and the Pb level in hair of the adolescent group could be mainly attributed to dietary habits and/or socioeconomic status.

[Effect of a global intervention in the integral control of multiple risk factors in patients at high or very high cardiovascular risk. CIFARC 2 project]. / Efecto de una intervención global sobre el control integral de múltiples factores de riesgo en pacientes con alto o muy alto riesgo cardiovascular. Estudio CIFARC 2.

OBJECTIVES: To analyze the effect of a global approach on patients with high cardiovascular risk for the integral control of cardiovascular risk factors. PATIENTS AND METHODS: Multicentric prospective study of patients with high vascular risk, followed-up for one year in internal medicine consultations. We measured the grade of control over major cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, tobacco, obesity) before and after the one-year follow-up period. RESULTS: We studied 456 patients (56% males; age: 66.1, standard deviation: 11.5 years); 54.4% were diabetics, 58.0% had target organ damage and 46.2% had cardiovascular disease. Blood pressure control varied from 50.5 to 60.6; LDL-cholesterol control from 44.7 to 58.1%; diabetes control from 56.5 to 56.6%; tobacco control from 63.0 to 87.5% and obesity control from 60.0 to 55.4%. Integral control of all cardiovascular risk factors varied from 10.7 to 23.2% of patients. Factors independently associated to lack of integral control were: diabetes (Odds Ratio [OR]: 4.42; 95% confidence interval [95%CI]: 2.75-7.14), basal systolic blood pressure (OR: 1.03; 95%CI 1.02-1.05) and basal body mass index (OR: 1.08; 95%CI: 1.02-1.14). Lack of integral control was independently associated to the incidence of cardiovascular events (OR: 2.00; 95%CI: 1.09-5.35). CONCLUSIONS: A global approach on the patient with high cardiovascular risk duplicated the integral control of the five main risk factors. Diabetes and obesity were factors which made integral control difficult. Lack of integral control increased two times the risk of cardiovascular events.

Efecto de una intervención global sobre el control integral de múltiples factores de riesgo en pacientes con alto o muy alto riesgo cardiovascular. Estudio CIFARC 2 / Effect of a global intervention in the integral control of multiple risk factors in patients at high or very high cardiovascular risk. CIFARC 2 project

Fundamento y objetivos. Analizar el impacto que tiene un abordaje global en consultas de Medicina Interna para controlar de forma integral todos los factores mayores de riesgo vascular. Pacientes y métodos. Estudio multicéntrico de cohorte, prospectivo, sobre pacientes con alto riesgo vascular seguidos durante un año en consultas de Medicina Interna. Se evaluó el grado de control de los factores mayores de riesgo vascular (hipertensión arterial, diabetes, colesterol ligado a lipoproteínas de baja densidad [c-LDL], tabaquismo y obesidad) al principio y al final del seguimiento y el número de recursos sanitarios consumidos para su control. Resultados. Se estudiaron 456 pacientes (56,9% varones; edad: 65,1 años; desviación estándar: 10,6 años). El 54,4% eran diabéticos, el 58% presentaban lesión de órgano diana y el 46,2% enfermedad cardiovascular. El porcentaje de pacientes con control inicial y final, respectivamente, de los distintos factores de riesgo fue: presión arterial el 50,55% y el 60,6% (p 0,05); tabaquismo el 63,0% y el 87,5% (p < 0,001), y obesidad el 60,0% y el 55,4% (p < 0,05). El control integral de todos los factores de riesgo basal y final fue el 10,7% y el 23,2% (p < 0,001). Se asociaron a la falta de control integral la diabetes (odds ratio [OR] 4,42; intervalo de confianza del 95% [IC 95%] 2,75-7,14), la presión arterial basal (OR 1,03; IC 95% 1,02-1,05) y el índice de masa corporal (OR 1,08; IC 95% 1,2-1,4). La falta de control integral se asoció con la incidencia de eventos vasculares (OR 2,00; IC 95% 1,09-5,35). Conclusiones. El abordaje global sobre el paciente con alto riesgo vascular consiguió duplicar al año el grado de control integral de los 5 principales factores de riesgo. La diabetes y la obesidad dificultaron el control. La falta de control integral incrementó en 2 veces el riesgo de eventos vasculares (AU)

Objectives. To analyze the effect of a global approach on patients with high cardiovascular risk for the integral control of cardiovascular risk factors. Patients and methods. Multicentric prospective study of patients with high vascular risk, followed-up for one year in internal medicine consultations. We measured the grade of control over major cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, tobacco, obesity) before and after the one-year follow-up period. Results. We studied 456 patients (56% males; age: 66.1, standard deviation: 11.5 years); 54.4% were diabetics, 58.0% had target organ damage and 46.2% had cardiovascular disease. Blood pressure control varied from 50.5 to 60.6; LDL-cholesterol control from 44.7 to 58.1%; diabetes control from 56.5 to 56.6%; tobacco control from 63.0 to 87.5% and obesity control from 60.0 to 55.4%. Integral control of all cardiovascular risk factors varied from 10.7 to 23.2% of patients. Factors independently associated to lack of integral control were: diabetes (Odds Ratio [OR]: 4.42; 95% confidence interval [95%CI]: 2.75-7.14), basal systolic blood pressure (OR: 1.03; 95%CI 1.02-1.05) and basal body mass index (OR: 1.08; 95%CI: 1.02-1.14). Lack of integral control was independently associated to the incidence of cardiovascular events (OR: 2.00; 95%CI: 1.09-5.35). Conclusions. A global approach on the patient with high cardiovascular risk duplicated the integral control of the five main risk factors. Diabetes and obesity were factors which made integral control difficult. Lack of integral control increased two times the risk of cardiovascular events (AU)

[Mesenteric panniculitis in the differential diagnosis of abdominal pain]. / La paniculitis mesentérica en el diagnóstico diferencial del dolor abdominal.

Mesenteric panniculitis is a rare disease affecting adipose tissue of the mesentery that may result in the development of large masses in the abdomen. Diffuse chronic or intermittent abdominal pain is the most frequent symptom. It usually follows a benign course though surgery is sometime needed. We describe a patient with recurrent abdominal pain who was diagnosed of mesenteric panniculitis. An abdominal CT scan oriented to the diagnosis and an open laparotomy and biopsy was needed for a definitive diagnosis. A brief review of the literature is added.

[Cyclosporin A in the treatment of Eaton-Lambert myasthenic syndrome]. / Ciclosporina-A como tratamiento del síndrome miasteniforme de Eaton-Lambert.

The Lambert-Eaton myasthenic syndrome (LEMS) is a disorder of he cholinergic neurotransmition at the presinaptic terminal of the neuromuscular junction. Clinically it is characterized by muscular weakness, hyporeflexia and autonomic dysfunction. In this entity thet presence of antibodies against calcium channels impair acetylcholine release. Whe used cyclosporin-A in a patient with LEMS and this resulted in a complete clinical and neurophysiological recovery after four months of therapy.