Impact of hypochloremia as a prognostic factor in patients with heart failure, a retrospective cohort study.

BACKGROUND: some studies suggest that hypochloremia is a risk factor in the prognosis of heart failure (HF) in patients with recent decompensation. MATERIALS AND METHODS: retrospective cohort study of patients discharged due to HF decompensation who began follow-up in a specialized clinic. Two groups are defined: patients with hypochloremia (chloride < 98 mmol/L) and normochloremic patients (chloride > 98 mmol/L) in the initial assessment within the first month after discharge. The rate of intravenous diuretic rescue, emergency department visits, readmission for HF and cardiovascular (CV) death are compared using a Cox proportional hazards model. RESULTS: 165 patients were included (59% women, mean age 85 years), with 60 (36%) having hypochloremia. Both groups were comparable in terms of baseline characteristics, except for female sex, presence of peripheral artery disease, moderate-to-severe liver disease (more prevalent in the hypochloremia group), PROFUND index, and baseline furosemide dose (higher in patients with hypochloremia). The incidence of the primary event was higher in subjects with hypochloremia than in normochloremic subjects (HR: 1.59, 95% CI 0.97-2.62), mainly due to the need for intravenous diuretic rescue (HR: 1.86, 95% CI 1.07-3.24). CONCLUSIONS: hypochloremia following admission for HF decompensation is associated with a greater need for intravenous diuretic rescue therapy and probably worse overall prognosis across the spectrum of the disease, regardless of left ventricular ejection fraction (LVEF).

Ondas de choque. Evidencias y recomendaciones SETOC (Sociedad Española de Tratamientos con Ondas de Choque) / Current evidences in shockwave treatment. SETOC (Spanish Society of Shockwave Treatment) recommendations

El documento consenso SETOC muestra la evidencia científica de la tecnología en ondas de choque extracorpóreas (OCE) y ondas de presión radial (OPR) en diversidad de patologías musculoesqueléticas, cutáneas, espasticidad, urológicas, etc. Las OCE y las OPR son un tratamiento eficaz, seguro, no invasivo, coste-efectivo, bien tolerado por el paciente, sin necesidad de anestesia, que reduce la necesidad de cirugía, con menor riesgo de complicaciones y menor tiempo de recuperación que una cirugía. Por todo ello, las OCE y las OPR deberían ser la primera opción terapéutica de las patologías crónicas mencionadas, cuando las alternativas conservadoras hayan fallado, teniendo en cuenta las recomendaciones de este artículo, de las sociedades científicas y de la evidencia para cada tecnología (AU)

This SETOC consensus document shows the scientific evidence of the technology in shockwaves (SW) and radial pressure waves (RPW) in a variety of spasticity disorders, musculoskeletal, skin, urological diseases, etc. SW and RPW, without anesthesia, are an effective, safe, non-invasive, cost-effective treatment, which reduces the need for surgery, lower risk of complications, faster recovery and greater acceptability to patients than surgery. Consequently, SW and RPW should be the first therapeutic option in the aforementioned chronic pathologies, when conservative alternatives have failed. SETOC advises to follow the recommendations given in this article, including the ones given by SW scientific societies and best evidence for each technology as well (AU)

[Current evidences in shockwave treatment. SETOC (Spanish Society of Shockwave Treatment) recommendations]. / Ondas de choque. Evidencias y recomendaciones SETOC (Sociedad Española de Tratamientos con Ondas de Choque).

This SETOC consensus document shows the scientific evidence of the technology in shockwaves (SW) and radial pressure waves (RPW) in a variety of spasticity disorders, musculoskeletal, skin, urological diseases, etc. SW and RPW, without anesthesia, are an effective, safe, non-invasive, cost-effective treatment, which reduces the need for surgery, lower risk of complications, faster recovery and greater acceptability to patients than surgery. Consequently, SW and RPW should be the first therapeutic option in the aforementioned chronic pathologies, when conservative alternatives have failed. SETOC advises to follow the recommendations given in this article, including the ones given by SW scientific societies and best evidence for each technology as well.

Utilization of D-ribitol by Lactobacillus casei BL23 requires a mannose-type phosphotransferase system and three catabolic enzymes.

Lactobacillus casei strains 64H and BL23, but not ATCC 334, are able to ferment D-ribitol (also called D-adonitol). However, a BL23-derived ptsI mutant lacking enzyme I of the phosphoenolpyruvate:carbohydrate phosphotransferase system (PTS) was not able to utilize this pentitol, suggesting that strain BL23 transports and phosphorylates D-ribitol via a PTS. We identified an 11-kb region in the genome sequence of L. casei strain BL23 (LCABL_29160 to LCABL_29270) which is absent from strain ATCC 334 and which contains the genes for a GlpR/IolR-like repressor, the four components of a mannose-type PTS, and six metabolic enzymes potentially involved in D-ribitol metabolism. Deletion of the gene encoding the EIIB component of the presumed ribitol PTS indeed prevented D-ribitol fermentation. In addition, we overexpressed the six catabolic genes, purified the encoded enzymes, and determined the activities of four of them. They encode a D-ribitol-5-phosphate (D-ribitol-5-P) 2-dehydrogenase, a D-ribulose-5-P 3-epimerase, a D-ribose-5-P isomerase, and a D-xylulose-5-P phosphoketolase. In the first catabolic step, the protein D-ribitol-5-P 2-dehydrogenase uses NAD(+) to oxidize D-ribitol-5-P formed during PTS-catalyzed transport to D-ribulose-5-P, which, in turn, is converted to D-xylulose-5-P by the enzyme D-ribulose-5-P 3-epimerase. Finally, the resulting D-xylulose-5-P is split by D-xylulose-5-P phosphoketolase in an inorganic phosphate-requiring reaction into acetylphosphate and the glycolytic intermediate D-glyceraldehyde-3-P. The three remaining enzymes, one of which was identified as D-ribose-5-P-isomerase, probably catalyze an alternative ribitol degradation pathway, which might be functional in L. casei strain 64H but not in BL23, because one of the BL23 genes carries a frameshift mutation.

A green analytical method using ultrasound in sample preparation for the flow injection determination of iron, manganese, and zinc in soluble solid samples by flame atomic absorption spectrometry.

A simple and rapid analytical method was developed for the determination of iron, manganese, and zinc in soluble solid samples. The method is based on continuous ultrasonic water dissolution of the sample (5-30 mg) at room temperature followed by flow injection flame atomic absorption spectrometric determination. A good precision of the whole procedure (1.2-4.6%) and a sample throughput of ca. 25 samples h(-1) were obtained. The proposed green analytical method has been successfully applied for the determination of iron, manganese, and zinc in soluble solid food samples (soluble cocoa and soluble coffee) and pharmaceutical preparations (multivitamin tablets). The ranges of concentrations found were 21.4-25.61 µg g(-1) for iron, 5.74-18.30 µg g(-1) for manganese, and 33.27-57.90 µg g(-1) for zinc in soluble solid food samples and 3.75-9.90 µg g(-1) for iron, 0.47-5.05 µg g(-1) for manganese, and 1.55-15.12 µg g(-1) for zinc in multivitamin tablets. The accuracy of the proposed method was established by a comparison with the conventional wet acid digestion method using a paired t-test, indicating the absence of systematic errors.

Role of α-phosphoglucomutase and phosphoglucose isomerase activities at the branching point between sugar catabolism and anabolism in Lactobacillus casei.

AIMS: To evaluate the role of α-phosphoglucomutase (α-Pgm) and phosphoglucose isomerase (Pgi) activities in growth rate, sugar-phosphates, UDP-sugars and lactate biosynthesis in Lactobacillus casei. METHODS AND RESULTS: The pgm and pgi genes coding for α-Pgm and Pgi activities in L. casei BL23, respectively, were identified, cloned and shown to be functional by homologous overexpression. In MRS fermentation medium with glucose, overexpression of pgm gene in L. casei resulted in a growth rate reduced to 75% and glucose-6P levels reduced to 47%. By contrast, with lactose, the growth rate was raised to 119%. An increment of α-Pgm activity had no significant effect on UDP-sugar levels. Remarkably, Pgi overexpression in L. casei grown in lactose or galactose resulted in almost a double growth rate with respect to the control strain. The increased Pgi activity also resulted in glucose-6P levels reduced to 25 and 59% of control strain cultured in glucose and lactose, respectively, and the fructose-6P levels were increased to 128% on glucose. UDP-glucose and UDP-galactose levels were reduced to 66 and 55%, respectively, of control strain levels cultured in galactose. In addition, the lactate yield increased to 115% in the strain overproducing Pgi grown in galactose. CONCLUSIONS: The physiological amount of α-Pgm and Pgi activities is limited for L. casei growth on lactose, and lactose and galactose, respectively, and that limitation was overcome by pgm and pgi gene overexpression. The increment of α-Pgm and Pgi activities, respectively, resulted in modified levels of sugar-phosphates, sugar-nucleotides and lactate showing the modulation capacity of the carbon fluxes in L. casei at the level of the glycolytic intermediate glucose-6P. SIGNIFICANCE AND IMPACT OF THE STUDY: Knowledge of the role of key enzymes in metabolic fluxes at the branching point between anabolic and catabolic pathways would allow a rational design of engineering strategies in L. casei.

A simple indirect automatic method to determine total iodine in milk products by flame atomic absorption spectrometry.

A simple, precise and accurate automatic method for the determination of total iodine in milk products by indirect atomic absorption spectrometry is proposed. Iodide in solutions resulting from alkaline ashing of samples is precipitated with silver ion in a precipitation-dissolution flow manifold, which allows performing on-line the retention of the silver iodide precipitate formed on a filter, its wash with diluted ammonia and its dissolution with a diluted thiosulfate solution. Dissolved silver is also determined on-line by flame atomic absorption, and the achieved amount of this metal is proportional to that of iodine in the sample. The proposed method is very selective, avoids interferences from anions present in the samples, which can be also precipitated with silver, because these silver compounds are dissolved with ammonia at the washing step. This method allows the determination of iodine in the range 0.011-0.35 microg mL(-1) with a relative standard deviation between 1.3 and 6.8% at a rate of ca. 17 samplesh(-1).

[Cardiac myxoma: an analysis of 30 patients]. / Mixoma cardíaco: serie de 30 pacientes.

INTRODUCTION: Myxomas are the most common type of benign heart tumors. The aim of this study was to correlate the clinical forms of presentation of cardiac myxoma and complementary laboratory results with the morphological features of the tumor. MATERIALS AND METHODS: We reviewed retrospectively a total of 30 cardiac myxomas seen in 2 institutions after a period of 22 years. In the same period 5 cardiac sarcomas were identified. The Chi-Square test and Fischer's exact test were used to compare the variables. In one patient the IL-6 production by peripherals blood cells before and after surgical tumor resection was evaluated. RESULTS: The patients were evenly distributed between genders. The mean age of this group was 60 years. The most prevalent clinical manifestations were cardiac symptoms (73,3%), constitutional symptoms (30%) and embolisms (26,7%). All cases were diagnosed by transthoracic echocardiography and the most frequent location of the tumor was the left atrium. Larger-diameter myxomas were observed in older patients and correlated with cardiac symptoms, radiological and electrocardiographical abnormalities. Smaller-diameter myxomas presented more frequently embolic phenomenons. There were no deaths during the postoperative period and the principal postoperative complication was transient arrhytmias. There was no evidence of recurrence of the disease. In one patient with systemic manifestations monocytes were observed to contribute to the increased serum levels of IL-6. CONCLUSIONS: Myxomas are the most frequent tumors of the heart. The most common initial manifestations were cardiac symptoms. Diagnosis was achieved in all patients by transthoracic echocardiography. The size and macroscopic appearance of the tumor correlated with the age of the patients and some clinical symptoms and laboratory RESULTS: Surgical excision was a safe and effective procedure. (c) 2009 Elsevier España, S.L. All rights reserved.

Mixoma cardíaco: serie de 30 pacientes / Cardiac myxoma: an analysis of 30 patients

Introducción y objetivos: El mixoma es la neoplasia benigna cardíaca más frecuente. El objetivo de este estudio es relacionar los síntomas y los hallazgos en las pruebas complementarias de los pacientes diagnosticados de mixoma con las características macroscópicas del tumor. Material y métodos: Se analizaron de forma retrospectiva en dos hospitales de tercer nivel un total de 30 mixomas cardíacos en los últimos 22 años. En el mismo período se identificaron 5 sarcomas cardíacos. Para las comparaciones se utilizó el test de la ji cuadrado y el test exacto de Fischer. En un paciente con síntomas sistémicos e inflamatorios se determinó la producción de interleucina 6 (IL-6) en células mononucleares de sangre periférica antes y después de la cirugía. Resultados: La distribución de los enfermos fue equitativa para ambos sexos. La edad media fue de 60 años. Las manifestaciones clínicas más prevalentes fueron los síntomas cardíacos (73,3%), seguidos de los síntomas generales (30%) y las manifestaciones embólicas (26,7%). El diagnóstico se realizó mediante ecocardiograma, siendo la localización predominante la aurícula izquierda. Los tumores de mayor tamaño se presentaron en edades avanzadas y se relacionaron más frecuentemente con manifestaciones cardíacas y con más alteraciones radiológicas y electrocardiográficas. Por el contrario, los tumores de menor tamaño y pediculados tuvieron manifestaciones embólicas con mayor asiduidad. No hubo mortalidad postoperatoria aunque sí arritmias transitorias. No se describieron recidivas locales. Se comprobó que los monocitos de sangre periférica contribuyen de forma mayoritaria a la producción de IL-6 en un paciente con síntomas sistémicos. Conclusiones: El mixoma es la neoplasia cardíaca más frecuente. Los síntomas cardíacos son la forma de presentación más común de los mixomas. El diagnóstico se realizó mediante ecocardiografía. El tamaño y la morfología del tumor se relacionan con la edad del paciente y con algunas manifestaciones clínicas y hallazgos de las pruebas complementarias. El tratamiento es quirúrgico y suele ser seguro y curativo (AU)

Introduction: Myxomas are the most common type of benign heart tumors. The aim of this study was to correlate the clinical forms of presentation of cardiac myxoma and complementary laboratory results with the morphological features of the tumor. Materials and methods: We reviewed retrospectively a total of 30 cardiac myxomas seen in 2 institutions after a period of 22 years. In the same period 5 cardiac sarcomas were identified. The Chi-Square test and Fischer's exact test were used to compare the variables. In one patient the IL-6 production by peripherals blood cells before and after surgical tumor resection was evaluated. Results: The patients were evenly distributed between genders. The mean age of this group was 60 years. The most prevalent clinical manifestations were cardiac symptoms (73,3%), constitutional symptoms (30%) and embolisms (26,7%). All cases were diagnosed by transthoracic echocardiography and the most frequent location of the tumor was the left atrium. Larger-diameter myxomas were observed in older patients and correlated with cardiac symptoms, radiological and electrocardiographical abnormalities. Smallerdiameter myxomas presented more frequently embolic phenomenons. There were no deaths during the postoperative period and the principal postoperative complication was transient arrhytmias. There was no evidence of recurrence of the disease. In one patient with systemic manifestations monocytes were observed to contribute to the increased serum levels of IL-6. Conclusions: Myxomas are the most frequent tumors of the heart. The most common initial manifestations were cardiac symptoms. Diagnosis was achieved in all patients by transthoracic echocardiography. The size and macroscopic appearance of the tumor correlated with the age of the patients and some clinical symptoms and laboratory results. Surgical excision was a safe and effective procedure (AU)

A new strategy of delayed long-term prophylaxis could prevent cytomegalovirus disease in (D+/R-) solid organ transplant recipients.

Long-term prophylaxis against cytomegalovirus (CMV) started immediately after transplantation in (D+/R-) poses a higher risk of late-onset CMV disease. Delayed CMV prophylaxis could allow a transitory exposure of the immune system to CMV, which would let the immune system mount an adequate CMV-specific cytotoxic response in (D+/R-) patients and confer protection against CMV disease. We included all (D+/R-) solid organ transplant recipients (SOT) performed at our institution (January 3/October 6) who received CMV prophylaxis (mainly with oral valganciclovir) during 100 d. In the first period (until December 4), prophylaxis was initiated immediately after transplantation (conventional prophylaxis: CP). Since January 5, it was initiated after 14 d (delayed prophylaxis: DP). Incidence and severity of CMV disease was compared between both groups. A total of 44 SOT recipients were included (CP: 26 and DP: 18). CMV disease was diagnosed in eight patients (18%), seven of 26 (27%) in the CP group, and one of 18 (5.5%) in the DP group (p = 0.07). CMV colitis was reported in five of 26 patients in the CP group (19%), whereas there were no cases of visceral CMV disease in the DP group (p = 0.048). A 14-d delay in the beginning of long-term prophylaxis against CMV in (D+/R-) is safe and could prevent the onset of late-CMV disease.

Automatic determination of nickel in foods by flame atomic absorption spectrometry.

A new sensitive and low cost flow injection method that combines acid extraction, preconcentration and flame atomic absorption spectrometric determination of nickel in food samples at µg/g levels is described. The dynamic acid extraction step was carried out by using a continuous ultrasound-assisted extraction system. The acid extract was preconcentrated on-line on a minicolumn packed with a chelating resin (Serdolit Che, with iminodiacetic groups) and nickel was eluted with diluted hydrochloric acid, being continuously monitored by flame atomic absorption spectrometry. An experimental design (Plackett-Burman 2(6)×3/16) is used to optimise the methodology proposed. The method allowed a total sampling frequency of 13-28 samples per hour. Good precision of the whole procedure (1.9-3.6% expressed as relative standard deviation) and a detection limit of 0.12µg/g, for 60mg of sample were achieved. The method was successfully applied to the determination of trace amounts of nickel in food samples.

Influence of the carbohydrate source on beta-glucan production and enzyme activities involved in sugar metabolism in Pediococcus parvulus 2.6.

The influence of carbohydrate source on growth, exopolysaccharide (EPS) production and on the activity of the enzymes implicated in energy generation and UDP-glucose synthesis in Pediococcus parvulus 2.6 was evaluated. The highest EPS production was obtained on glucose, while fructose was a poor substrate for EPS synthesis. HPLC and NMR analysis on monomer composition and structure of the EPS showed that this strain produced the same beta-glucan, regardless of the carbohydrate source. The alpha-phosphoglucomutase specific activities were dependent on the carbohydrate source and a high correlation between the activity of this enzyme and the amount of EPS was found in glucose- and maltose-grown cultures. alpha-UDP-glucose pyrophosphorylase activity, necessary for the activation of glucose, was very low, but significantly higher on glucose as sugar source. In vitro phosphorylation assays and transport activities showed that glucose is taken up by a proton motive force-dependent permease, while fructose is internalized by an inducible phosphotransferase system, which renders fructose-6-phosphate. The levels of 6-phosphofructokinase activity and alpha-phosphoglucomutase activities determined on fructose were higher and lower, than those found on glucose or maltose, respectively. This suggests that fructose-6-phosphate is mainly diverted to glycolysis and explains the low EPS synthesis on fructose. Results indicate that alpha-phosphoglucomutase and/or alpha-UDP-glucose pyrophosphorylase might be the bottlenecks for EPS biosynthesis, opening the field for metabolic-engineering strategies aimed to improve EPS production.

Flow-injection flame atomic absorption spectrometric determination of trace amounts of cadmium in solid and semisolid milk products coupling a continuous ultrasound-assisted extraction system with the online preconcentration on a chelating aminomethylphosphoric acid resin.

A new sensitive and low-cost method that combines continuous acid extraction, online preconcentration, and flame atomic absorption spectrometry for cadmium determination at microg levels in solid and semisolid milk products is described. A continuous ultrasound-assisted extraction system is used to carry out the dynamic acid extraction step. The acid extract is preconcentrated online on a minicolumn packed with a chelating resin (Chelite P, with aminomethylphosphoric acid groups), and the retained cadmium is eluted with hydrochloric acid and continuously monitored by flame atomic absorption spectrometry. An experimental design (Plackett-Burman 2-6*3/16) is used to optimize the continuous extraction and the preconcentration step. The method allowed a total sampling frequency of 28 samples/h. A good precision of the whole procedure (3.0% relative standard deviation) for a cheese sample containing 0.103 +/- 0.004 microg/g Cd (dry mass), a high enrichment factor (20.5), and detection and quantification limits of 0.014 and 0.067 microg/g, respectively, for a 60 mg of sample were obtained with this methodology. The method was successfully applied to the determination of trace amounts of cadmium in solid and semisolid milk products, such as cheese and yogurt samples.

[Venous thromboembolism and hyperhomocysteinemia as first manifestation of pernicious anemia]. / Tromboembolia venosa e hiperhomocisteinemia como primera manifestación de una anemia perniciosa.

INTRODUCTION AND OBJECTIVE: Hyperhomocysteinemia is associated to thrombosis and atherosclerosis. Vitamin B12 is among its main causes and may be due to a pernicious anemia. This study aimed to know the prevalence of this disease in patients who have venous thromboembolism and hyperhomocysteinemia. PATIENTS AND METHODS: A total of 80 consecutive patients (55 men and 25 women; age: mean [standard deviation] 63 [15] years) with pulmonary embolism and/or venous thrombosis and elevated values of homocysteine (> 12 micromol/l) were studied. RESULTS: Pernicious anemia was diagnosed (positive Schilling test, presence of anti-intrinsic factor antibodies and/or anti-parietal cells and fundal atrophic gastritis) in 5 patients (6.25% with range of age: 42-73 years. Only one of them had macrocytic anemia and there were no alterations in any of them in the thrombophilia study. The patients were treated with vitamin B12, administering it orally (1 mg/day) in 4 of them. The homocysteine and vitamin B12 values were normalized in every case at 6 months. CONCLUSIONS: Although the prevalence of pernicious anemia is not elevated in patients with venous thromboembolism and hyperhomocysteinemia, its existence must be ruled out to avoid other thrombotic and neurological complications.

Tromboembolia venosa e hiperhomocisteinemia como primera manifestación de una anemia perniciosa / Venous thromboembolism and hyperhomocysteinemia as first manifestation of pernicious anemia

Fundamento y objetivo. La hiperhomocisteinemia se asocia a trombosis y aterosclerosis. Entre sus principales causas está la deficiencia de vitamina B12, que puede deberse a una anemia perniciosa. El objetivo del estudio ha sido conocer la prevalencia de esta enfermedad en los pacientes que presentan tromboembolia venosa e hiperhomocisteinemia. Pacientes y método. Se estudiaron consecutivamente 80 pacientes (55 varones y 25 mujeres; edad: media [desviación estándar]: 63 [15] años) con embolia pulmonar y/o trombosis venosa y valores elevados de homocisteína (> 12 µmol/l). Resultados. En 5 pacientes (6,25%), con rango de edad: 42-73 años se diagnosticó una anemia perniciosa (prueba de Schilling positiva, presencia de anticuerpos antifactor intrínseco y/o anticélulas parietales y gastritis atrófica fúndica). Sólo uno de ellos tenía anemia macrocítica y en ninguno existían otras alteraciones en el estudio de trombofilia. Los pacientes se trataron con vitamina B12, administrándosela a 4 de ellos por vía oral (1 mg/día), y en todos los casos se normalizaron a los 6 meses los valores de homocisteína y de vitamina B12. Conclusiones. En los pacientes con tromboembolia venosa e hiperhomocisteinemia, aunque la prevalencia de anemia perniciosa no es elevada, es necesario descartar su existencia para evitar otras complicaciones trombóticas y neurológicas

Introduction and objective. Hyperhomocysteinemia is associated to thrombosis and atherosclerosis. Vitamin B12 is among its main causes and may be due to a pernicious anemia. This study aimed to know the prevalence of this disease in patients who have venous thromboembolism and hyperhomocysteinemia. Patients and methods. A total of 80 consecutive patients (55 men and 25 women; age: mean [standard deviation] 63 [15] years) with pulmonary embolism and/or venous thrombosis and elevated values of homocysteine (> 12 µmol/l) were studied. Results. Pernicious anemia was diagnosed (positive Schilling test, presence of anti-intrinsic factor antibodies and/or anti-parietal cells and fundal atrophic gastritis) in 5 patients (6.25% with range of age: 42-73 years. Only one of them had macrocytic anemia and there were no alterations in any of them in the thrombophilia study. The patients were treated with vitamin B12, administering it orally (1 mg/day) in 4 of them. The homocysteine and vitamin B12 values were normalized in every case at 6 months. Conclusions. Although the prevalence of pernicious anemia is not elevated in patients with venous thromboembolism and hyperhomocysteinemia, its existence must be ruled out to avoid other thrombotic and neurological complicationsIntroduction and objective. Hyperhomocysteinemia is associated to thrombosis and atherosclerosis. Vitamin B12 is among its main causes and may be due to a pernicious anemia. This study aimed to know the prevalence of this disease in patients who have venous thromboembolism and hyperhomocysteinemia. Patients and methods. A total of 80 consecutive patients (55 men and 25 women; age: mean [standard deviation] 63 [15] years) with pulmonary embolism and/or venous thrombosis and elevated values of homocysteine (> 12 µmol/l) were studied. Results. Pernicious anemia was diagnosed (positive Schilling test, presence of anti-intrinsic factor antibodies and/or anti-parietal cells and fundal atrophic gastritis) in 5 patients (6.25% with range of age: 42-73 years. Only one of them had macrocytic anemia and there were no alterations in any of them in the thrombophilia study. The patients were treated with vitamin B12, administering it orally (1 mg/day) in 4 of them. The homocysteine and vitamin B12 values were normalized in every case at 6 months. Conclusions. Although the prevalence of pernicious anemia is not elevated in patients with venous thromboembolism and hyperhomocysteinemia, its existence must be ruled out to avoid other thrombotic and neurological complications

Continuous ultrasound-assisted extraction of cadmium from legumes and dried fruit samples coupled with on-line preconcentration-flame atomic absorption spectrometry.

Cadmium was continuously extracted with diluted nitric acid from legumes and dried fruit samples using a simple, rapid and continuous ultrasound-assisted extraction system. A minicolumn packed with a chelating resin (Chelite P, with aminomethylphosphoric acid groups) was placed between the extraction unit and the detector for cadmium preconcentration. The cadmium content in the acid extract was retained into the minicolumn, and elution was carried out with hydrochloric acid, with this trace metal continuously monitored by flame atomic absorption spectrometry. An experimental design (Plackett-Burman 2(6) x 3/16) was used to optimize the continuous leaching procedure and the preconcentration step. The method allowed a total sampling frequency of 10 and 14 samples per hour for legumes and dried fruit, respectively. The procedure displayed good precision (2.0 and 2.5%, respectively, expressed as relative standard deviations) for samples containing 0.202+/-0.005 microg g(-1) Cd (broad bean) and 0.239+/-0.004 microg g(-1) Cd (peanut). Detection limits of 0.014 microg g(-1) Cd for 60 mg of legume samples and 0.011 microg g(-1) Cd for 80 mg of dried fruit samples were obtained. The method was successfully applied to the determination of trace amounts of cadmium in legumes and dried fruit samples.

Continuous ultrasound-assisted extraction coupled to a flow injection-flame atomic absorption spectrometric system for calcium determination in seafood samples.

Calcium was extracted on-line from solid seafood samples by a simple and rapid continuous ultrasound-assisted extraction system. This system is connected to a flow injection manifold, which allows the on-line flame atomic absorption spectrometric determination of calcium. This method enables the analysis of solid samples avoiding time-consuming traditional sample preparation methods and their inherent errors. The on-line manifold for calcium determination is the simplest possible, because a volume of 250 microL of acid extract is injected into an ultrapure water carrier stream. The acid extract was diluted on-line with lanthanum, which also acts as masking agent in order to avoid chemical interferences. The continuous monitoring of the calcium signal was accomplished by flame atomic absorption spectrometry. A Plackett-Burman experimental design was used for the optimisation of the continuous leaching procedure. The method allowed a total sampling frequency of 40 samples per hour, with a relative standard deviation for the complete procedure of 0.9% (for a sample containing 3414.35 mg/kg calcium (dry mass)). The limit of detection was found to be 44.4 mg/kg (dry mass) for 5 mg of sample. The analytical procedure was applied to real seafood samples.

Preparation of a soluble solid sample by a continuous ultrasound assisted dissolution system for the flow-injection atomic absorption spectrometric determination of iron in milk powder and infant formula.

A simple and new flow-injection manifold (CUDS) for the continuous ultrasound assisted dissolution of a soluble solid sample coupled to a flow-injection flame atomic absorption spectrometric manifold for the continuous iron determination is described. An experimental design was used for the evaluation of factors involving the CUDS. The method was applied to a certified reference material (CRM-151, skim milk powder) for quality assurance/validation and to real samples (milk powder and infant formulas). The total sampling frequency achieved was 80 samples per hour with a relative standard deviation for the complete procedure of 1.1%. The detection limit was 0.60mugg(-1) for a sample amount of 30mg. The results demonstrated that the CUDS is an innovative and efficient tool as compared to the manual-traditional sample preparation methods, but with drastic increase of both sample throughput and precision.