Living in a transient world: ICP-MS reinvented via time-resolved analysis for monitoring single events.

After 40 years of development, inductively coupled plasma-mass spectrometry (ICP-MS) can hardly be considered as a novel technique anymore. ICP-MS has become the reference when it comes to multi-element bulk analysis at (ultra)trace levels, as well as to isotope ratio determination for metal(loid)s. However, over the last decade, this technique has managed to uncover an entirely new application field, providing information in a variety of contexts related to the individual analysis of single entities (e.g., nanoparticles, cells, or micro/nanoplastics), thus addressing new societal challenges. And this profound expansion of its application range becomes even more remarkable when considering that it has been made possible in an a priori simple way: by providing faster data acquisition and developing the corresponding theoretical substrate to relate the time-resolved signals thus obtained with the elemental composition of the target entities. This review presents the underlying concepts behind single event-ICP-MS, which are needed to fully understand its potential, highlighting key areas of application (e.g., single particle-ICP-MS or single cell-ICP-MS) as well as of future development (e.g., micro/nanoplastics).

Prevalencia de diabesidad en población laboral española: influencia de variables sociodemográficas y consumo de tabaco / Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption

Fundamento. La obesidad predispone a sufrir diabetes tipo 2 con tanta frecuencia que su combinación se denomina diabesidad. El objetivo de este estudio fue determinar la prevalencia de diabesidad en la población trabajadora y analizar las variables con las que se asocia. Material y métodos. Estudio transversal realizado entre enero de 2019 y junio de 2020 en 418.343 trabajadores de 18 a 67 años, de diferentes profesiones y áreas geográficas españolas. Se determinó la prevalencia de diabesidad con seis fórmulas diferentes para obesidad: IMC (índice de masa corporal), CUN BAE (Clínica Universidad de Navarra Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Fórmula Palafolls, IMG (índice de masa grasa) de Deuremberg y RFM (Relative Fat Mass). Se analizó la asociación entre diabesidad y edad, sexo, clase social y tabaco. Resultados. La prevalencia global de diabesidad osciló entre 2,6 % por el IMC y 5,8% por la fórmula Palafolls. La variable más relacionada con la diabesidad fue la edad mayor de 50 años (OR = 5,9; IC95%: 5,7-6,2 para IMC, y OR = 8,1; IC95%: 7,9-8,4 para IMG de Deuremberg). El sexo masculino y la clase social III se relacionaron con la diabesidad estimada con todas las escalas, ser fumador solo con la fórmula Palafolls. Conclusiones. La prevalencia de diabesidad varía en función de la fórmula empleada, con una prevalencia menor entre las mujeres y un aumento con la edad independientemente de la fórmula utilizada. Su prevalencia es mayor en las clases sociales más bajas.(AU)

Background. Obesity predisposes to type 2 diabetes so often that the combination is called diabesity. The aim of this study was to determine the prevalence of diabesity in the working population and to analyze the variables associated with it. Method. Cross-sectional study between January 2019 and June 2020 by 418,343 workers from 18 to 67 year-old, from different professions and Spanish geographic areas. The prevalence of diabesity was determined with six different formulae for obesity: BMI (body mass index), CUN BAE (Clínica Universidad de Navarra-Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Formula Palafolls, FMI (fat mass index) of Deuremberg and RFM (relative fat mass). The association between diabetes and age, sex, social class and tobacco was analyzed. Results. The global prevalence of diabetes ranged from 2.6% for BMI to 5.8% for the Palafolls formula. The variable most related to diabesity was age over 50 years (OR=5.9; 95%CI: 5.7-6.2 for BMI, and OR = 8.1; 95%CI: 7.9-8.4 for FMI of Deuremberg). Male sex and social class III related with diabesity estimated by all formulas, while being a smoker was only related with the Palafolls formula. Conclusion. Diabesity prevalence varies depending on the formula used, with much lower prevalence among women and increased with age independent of the formula used. Its prevalence is higher in the lower social classes.(AU)

[Prevalence of diabesity in the Spanish working population: influence of sociodemographic variables and tobacco consumption].

BACKGROUND: Obesity predisposes to type 2 diabetes so often that the combination is called diabesity. The aim of this study was to determine the prevalence of diabesity in the working population and to analyze the variables associated with it. METHOD: Cross-sectional study between January 2019 and June 2020 by 418,343 workers from 18 to 67 year-old, from different professions and Spanish geographic areas. The prevalence of diabesity was determined with six different for-mulae for obesity: BMI (body mass index), CUN BAE (Clínica Universidad de Navarra Body Adiposity Estimator), ECORE-BF (Equation Córdoba for Estimation of Body Fat), Formula Palafolls, FMI (fat mass index) of Deuremberg and RFM (relative fat mass). The association between diabetes and age, sex, social class and tobacco was analyzed. RESULTS: The global prevalence of diabetes ranged from 2.6% for BMI to 5.8% for the Palafolls formula. The variable most related to diabesity was age over 50 years (OR?=?5.9; 95%CI: 5.7-6.2 for BMI, and OR?=?8.1; 95%CI: 7.9-8.4 for FMI of Deuremberg). Male sex and social class III related with diabesity estimated by all formulas, while being a smoker was only related with the Palafolls formula. CONCLUSION: Diabesity prevalence varies depending on the formula used, with much lower prevalence among women and increased with age independent of the formula used. Its prevalence is higher in the lower social classes.

The intake of high-fat diets induces the acquisition of brown adipocyte gene expression features in white adipose tissue.

BACKGROUND/OBJECTIVE: White-to-brown adipose tissue remodeling (browning) in response to different stimuli constitutes an active research area for obesity treatment. The emergence in traditional white adipose tissue (WAT) depots of multilocular adipocytes that express uncoupling protein 1 (UCP1) and resemble brown adipocytes, the so called 'brite' adipocytes, could contribute to increased energy expenditure. In rodents, obesogenic stimuli such as the intake of hyperlipidic diets can increase brown adipose tissue (BAT) thermogenic capacity and contribute to maintaining body weight. The aim of this study was to investigate the potential of two different hyperlipidic diets, a commercial high-fat (HF) diet and a highly palatable cafeteria (CAF) diet, to induce WAT browning. METHODS: We analyzed gene expression of a wide number of brown/brite adipocyte markers in different WAT depots, in BAT and in peripheral blood mononuclear cells (PBMCs) increasingly being used in nutrition studies as a potential source of biomarkers of physiological effects. We also performed morphological analysis of adipose tissue. RESULTS: Both HF diets studied were able to increase the expression of the markers studied in WAT in a depot-specific manner, as well as in BAT; some of these changes were also reflected in PBMCs. This increased browning capacity was translated into the appearance of UCP1- and CIDE-A (cell death-inducing DFFA-like effector A)-positive brite adipocytes in retroperitoneal WAT. Administration of the CAF diet, associated with higher adiposity, produced the strongest impact on the parameters studied while its withdrawal restored basal conditions. CONCLUSIONS: Acquisition of brown adipocyte features in WAT could evidence an adaptation to try to counteract increased adiposity due to the intake of HF diets. Additionally, PBMCs could constitute an interesting easily obtainable material to assess the effect of nutritional interventions on browning capacity.

Progress in the determination of metalloids and non-metals by means of high-resolution continuum source atomic or molecular absorption spectrometry. A critical review.

This work examines the new possibilities introduced with the arrival of commercially available high-resolution continuum source atomic absorption spectrometers for the determination of metalloids (B, Si, Ge, As, Se, Sb and Te) and non-metals (P, S, F, Cl, Br, I and N-based species), such as the improved potential to detect and correct for spectral overlaps and the strategies available to correct for matrix effects. In particular, and considering the increasing number of papers reporting on the use of molecular absorption spectrometry using graphite furnaces and flames as vaporizers, the work discusses in detail the advantages and limitations derived from the monitoring of molecular spectra from a practical point of view, in an attempt to guide future users of the technique.

Laboratory rearing and life history of an emerging grape pest, Xylotrechus arvicola (Coleoptera: Cerambycidae).

Several aspects of the biology of Xylotrechus arvicola (Olivier), an emerging grape pest, were studied under laboratory conditions. Four diets were tested to rear this species in the laboratory. Among them, only one made rearing from larva to adult possible. The highest mortality, in all cases, was recorded during the first days of larval development. Larvae were kept 45 days at 8°C to break diapause in order to reduce the normal field larval developmental time. The species' developmental time was similar between sexes, while pupal developmental time and weight were significantly greater for females than for males. As part of a complementary study, life table parameters of females obtained from the larvae reared on the artificial diet were compared to those of females emerged from field-infested grape root wood. Both laid the majority of eggs in the first two weeks after emergence, and they had a similar pre-laying period. Nevertheless, the females from the diet-reared larvae lived significantly longer, laid eggs over a longer period of time and showed higher fertility than those emerging from infested grape root, suggesting that diet fulfils larval nutritional needs. The species' laboratory-reared population exhibited a low intrinsic growth rate value (rm=0.01) as a result of its long egg-to-adult developmental time and its high larval mortality.

Effects of variable and constant temperatures on the embryonic development and survival of a new grape pest, Xylotrechus arvicola (Coleoptera: Cerambycidae).

Xylotrechus arvicola Olivier (Coleoptera: Cerambycidae) has become a new expanding pest in grape (Vitis spp.) crops. To better improve control tactics, the consequences of 11 constant (12, 15, 18, 21, 24, 27, 30, 32, 34, 35 and 36°C) and nine variable temperatures (with equal mean temperatures at each of the nine constant rates ranging from 15 to 35°C) on survival and embryonic development were studied. The eggs were able to complete development at constant temperatures between 15 and 35°C, with mortality rates at the extremes of the range of two and 81.5%, respectively. Using variable temperatures a mortality rate of 38.9% at a mean temperature of 15°C and 99% at 35°C was observed. The range of time for embryonic development was 29.5 d at 15°C to 6 d at 32°C at constant temperatures, and from 29.6 d at 15°C to 7.2 d at 32°C at variable temperatures. The goodness-of-fit of different development models was evaluated for the relationship between the development rate and temperature. The models that gave the best fit were the Logan type III for constant temperatures and the Brière for variable temperatures. Optimum temperatures were estimated to be from 31.7 to 32.9°C. The models that best described embryo development under natural field conditions were the Logan type III model for constant temperatures (98.7% adjustment) and the Lactin model for variable temperatures (99.2% adjustment). Nonlinear models predicted faster development at constant temperatures and slower development at variable ones when compared with real field development, whereas the linear model always predicted faster development than what actually took place.

Characterization of cobalt pigments found in traditional Valencian ceramics by means of laser ablation-inductively coupled plasma mass spectrometry and portable X-ray fluorescence spectrometry.

In this work, a comparison of the performances of laser ablation-inductively coupled plasma mass spectrometry (LA-ICPMS) and portable X-ray fluorescence (XRF) spectrometry for the characterization of cobalt blue pigments used in the decoration of Valencian ceramics is presented. Qualitative data on the elemental composition of the blue pigments obtained using both techniques show a good agreement. Moreover, the results clearly illustrate that potters utilized different kinds of cobalt pigments in different historical periods. While both techniques seem suitable for the proposed task, they show different strengths and weaknesses. Portable X-ray fluorescence spectrometry is a cheaper and totally non-destructive technique, capable of providing fast and reliable results at the mgg(-1) level. LA-ICPMS, on the other hand, offers a much higher detection power and better spatial resolution, but its use results in some sample damage (sample consumption at the mug level), while it is a more expensive and non-portable technique.

Solid sampling-graphite furnace atomic absorption spectrometry for the direct determination of silver at trace and ultratrace levels.

In this work, the possibilities of solid sampling-graphite furnace atomic absorption spectrometry for the direct determination of silver in solid samples of very different nature (a biological sample, a soil, an ore concentrate and a polymer) and showing substantial differences in their analyte content (from approximately, 40 ng g(-1) up to 350 microg g(-1)) have been evaluated, the goal always being to develop fast methods, only relying on the use of aqueous standards for calibration. Different factors had to be taken into account in order to develop suitable procedures for all the samples under investigation. Among the most important ones, the following can be mentioned: (i) optimization of the temperature program in order to selectively atomize the analyte; (ii) the use of chemical modifiers (such as Pd or HNO3), depending on the sample characteristics; (iii) appropriate wavelength, argon flow and sample mass selection (depending on the analyte content); (iv) the use of 3-field mode Zeeman-effect background correction in order to further expand the linear range up to 1000 ng of Ag, which was needed for analysis of the sample showing the highest Ag content (polypropylene). The procedures finally proposed show interesting features for the determination of silver in solid samples: the advantage of using aqueous standard solutions for calibration, a high sample throughput (approximately, 15 min per sample), a low detection limit (2 ng g(-1)), sufficient precision (R.S.D. values in the vicinity of 10%) and a reduced risk of analyte losses and contamination.

Interacciones farmacológicas potenciales entre antihipertensivos y otros medicamentos de uso crónico / Potential drug interactions between antihypertensive drugs and other chronic use drugs

Objetivo. Determinar en el ámbito de Atención Primaria la frecuencia de las potenciales interacciones farmacológicas de los medicamentos antihipertensivos. Diseño. Estudio observacional transversal. Emplazamiento. Centro de salud de características urbanas. Participantes. Trescientos veintitrés pacientes seleccionados mediante muestreo consecutivo a partir de tarjetas de largo tratamiento. Nivel de confianza del 95 %; precisión ± 5 %; proporción esperada de interacciones del 30 %. Sujetos: pacientes hipertensos que consumen medicación antihipertensiva. Variables: medicación antihipertensiva, otros fármacos de uso crónico y datos sociodemográficos. Para valorar las combinaciones inadecuadas se utilizó la Guía de Interacciones de Fármacos 2002 de la Sociedad Española de Farmacia Hospitalaria. Análisis de datos: descripción de variables, pruebas de comparación de medias y proporciones en grupos independientes. Mediciones principales. Consumo de antihipertensivos, medicación concomitante, presencia de interacciones según las fichas técnicas de la Sociedad Española de Farmacia Hospitalaria y variables sociodemográficas. Resultados. Edad media de 64,33 años ± 12,24 DE (rango: 32-97), porcentaje de mujeres del 57 %. Número medio de otros medicamentos 3,56 ± 1,45 DE. La distribución con porcentajes de medicamentos antihipertensivos fue: calcioantagonistas: 29 (13,2 %); inhibidores de la enzima conversora de la angiotensina: 225 (70 %); antagonistas del receptor de la angiotensina II: 47 (19,6%); betabloqueantes: 24 (7,2%); alfabloqueantes: 47 (14,6%); alfa-betabloqueantes: 4 (1,2%), y diuréticos: 75 (38,7%). Presentaron alguna interacción moderada o grave el 19,5 % de los pacientes (IC 95 %: 15,2-23,8). Las principales interacciones fueron: enalapril y diuréticos ahorradores de potasio: 8 (2,4 %); captopril y ácido acetilsalicílico: 7 (2,2%); captopril y alopurinol: 3 (0,9 %); nifedipino y omeprazol: 4 (1,2%); nifedipino y antidiabéticos orales: 2 (0,6 %); verapamil y calcio: 2 (0,6 %); doxazosina y diuréticos: 11 (3,4 %); doxazosina y digoxina: 1 (0,3 %); inhibidores de la enzima conversora de la angiotensina o antagonistas del receptor de la angiotensina II y diuréticos como enalapril y tiacidas: 20 (6,2%). La proporción de interacciones no fue significativamente diferente en ambos sexos y tampoco la edad media fue diferente desde el punto de vista estadístico en los pacientes con o sin alguna interacción. Conclusiones. Es elevada la proporción de pacientes consumidores de medicación antihipertensiva que presentan interacciones moderadas o graves, especialmente en el caso del enalapril, captopril, nifedipino, verapamil y doxazosina. Determinadas interacciones pueden ser la causa de un mal control de las cifras tensionales o descompensación de otras patologías. Frente al riesgo potencial de las interacciones de los medicamentos antihipertensivos el médico de Atención Primaria debe considerar, cada vez más por su mayor utilización, la compatibilidad de los mismos con el resto de los fármacos

Objective. To determine the frequency of potential drug interactions of antihypertensive drugs in the Primary Health Care Setting. Design. Cross-sectional observational study. Site. Urban health care center. Participants. 323 patients selected by consecutive sampling from long treatment cards. 95 % confidence interval. Accuracy ± 5 %. Expected proportion of interactions 30 %. Subjects: hypertensive patients who take antihypertensive drugs. Endpoints: antihypertensive drugs, other chronic use drugs, and sociodemographic data. To assess inadequate combinations, the 2002 Drug Interactions Guide of the Spanish Society of Hospital Drugs was used. Data analysis: description of endpoints, mean comparison tests and proportions in independent groups. Main measurements. Use of antihypertensive drugs, concomitant medications, presence of interactions according to Spanish Society of Hospital Drug data sheets and sociodemographic endpoints. Results. Mean age of 64.33 years ± 12.24 SD (range: 32-97), percentage of women 57 %. Mean number of other drugs 3.56 ± 1.45 SD. Distribution with percentages of antihypertensive drugs was: calcium antagonists: 29 (13.2 %); ACEIs: 225 (70 %); ARA II: 47 (19.6 %); beta blockers: 24 (7.2 %); alpha blockers: 47 (14.6%); alpha-beta blockers: 4 (1.2 %) and diuretics: 75 (38.7%). A total of 19.5 % of the patients had some moderate or serious interaction (95 % CI: 15.2-23.8). The main interactions were: enalapril and potassium saving diuretics: 8 (2.4 %); captopril and ASA: 7 (2.2%); captopril and allopurinol: 3 (0.9 %); nifedipine and omeprazole: 4 (1.2 %); nifedipine and oral antidiabetics: 2 (0.6 %); verapamil and calcium 2 (0.6 %); doxazosine and diuretics: 11 (3.4%); doxazosine and digoxine 1 (0.3 %), ACEI or ARA II and diuretics as enalapril and thiazides: 20 (6.2 %). The proportion of interactions was not significantly different in both genders and the mean age was also not different from the statistical point of view in patients with or without some interaction. Conclusions. The percentage of patients using antihypertensive drugs who have moderate or serious interactions is high, especially in the case of enalapril, captopril, nifedipine, verapamil and doxazosine. Certain interactions may be the cause of poor control of tension values or decompensation of other diseases. Faced with the potential risk of the interactions of antihypertensive drugs, the Primary Health care physician should increasingly consider the compatibility of these with the remaining drugs due to its greater useObjective. To determine the frequency of potential drug interactions of antihypertensive drugs in the Primary Health Care Setting. Design. Cross-sectional observational study. Site. Urban health care center. Participants. 323 patients selected by consecutive sampling from long treatment cards. 95 % confidence interval. Accuracy ± 5 %. Expected proportion of interactions 30 %. Subjects: hypertensive patients who take antihypertensive drugs. Endpoints: antihypertensive drugs, other chronic use drugs, and sociodemographic data. To assess inadequate combinations, the 2002 Drug Interactions Guide of the Spanish Society of Hospital Drugs was used. Data analysis: description of endpoints, mean comparison tests and proportions in independent groups. Main measurements. Use of antihypertensive drugs, concomitant medications, presence of interactions according to Spanish Society of Hospital Drug data sheets and sociodemographic endpoints. Results. Mean age of 64.33 years ± 12.24 SD (range: 32-97), percentage of women 57 %. Mean number of other drugs 3.56 ± 1.45 SD. Distribution with percentages of antihypertensive drugs was: calcium antagonists: 29 (13.2 %); ACEIs: 225 (70 %); ARA II: 47 (19.6 %); beta blockers: 24 (7.2 %); alpha blockers: 47 (14.6%); alpha-beta blockers: 4 (1.2 %) and diuretics: 75 (38.7%). A total of 19.5 % of the patients had some moderate or serious interaction (95 % CI: 15.2-23.8). The main interactions were: enalapril and potassium saving diuretics: 8 (2.4 %); captopril and ASA: 7 (2.2%); captopril and allopurinol: 3 (0.9 %); nifedipine and omeprazole: 4 (1.2 %); nifedipine and oral antidiabetics: 2 (0.6 %); verapamil and calcium 2 (0.6 %); doxazosine and diuretics: 11 (3.4%); doxazosine and digoxine 1 (0.3 %), ACEI or ARA II and diuretics as enalapril and thiazides: 20 (6.2 %). The proportion of interactions was not significantly different in both genders and the mean age was also not different from the statistical point of view in patients with or without some interaction. Conclusions. The percentage of patients using antihypertensive drugs who have moderate or serious interactions is high, especially in the case of enalapril, captopril, nifedipine, verapamil and doxazosine. Certain interactions may be the cause of poor control of tension values or decompensation of other diseases. Faced with the potential risk of the interactions of antihypertensive drugs, the Primary Health care physician should increasingly consider the compatibility of these with the remaining drugs due to its greater use

Interacciones farmacológicas potenciales entre antihipertensivos y otros medicamentos de uso crónico / Potential drug interactions between antihypertensive drugs and other chronic use drugs

Objetivo. Determinar en el ámbito de Atención Primaria la frecuencia de las potenciales interacciones farmacológicas de los medicamentos antihipertensivos. Diseño. Estudio observacional transversal. Emplazamiento. Centro de salud de características urbanas. Participantes. Trescientos veintitrés pacientes seleccionados mediante muestreo consecutivo a partir de tarjetas de largo tratamiento. Nivel de confianza del 95 %; precisión ± 5 %; proporción esperada de interacciones del 30 %. Sujetos: pacientes hipertensos que consumen medicación antihipertensiva. Variables: medicación antihipertensiva, otros fármacos de uso crónico y datos sociodemográficos. Para valorar las combinaciones inadecuadas se utilizó la Guía de Interacciones de Fármacos 2002 de la Sociedad Española de Farmacia Hospitalaria. Análisis de datos: descripción de variables, pruebas de comparación de medias y proporciones en grupos independientes. Mediciones principales. Consumo de antihipertensivos, medicación concomitante, presencia de interacciones según las fichas técnicas de la Sociedad Española de Farmacia Hospitalaria y variables sociodemográficas. Resultados. Edad media de 64,33 años ± 12,24 DE (rango: 32-97), porcentaje de mujeres del 57 %. Número medio de otros medicamentos 3,56 ± 1,45 DE. La distribución con porcentajes de medicamentos antihipertensivos fue: calcioantagonistas: 29 (13,2 %); inhibidores de la enzima conversora de la angiotensina: 225 (70 %); antagonistas del receptor de la angiotensina II: 47 (19,6%); betabloqueantes: 24 (7,2%); alfabloqueantes: 47 (14,6%); alfa-betabloqueantes: 4 (1,2%), y diuréticos: 75 (38,7%). Presentaron alguna interacción moderada o grave el 19,5 % de los pacientes (IC 95 %: 15,2-23,8). Las principales interacciones fueron: enalapril y diuréticos ahorradores de potasio: 8 (2,4 %); captopril y ácido acetilsalicílico: 7 (2,2%); captopril y alopurinol: 3 (0,9 %); nifedipino y omeprazol: 4 (1,2%); nifedipino y antidiabéticos orales: 2 (0,6 %); verapamil y calcio: 2 (0,6 %); doxazosina y diuréticos: 11 (3,4 %); doxazosina y digoxina: 1 (0,3 %); inhibidores de la enzima conversora de la angiotensina o antagonistas del receptor de la angiotensina II y diuréticos como enalapril y tiacidas: 20 (6,2%). La proporción de interacciones no fue significativamente diferente en ambos sexos y tampoco la edad media fue diferente desde el punto de vista estadístico en los pacientes con o sin alguna interacción. Conclusiones. Es elevada la proporción de pacientes consumidores de medicación antihipertensiva que presentan interacciones moderadas o graves, especialmente en el caso del enalapril, captopril, nifedipino, verapamil y doxazosina. Determinadas interacciones pueden ser la causa de un mal control de las cifras tensionales o descompensación de otras patologías. Frente al riesgo potencial de las interacciones de los medicamentos antihipertensivos el médico de Atención Primaria debe considerar, cada vez más por su mayor utilización, la compatibilidad de los mismos con el resto de los fármacos

Objective. To determine the frequency of potential drug interactions of antihypertensive drugs in the Primary Health Care Setting. Design. Cross-sectional observational study. Site. Urban health care center. Participants. 323 patients selected by consecutive sampling from long treatment cards. 95 % confidence interval. Accuracy ± 5 %. Expected proportion of interactions 30 %. Subjects: hypertensive patients who take antihypertensive drugs. Endpoints: antihypertensive drugs, other chronic use drugs, and sociodemographic data. To assess inadequate combinations, the 2002 Drug Interactions Guide of the Spanish Society of Hospital Drugs was used. Data analysis: description of endpoints, mean comparison tests and proportions in independent groups. Main measurements. Use of antihypertensive drugs, concomitant medications, presence of interactions according to Spanish Society of Hospital Drug data sheets and sociodemographic endpoints. Results. Mean age of 64.33 years ± 12.24 SD (range: 32-97), percentage of women 57 %. Mean number of other drugs 3.56 ± 1.45 SD. Distribution with percentages of antihypertensive drugs was: calcium antagonists: 29 (13.2 %); ACEIs: 225 (70 %); ARA II: 47 (19.6 %); beta blockers: 24 (7.2 %); alpha blockers: 47 (14.6%); alpha-beta blockers: 4 (1.2 %) and diuretics: 75 (38.7%). A total of 19.5 % of the patients had some moderate or serious interaction (95 % CI: 15.2-23.8). The main interactions were: enalapril and potassium saving diuretics: 8 (2.4 %); captopril and ASA: 7 (2.2%); captopril and allopurinol: 3 (0.9 %); nifedipine and omeprazole: 4 (1.2 %); nifedipine and oral antidiabetics: 2 (0.6 %); verapamil and calcium 2 (0.6 %); doxazosine and diuretics: 11 (3.4%); doxazosine and digoxine 1 (0.3 %), ACEI or ARA II and diuretics as enalapril and thiazides: 20 (6.2 %). The proportion of interactions was not significantly different in both genders and the mean age was also not different from the statistical point of view in patients with or without some interaction. Conclusions. The percentage of patients using antihypertensive drugs who have moderate or serious interactions is high, especially in the case of enalapril, captopril, nifedipine, verapamil and doxazosine. Certain interactions may be the cause of poor control of tension values or decompensation of other diseases. Faced with the potential risk of the interactions of antihypertensive drugs, the Primary Health care physician should increasingly consider the compatibility of these with the remaining drugs due to its greater use

Comparison of biosensors based on entrapment of cholesterol oxidase and cholesterol esterase in electropolymerized films of polypyrrole and diaminonaphthalene derivatives for amperometric determination of cholesterol.

Cholesterol amperometric biosensors constructed with enzymes entrapped in electropolymerized layers of polypyrrole and poly-naphthalene derivative polymers are compared. The biosensors are based on entrapment of cholesterol oxidase and/or cholesterol esterase in monolayer or multilayer films electrochemically synthesised from pyrrole, 1,8-diaminonaphthalene (1,8-DAN), and 1,5-diaminonaphthalene (1,5-DAN) monomers. Seven configurations were assayed and compared, and different analytical properties were obtained depending on the kind of polymer and the arrangement of the layers. The selectivity properties were evaluated for the different monolayer and bilayer configurations proposed as a function of the film permeation factor. All the steps involved in the preparation of the biosensors and determination of cholesterol were carried out in a flow system. Sensitivity and selectivity depend greatly on hydrophobicity, permeability, compactness, thickness, and the kind of the polymer used. In some cases a protective outer layer of non-conducting poly( o-phenylenediamine) polymer improves the analytical characteristics of the biosensor. A comparative study was made of the analytical performance of each of the configurations developed. The biosensors were also applied to the flow-injection determination of cholesterol in a synthetic serum.

[Pharmacological interactions of statins]. / Interacciones farmacológicas de las estatinas.

OBJECTIVE: To determine in primary care the frequency of pharmacological interactions of statins. DESIGN: Transversal observational study.Setting. Urban health centre.Participants. 384 patients taking statins who were chosen by systematic sampling based on long-treatment cards (95% CI, accuracy 5% and expected proportion of possible interactions unknown). MAIN MEASUREMENTS: Consumption of statins, the accompanying medication taken, presence of interactions according to the technical details of statins (Spanish Medication Agency, Ministry of Health and Consumption) and social and demographic variables. RESULTS: In 55 patients (14.3%) (95% CI, 10.8%-17.8%) one of the statin interactions with the other drugs was checked, especially with acenocoumarol, digoxin and anti-acid drugs. In patients with some interaction, the mean number of other drugs was significantly higher (4.51.5 vs 3.31.9 SD; P<.001). 19.1% of men and 10.8% of women showed interactions, the difference being statistically significant (P=.02). By means of logistic regression, both masculine gender (OR=1.8) and taking of other medication in quantities of 5 or more (OR=2.7) appeared as variables associated with the presence of interactions. CONCLUSIONS: The potential pharmacological interactions of statins reach 14.3% of patients with hypercholesterolaemia who take medication long-term. The possibility of reaching high plasma concentrations of statins and/or of modifying the therapeutic effect of various drugs enables a more appropriate use of statins to be recommended, with prescription of those statins that metabolise less through the P450 cytochrome.

Interacciones farmacológicas de las estatinas / Pharmacological interactions of statins

Objetivo. Determinar en el ámbito de atención primaria la frecuencia de potenciales interacciones farmacológicas de las estatinas. Diseño. Estudio observacional transversal. Emplazamiento. Centro de salud de características urbanas. Participantes. Se seleccionó a 384 pacientes consumidores de estatinas mediante muestreo sistemático a partir de las cartillas de largo tratamiento (nivel de confianza del 95 por ciento, precisión del ñ 5 por ciento y proporción esperada de posibles interacciones desconocida).Mediciones principales. Consumo de estatinas, medicación concomitante, presencia de interacciones según las fichas técnicas de las estatinas (Agencia Española del Medicamento. Ministerio de Sanidad y Consumo) y variables sociodemográficas. Resultados. En 55 pacientes (14,3 por ciento; IC del 95 por ciento, 10,8-17,8 por ciento) se comprobó alguna de las interacciones de las estatinas con el resto de los fármacos, sobre todo con acenocumarol, digoxina y antiácidos. Entre los pacientes con alguna interacción, el número medio de otros medicamentos fue significativamente superior (DE, 4,5 ñ 1,5 frente a 3,3 ñ 1,9; p < 0,001). Presentaron interacciones el 19,1 por ciento de los varones y el 10,8 por ciento de las mujeres, resultando la diferencia estadísticamente significativa (p = 0,02). Mediante regresión logística, tanto el sexo masculino (OR= 1,8) como el consumo de otros medicamentos en número de 5 o más (OR = 2,7) aparecieron como variables asociadas a la presencia de interacciones. Conclusiones. Las potenciales interacciones farmacológicas de las estatinas alcanzan al 14,3 por ciento de los pacientes con hipercolesterolemia que consumen medicación de forma crónica. La posibilidad de alcanzar concentraciones plasmáticas elevadas de estatinas o de modificar el efecto terapéutico de diversos fármacos permite aconsejar un uso más apropiado de aquéllas, prescribiendo las que utilizan en menor medida el citocromo P-450 para su metabolismo (AU)

[Tetrabamate-induced hepatotoxicity. Report of seven cases and literature review]. / Hepatotoxicidad por tetrabamato. Presentación de 7 casos y revisión de la bibliografía.

OBJECTIVES: Analysis of all cases of tetrabamate (Atrium)-induced hepatotoxicity reported in the Andalusian Registry of drug-induced liver disorders and comparison with cases reported in the literature. MATERIAL AND METHOD: Information was gathered in a structured protocol. The causal role of tetrabamate was estimated in each case using the diagnostic scale of the Council for International Organizations of Medical Sciences (CIOMS). RESULTS: Of 327 cases of hepatotoxicity, 7 (2%) were due to tetrabamate. The mean age was 57 years (4 men). In 57% of the cases, the presenting symptom was tremor. The latency period was between 15 and 730 days. Liver damage was mainly cytolytic without signs of hypersensitivity. In all cases outcome was favorable with complete recovery between 60 and 120 days. The CIOMS diagnostic scale rated a causal role of tetrabamate as highly probable in six cases and as probable in one. CONCLUSION: Tetrabamate can induce hepatotoxicity, probably due to an idiosyncratic metabolic mechanism. Because of this finding and the existence of more appropriate therapeutic alternatives, tetrabamate should not be used in the treatment of alcohol withdrawal.

Flutamide-induced hepatotoxicity: report of a case series.

OBJECTIVE: To evaluate the characteristics of flutamide induced hepatotoxicity. MATERIAL AND METHODS: In this retrospective study we have analyzed all cases of flutamide hepatotoxicity submitted to the Andalucian Registry of drug-induced liver disease. Data were collected using a structured reporting form. Causality assessment was performed using two clinical scales: the standard CIOMS scale and the recently developed María and Victorino scale. RESULTS: Nine of 185 patients (4.9%) were identified. In 8 male patients, mean age 75 years (range 65-83), flutamide was indicated for palliative therapy of disseminated prostatic carcinoma, and in one young female (14 years) was given for the treatment of facial hirsutism. The mean duration of the flutamide therapy was 151 days (range 4-443). All patients presented with overt liver injury, the most frequent features being asthenia, anorexia, weight loss, nausea, vomiting and jaundice. No patient showed hypersensitivity features. In two patients (22%) the hepatic damage evolved to fulminant liver failure, one of them undergoing a liver transplantation and the other subsequently died. An additional patient died of a non-hepatic related cause when his liver function was improving. Causality assessment by the two clinical scales did not exclude any case, but the two patients who died where classified as unlikely by the María and Victorino scale. CONCLUSIONS: Flutamide can induce severe acute hepatitis, probably due to an idiosyncratic metabolic mechanism. Liver tests monitoring should probably be mandatory during the first months of flutamide therapy and the drug withdrawn if transaminases began to increase.

Hepatotoxicidad por flutamida: análisis de una serie / Flutamide-induced hepatotoxicity: report of a case series

Objetivo: evaluar las características de la hepatotoxicidad por flutamida.Material y métodos: análisis de 9 casos de toxicidad hepática secundaria a este fármaco remitidos al Registro Andaluz de Hepatopatías asociadas a medicamentos. La información se recogió en un protocolo estructurado. La imputabilidad de la flutamida se estimó en cada uno de los casos por dos escalas diagnósticas; Council for International Organization of Medical Sciences (CIOMS) y una recientemente validada (María y Victorino).Resultados: 9 de 185 casos (4,9 por ciento) de hepatotoxicidad remitidos al registro eran debidos a flutamida. En 8 pacientes varones con edad media de 75 años (rango 65-83), la flutamida se indicó para la paliación del carcinoma de próstata metastásico, y en una mujer de 14 años para el tratamiento del hirsutismo facial. El tiempo medio de duración del tratamiento fue de 151 días (rango 4-433). El episodio de hepatotoxicidad tuvo expresión clínica en todos los pacientes, siendo las manifestaciones más frecuentes: astenia, anorexia, pérdida de peso, náuseas, vómitos e ictericia. Ningún paciente presentó manifestaciones de hipersensibilidad. Dos pacientes (22 por ciento) presentaron fallo hepático fulminante, falleciendo uno y realizándose transplante hepático en el otro. Un tercer paciente falleció cuando la lesión hepática estaba en fase de resolución. No hubo ningún caso excluido en la evaluación de im putabilidad, pero los dos casos de éxitus fueron clasificados como dudosos por la escala de María y Victorino. Conclusiones: flutamida puede producir hepatitis aguda grave, ocasionalmente fulminante, por un mecanismo presuntamente de idiosincrasia metabólica. Debería monitorizarse el perfil hepático durante los primeros meses de tratamiento con flutamida, suspendiéndose el fármaco en caso de detectarse alteraciones (AU)

Strategies for the improvement of an amperometric cholesterol biosensor based on electropolymerization in flow systems: use of charge-transfer mediators and platinization of the electrode.

Different configurations based on an amperometric biosensor with cholesterol oxidase entrapped in a polypyrrole film have been developed with a view to improving the analytical properties of this biosensor. The alternatives considered involve the simultaneous entrapment of the enzyme and a charge-transfer mediator as well as previous platinization of the surface of the Pt electrode. Both artificial (a ferrocene derivative) and natural (flavin nucleotides) mediators were studied as constituents of the charge-transfer process between the enzyme and the electrode. The comparative study of these biosensors, which were prepared in situ in a continuous flow system, made it possible to determine the advantages and disadvantages of each configuration when applied to flow-injection determination of cholesterol.

[Burn-out of nurses]. / Está "quemada" la enfermería?: síndrome de burn-out.

The burn-out rate among nurses in three health-care centers in the province of Barcelona, Spain was studied in a sample of 250 professional nurses who completed a three-part questionnaire that addressed: occupational situation, personal situation, and 20 items. Generally speaking, abnormal levels (0.9%) were not found, but 14.4% of the sample presented a moderate state of "burn-out". These results surprised us because nurses often complain of burn-out, but our study of the syndrome by questionnaire revealed that 84.6% judged their state as optimal.