C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain.

OBJECTIVE: To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia. MATERIAL AND METHODS: An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score. MEASUREMENTS AND MAIN RESULTS: Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; P = 0.0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; P < 0.0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA P < 0.05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (P > 0.05 vs AUC-ROC development). CONCLUSION: Patients COVID-19 presenting at admission SOFA score ≥ 2 combined with CRP ≥ 9.1 mg/mL could be at high risk to require critical care.

C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain. / Proteína C reactiva y escala SOFA: una simple escala como factor predictivo temprano de la necesidad de cuidados críticos en los pacientes con neumonía causada por COVID-19 en España.

OBJECTIVE: To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia. MATERIAL AND METHODS: An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score. MEASUREMENTS AND MAIN RESULTS: Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; P=.0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; P<.0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA P<.05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (P>0.05 vs AUC-ROC development). CONCLUSION: Patients COVID-19 presenting at admission SOFA score ≥2 combined with CRP ≥9,1mg/mL could be at high risk to require critical care.

[C-Reactive protein and SOFA scale: A simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain]. / Proteína C reactiva y escala SOFA: una simple escala como factor predictivo temprano de la necesidad de cuidados críticos en los pacientes con neumonía causada por COVID-19 en España.

OBJECTIVE: To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia. MATERIAL AND METHODS: An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score. MEASUREMENTS AND MAIN RESULTS: Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; P = .0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; P < .0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA P < .05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (P > 0.05 vs AUC-ROC development). CONCLUSION: Patients COVID-19 presenting at admission SOFA score ≥ 2 combined with CRP ≥ 9,1 mg/mL could be at high risk to require critical care.

Sample pre-treatment and analytical methodology for the simultaneous determination of pharmaceuticals and personal care products in sewage sludge.

This work describes the design, optimization and validation of an analytical method for the simultaneous determination of 14 pharmaceuticals and personal care products (PPCPs) in sewage sludge. A thorough optimization of the sample pre-treatment was carried out. As a result, microwave-assisted extraction (MAE) was combined with an in-situ clean-up stage and a filtration step. A combination of MilliQ® water/MeOH 95:5 (v/v) adjusted to pH 9 turned out to be the optimal solvent mixture for extraction. The instrumental part of the method presents a significant novelty based on a fully automated sample preparation for the analysis of PPCPs. It consisted of a direct immersion solid phase microextraction followed by on-fiber derivatization, online coupled to gas chromatography - mass spectrometry (DI-SPME-On-fiber derivatization - GC-MS). An isotope dilution approach was used for quantifying, which conferred high reliability to the method. This methodology was validated for 10 compounds with good analytical performance, limit of detection below 20 ng g-1 and absolute recovery in the range of 30-70% for most of the compounds. It supposes an ecological analytical alternative for many routine analysis laboratories around the world. The developed method was applied to different real samples generated in both a pilot-scale thermal hydrolysis treatment plant and an anaerobic digester operated in mesophilic conditions. Salicylic acid and naproxen were found at concentrations above 1000 ng g-1.

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients.

BACKGROUND: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. METHODS: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. RESULTS: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). CONCLUSION: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.

ANTECEDENTES: La estratificación de la gravedad de una infección se basa actualmente en la puntuación SOFA (Sequential Organ Failure Assessment), que es difícil de calcular fuera de la unidad de cuidados intensivos. Los biomarcadores podrían ayudar a estratificar la gravedad de la infección en pacientes quirúrgicos. MÉTODOS: Se compararon las concentraciones de 10 biomarcadores que denotan disfunción endotelial, 22 que indican granulopoyesis de emergencia y 6 que expresan la degranulación de neutrófilos en tres grupos de pacientes de tres hospitales españoles (100 con infección, 95 con sepsis y 57 con shock séptico) en las primeras doce horas después del diagnóstico. RESULTADOS: Siete biomarcadores que expresan disfunción endotelial (proadrenomedulina, sindecan-1, trombomodulina, angiopoyetina-2, endocan-1, molécula de adhesión endotelial 1 y E-selectina) mostraron una fuerte asociación con la sepsis en comparación con la infección aislada. La proadrenomedulina presentó el valor más alto de la razón de oportunidades (odds ratio, OR) en el análisis multivariable (OR 11,53, i.c. del 95% 4,15-32,08, P = 0,006) y la mejor área bajo la curva para detectar sepsis (AUC 0,86, i.c. del 95% 0,80-0,91, P < 0,001). En la comparación entre sepsis y shock séptico, los biomarcadores que mostraron la asociación más estrecha con el shock séptico fueron dos biomarcadores de degranulación de neutrófilos (proteinasa-3 y lipocalina-2) (OR 8,09, i.c. del 9% 1,34-48,91, P = 0,028; OR 6.62, i.c. del 95% 2,47-17,77, P = 0,002), pero la lipocalina-2 presentó la mejor AUC (0,81, i.c. del 95% 0,73-0,90, P < 0,001). CONCLUSIÓN: la proadrenomedulina y la lipocalina-2 podrían representar alternativas a la puntuación SOFA para detectar sepsis y shock séptico en pacientes quirúrgicos con infección.

Analytical methodologies for the determination of pharmaceuticals and personal care products (PPCPs) in sewage sludge: A critical review.

Several analytical approaches have been developed for the determination of emerging pollutants (EPs), including pharmaceuticals and personal care products (PPCPs) in environmental matrices. This paper reviews the sample preparation and instrumental methods proposed in the last few years (2012-2018) to assess PPCPs in sewage sludge. Three main steps are examined: extraction, clean-up and analysis. Sample preparation is critical as target compounds are normally found at low concentrations in complex matrices. Most procedures include sewage sludge pretreatment mostly through ultrasound-assisted extraction (UAE) although other novel techniques such as QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) or MSPD (matrix solid-phase dispersion) have been also employed. In one report, no differences in extraction efficiency were detected among the most commonly used extraction techniques such as ultrasound, microwave and pressurized liquid. Clean-up usually involves a conventional method such as solid phase extraction (SPE). This step is needed to appreciably reduce matrix suppression, and is followed by an instrumental analysis using techniques of preference such as gas chromatography (GC) or liquid chromatography (LC), mostly coupled to mass spectrometry (MS). A fully automated on-line system that includes extraction, chromatographic separation, and mass spectrometry in one-stage is here presented as a novel way of determining PPCPs in sewage sludge. This review also discusses the advantages and limitations of the different techniques used. Miniaturizing analytical techniques and the use of novel solid and liquid phase materials are emerging as efficient options that fulfill the principles of so-called "green chemistry".

Optimization of a thermal hydrolysis process for sludge pre-treatment.

At industrial scale, thermal hydrolysis is the most used process to enhance biodegradability of the sludge produced in wastewater treatment plants. Through statistically guided Box-Behnken experimental design, the present study analyses the effect of TH as pre-treatment applied to activated sludge. The selected process variables were temperature (130-180 °C), time (5-50 min) and decompression mode (slow or steam-explosion effect), and the parameters evaluated were sludge solubilisation and methane production by anaerobic digestion. A quadratic polynomial model was generated to compare the process performance for the 15 different combinations of operation conditions by modifying the process variables evaluated. The statistical analysis performed exhibited that methane production and solubility were significantly affected by pre-treatment time and temperature. During high intensity pre-treatment (high temperature and long times), the solubility increased sharply while the methane production exhibited the opposite behaviour, indicating the formation of some soluble but non-biodegradable materials. Therefore, solubilisation is not a reliable parameter to quantify the efficiency of a thermal hydrolysis pre-treatment, since it is not directly related to methane production. Based on the operational parameters optimization, the estimated optimal thermal hydrolysis conditions to enhance of sewage sludge digestion were: 140-170 °C heating temperature, 5-35min residence time, and one sudden decompression.

Masa cervical gigante. Un reto anestésico / Giant cervical mass. An anesthetic challenge

No disponible

El perfil de los ácidos grasos como factor identificador del tipode grasa utilizado en la elaboración de helados / Fatty acid profiles as markers of the type of fat used to prepare ice cream

El perfil de ácidos grasos permite caracterizar las materias utilizadas en la elaboración de helados. De la comparación de dichos perfiles con los de otras grasas(aceites, leches, etc.) se deduce que gran parte de los helados comerciales analizados parecen haber sido elaborados con aceite de coco o grasas elaboradas a partir del mismo. Por el contrario los helados artesanales analizados han sido elaborados con leche o derivados (mantequilla). Estas conclusiones cualitativas son confirmadas mediante análisis estadístico multivariante (análisis en factores y análisis clúster). En ambos casos puede comprobarse que gran parte de las muestras industriales se agrupan en las proximidades del aceite de coco. Dentro de los helados artesanales puede observarse un grupo en las proximidades de la leche y derivados (mantequilla), mientras que los helados de almendra y turrón aparecen en la zona del aceite de almendra, de gran parecido con otros aceites vegetales (oliva, girasol etc.) (AU)

By examining fatty acid profiles, the different ingredients used in ice cream production may be characterized. When these profiles were compared to those of other fats (oils, milk, etc.), many of the commercial brands of ice cream tested were found to contain coconut oil or coconut itself. In contrast, our data indicate that the smaller cottage industry-type ice creams examined were elaborated from milk or milk products(butter or cream). These qualitative findings were confirmed by multivariate statistical analysis (factor and cluster analyses). In the cluster diagrams presented, it can be seen that that many of the industrial samples grouped in the vicinity of coconut oil. Within the cottage ice cream grouping, appeared a group close to one clustering milk and butter, while ice-cream made of almond and nougat appeared in the almond oil zone, showing great similarity with other vegetable oils (olive, sunflower etc.) (AU)

Estudio comparativo de las dietas suministradas en distintos tipos de residencias de la tercera edad / Comparing the diets of elderly people living in different types of institution

Se lleva a cabo un estudio de las dietas suministradas en 5 residencias públicas y 10 residencias privadas de personas mayores durante un ciclo de 15 días. Se controla la composición nutricional de la ingesta para cada día del ciclo, la cantidad de cada alimento utilizado y la forma de cocinarlo, la cantidad de alimentos servidos a hombres y mujeres, la cantidad de alimentos preparados pero no servidos y la cantidad de alimentos servidos y no consumidos por hombres y mujeres. Todos los parámetros nutricionales obtenidos están dentro de los valores recomendados, por lo que el estudio indica que las dietas son equilibradas, la variabilidad de alimentos adecuada, el grado de aceptación bueno y el servicio correcto. La calidad de los alimentos es buena, si bien, según el tipo de residencia hay diferencias en la utilización de alimentos frescos o congelados y en las preparaciones. En todo caso las preparaciones no son habitualmente las más recomendadas, ya que se prefiere de forma muy significativa, los guisos, los fritos y las salsas frente a la plancha el hervido o el horno. El análisis estadístico mediante componentes principales agrupa las residencias públicas en la zona de predominio de la fibra y el colesterol, las privadas de coste medio en la zona de predominio de las grasas y por tanto de mayor número de kilocalorías, mientras que las de coste medio alto se agrupan en la zona de las proteínas (AU)

This study compares the diets administered to elderly persons living in 5 public and 10 private homes over a 15-day period. For each day of the study period, the following variables were recorded: the nutritional composition of the meals, the amount of each food type used and how it was cooked, the amounts of food types served to men and women, the number of meals prepared but not served and the number of meals served but not consumed by men and women. All the nutritional variables recorded were within recommended values such that the diets were well-balanced and sufficiently varied. All meals were also well accepted by the consumers and well-served. The quality of the different foods was good, although differences were observed in the use of fresh or frozen foods or how the food was prepared foods depending on the type of home. The modes of food preparation were generally not the most recommendable, since stews, fried food and sauces were significantly preferred to grilled, boiled or oven-cooked foods. Statistical analysis grouped the diets on a principal component plot as follows: those administered by public institutions in the area of predominating fibre and cholesterol, the diets of intermediate-cost homes in the zone of predominant fat and therefore greater number of kilocalories, while the meals supplied by intermediate to high cost homes grouped in the zone of high protein contents (AU)

Magnetic solids in analytical chemistry: a review.

Magnetic solids are widely used in detection and analytical systems because of the performance advantages they offer compared to similar solids that lack magnetic properties. These solids can be used to pre-concentrate analytes and for the magnetic separation and molecular identification of biomolecules, and organic and inorganic species. Magnetic solid separation techniques also offer benefits over centrifugation, filtration, and solid-phase extraction. In this review, we describe the synthesis, characterization and applications of a series of solids including silica supports, carbon nanotubes, alumina, organic polymers and other materials, mostly containing magnetite or paramagnetic metals. Also addressed are the future perspectives of magnetic solid applications.

Determination of non-steroidal anti-inflammatory drugs in wastewaters by magnetic matrix solid phase dispersion-HPLC.

A series of supports functionalized with different alkyl chains and covered with magnetite were synthesized, characterized and applied in the sample pre-concentration of four non-steroidal anti-inflammatory drugs (acetaminophen, naproxen, diclofenac and ibuprofen) contained in wastewater samples. The general methodology involved magnetic solid phase dispersion followed by the analysis by high-performance liquid chromatography with ultraviolet detection. The magnetic supports were initially dispersed in the samples with the aid of Triton X-100, then supports were magnetically isolated and the analytes were eluted with methanol. Finally the extract was injected into the HPLC system. The highest recovery percentage (>90%) was obtained with the support containing octyl chains (C8) at pH 3. The lowest limits of detection achieved ranged within 1-2microgL(-1) with repeatability (expressed as RSD) below 5% in all cases. The method was applied in the analysis of wastewater samples.

Determination of primary amino acids in wines by high performance liquid magneto-chromatography.

Eight amino acids (ethanolamine, glycine, alanine, beta-aminobutyric acid, leucine, methionine, histidine and asparagine) were identified and quantified in Spanish wines by high performance liquid magneto-chromatography (HPLMC) with UV-V spectrophotometry. For this method, the amino acids are first complexed with mono(1,10-phenanthroline)-Cu(II) to confer them paramagnetic properties, and then separated by application of a low magnetic field intensity (5.5 mT) to the stationary phase contained in the chromatographic column. Principal components analysis of the results obtained grouped together the wine samples according to their denomination of origin: "Ribera del Duero", "Rueda" or "Rioja" (Spain). Through cluster analysis, a series of correlations was also observed among certain amino acids, and between these groupings and the type of wine. These clusters were found to reflect the role played by the amino acids as primary or secondary nutrients for the bacteria involved in alcoholic and malolactic fermentation.

[Fat composition of several "fast food"]. / Composición grasa de diversos alimentos servidos en establecimientos de "comida rápida"

The percentage of fat of a variety of foods served in fast food establishments has been determined. This percentage is very variable, with mean contents of total fat of 35.83 +/- 10.68% in beef hamburgers, 35.84 +/- 8.66% in chips, 23.02 +/- 5.07% in chicken hamburgers and 34.02 +/- 13.49% in "hot dogs". The lipidic composition is mainly formed by saturated fatty acids (28-52% of total fat) and monounsaturated (46-48%), whereas the proportion of polyunsaturated fatty acids showed more variable values, ranging from 6.9% in beef hamburgers to 25.1% in chips. Statistical treatment of the results of relative percentage of fatty acids by multivariate methods revealed clusters of samples grouped as a function of the type of food and in some instances of its source, which can be interesting in case of healthy problems. Percentages of trans fatty acids slightly higher than the maximum recommended values have been detected in some cases. These results show the urgent need of modifying the laws to force fast food establishments to specify the type and amounts of fat used in the processing of these foods, as well as a greater control from the local administrations.

Composición grasa de diversos alimentos servidos en establecimientos de "comida rápida" / Fat composition of several “fast food”

Se determina el porcentaje de grasa, de diversos alimentos servidos en establecimientos de los denominados genéricamente de comida rápida ("fast food") o "hamburgueserías". Dicho porcentaje es muy variable, con un promedio del 35,83 ± 10,68% en hamburguesas de vacuno, 35,84 ± 8,66% en patatas fritas, el 23,02 ± 5,07% en hamburguesas de pollo y el 34,02 ± 13,49% en los denominados "perritos calientes". La composición lipídica está formada en su mayoría por ácidos grasos saturados (28 a 52% relativo al total de grasa y monoinsaturados (46-48%), mientras que la proporción de los ácidos grasos poliinsaturados tiene valores más dispares, oscilando desde el 6,9% en hamburguesas de vacuno al 25,1% en las patatas fritas. Cuando se tratan los resultados de los porcentajes relativos de los ácidos grasos contenidos en las distintas muestras mediante técnicas estadísticas apropiadas, se comprueba que se generan una serie de agrupaciones en función del tipo de alimento de que se trate y en algunos casos por lugar de origen, lo que puede ser interesante en caso de problemas relacionados con la salud. En algún caso se han detectado porcentajes ligeramente altos de ácidos grasos trans, respecto a lo recomendado. Estos resultados ponen de manifiesto la necesidad urgente de que la legislación obligue a especificar el tipo de grasa exacta utilizada en la elaboración de estos alimentos, así como un mayor control por parte de las administraciones (AU)

The percentage of fat of a variety of foods served in fast food establishments has been determined. This percentage is very variable, with mean contents of total fat of 35.83 ± 10.68% in beef hamburgers, 35.84 ± 8.66% in chips, 23.02 ± 5.07% in chicken hamburgers and 34.02 ± 13.49% in "hot dogs". The lipidic composition is mainly formed by saturated fatty acids (28-52% of total fat) and monounsaturated (46-48%), whereas the proportion of polyunsaturated fatty acids showed more variable values, ranging from 6.9% in beef hamburgers to 25.1% in chips. Statistical treatment of the results of relative percentage of fatty acids by multivariate methods revealed clusters of samples grouped as a function of the type of food and in some instances of its source, which can be interesting in case of healthy problems. Percentages of trans fatty acids slightly higher than the maximum recommended values have been detected in some cases. These results show the urgent need of modifying the laws to force fast food establishments to specify the type and amounts of fat used in the processing of these foods, as well as a greater control from the local administrations (AU)

Estudio del patrón de presiones plantares en pies con hallux valgus mediante un sistema de plantillas instrumentadas / Study of plantar pressure patterns by means of instrumented insoles in subjects with hallux valgus

Introducción. Las presiones que soporta el antepié en una patología como el hallux valgus ha sido un tema discutido, con resultados dispares. Este artículo pretende comparar las presiones soportadas por el antepié en un grupo de pies normales y en un grupo de pies con hallux valgus leves o moderados. Material y métodos. Se realiza un estudio en 60 sujetos (30 con hallux valgus y 30 con pies sanos), que son analizados con el sistema Biofoot/IBV de plantillas instrumentadas. El sistema emplea unas finas plantillas (0,7 mm de grosor) con 64 sensores piezoeléctricos. Se analiza la presión máxima en siete regiones, las cinco cabezas metatarsales, el hallux y los dedos menores. Resultados. Los picos máximos de presión en el grupo control se localizaron significativamente en segunda y tercera cabeza metatarsal (p = 0,001). El grupo de pies con hallux valgus registraron picos en la primera cabeza y en el ha- llux (p = 0,001). La localización de los picos de presión en el primer radio sugiere la pronación como factor desencadenante del hallux valgus. Conclusiones. Los sistemas de plantillas instrumentadas son excelentes para analizar las presiones normales y patológicas. Son necesarios estudios más amplios para llegar a conclusiones más precisas. Se abren diferentes vías de investigación, como el estudio de las presiones a cadencias y velocidades determinadas y con diferentes calzados

Introduction. The pressures exerted on the forefoot in a condition like hallux valgus have been the subject of much debate, with dissimilar results. This article aims to compare the pressures borne by the forefoot in a group of normal feet with those it bears in a group of feet with mild or moderate hallux valgus. Materials and methods. A study was performed of 60 subjects (30 with hallux valgus and 30 with normal feet), who were analyzed with the Biofoot/IBV instrumented insole system. The system uses a series of thin insoles (0.7 mm-thick) with 64 piezoelectric sensors. Maximum pressure was analyzed in seven regions, i.e. the five metatarsal heads, the hallux and the lesser rays. Results. Maximum pressure peaks in the control group were measured significantly in the second and third metatarsal heads (p = 0.001). The hallux valgus group had its pressure peaks at the first metatarsal head and at the hallux (p = 0.001). The presence of pressure peaks at the first ray points to pronation as the factor leading to hallux valgus. Conclusions. Instrumented insole systems are an excellent tool to analyze normal and pathological pressures. More detailed studies are necessary to come to more definite conclusions. In future, different research ways could be followed such as the study of pressures at pre-established values of cadence and speed of gait and with different kinds of footwear

Orthogonal array optimization of a multiresidue method for cereal herbicides in soils.

Nearly 40 herbicides, commonly used for barley, were selected for analysis in soils of this crop. The primary objective was to develop a multiresidue method taking into account that herbicides belonged to different chemical families. Some preliminary experiments with different solvents in combination with water, acetic acid and ammonium hydroxide, were developed in order to design the predefined region covered by the orthogonal array design used for optimization. Final extracts were splitted in two aliquots, one of them was directly analyzed by gas chromatography-mass spectrometry (GC-MS), and the other one was derivatized before the acidic analyte analysis. Principal component analysis (PCA) was applied to the data generated in the preliminary experiments, in order to clarify the relationships among the different variables studied. According to the obtained results, the following variables were selected: solvent type and ratio, amount of acetic acid and extraction time. The statistical analysis revealed that all the factors were significant being the most important, the type and ratio of solvent for basic and neutral herbicides and the acetic acid percentage for acid herbicides. The final optimized method consisted of shaking previously wet soil samples for 30 min with 30 ml of acetone acidified with 1% acetic acid. Method validation was evaluated following the EU guidelines.

Estudio baropodométrico de los valores de presión plantar en pies no patológicos / Baropodometry study of plantar pressure values in normal feet

Introducción. El objetivo de este estudio fue evaluar las presiones plantares normales en sujetos sanos mediante baropodometría electrónica. Material y métodos. Cuarenta y seis sujetos sanos fueron analizados con el sistema Biofootì de plantillas instrumentadas. El sistema emplea unas plantillas con 64 sensores piezoeléctricos. Se midieron las presiones en el talón, mediopié y antepié en 6 segundos de grabación para cada sujeto. El pico de presión máxima y la presión media fue calculado y analizado. Resultados. La media del tiempo de contacto fue de 0,81 segundos (desviación estándar [DE] 0,08) en el pie derecho, y 0,82 segundos (DE 0,09) en el izquierdo. La cadencia fue de 105,6 (± 8,4) pasos por minuto. El pico máximo de presión y presión media en el retropié fue de 750 y 253 kPa, respectivamente. En el mediopié el pico de presión fue de 400 kPa y la presión media de 65 kPa. En el antepié los valores encontrados fueron de 1.240 kPa para el pico de presión y de 220 kPa para la presión media. Discusión. Los picos de presión más elevados se encontraron en el antepié, seguidos del retropié y por último en el mediopié. En relación a la presión media, el porcentaje de apoyo del talón es del 46,4 %, el del mediopié de un 12 % y el del antepié de un 41,6 %. Con el número de pacientes analizados no se encontró correlación entre cadencia y presiones, aunque el peso presentaba una correlación significativa y positiva con los valores de presión en todas las zonas

Background. This study aimed to evaluate normal plantar pressures in healthy subjects using an electronic baropodometry. Material and methods. Forty-six healthy subjects, with no clear foot or lower limb diseases, were analyzed with the Biofootì (IBV, Valencia, Spain) in-shoe system. The Biofoot system uses insoles with 64 piezoelectric sensors. Heel, midfoot and forefoot pressures were measured in 6 second recordings for each subjects. Maximum pressure peak and mean pressure was calculated and analyzed. Results. Mean contact time was 0.81 (standard deviation [SD] 0.08) seconds in the right foot and 0.82 (SD 0.09) seconds in the left foot. Walking cadency was 105.6 (SD 8.4) steps per minute. Maximum peak and mean pressure in the heel was 750 and 253 kPa, respectively. In the midfoot, peak pressure was 400 kPa and mean pressure 65 kPa. The values found in the forefoot was 1,240 kPa for pressure peak and 220 kPa for mean pressure. Discussion. The highest pressure peaks were found in the forefoot, followed by the heel and finally in the midfoot. In relationship to mean pressure, percentage of heel support is 46.4 %, that of the midfoot 12 % and forefoot 41.6 %. No correlation was found between cadence and pressure values with the number of patients analyzed in this study, however, there was a significant and positive correlation of weight with the pressure values in all the regions

Bloqueo del ganglio estrellado y anestesia subaracnoidea. Caso Clínico / No disponible

El ganglio estrellado está formado por la unión del ganglio cervical inferior y el primer ganglio torácico. El bloqueo de dicho ganglio es usado para el diagnóstico y tratamiento de diversos síndromes dolorosos crónicos. Esta técnica con anestésicos locales suele ser segura aunque no exenta de complicaciones como convulsiones, neumotórax o anestesia espinal entre otras. Estas complicaciones pueden minimizarse con una adecuada vigilancia, monitorización y recursos adecuados. Para un correcto diagnóstico y tratamiento de las posibles complicaciones. Presentamos el caso de un bloqueo espinal completo tras la realización de un bloqueo del ganglio estrellado (AU)

The stellate ganglion refers to the ganglion formed by fusion of the inferior cervical and the first thoracic ganglion. Stellate ganglion blockade is a procedure mainly used for the diagnosis and treatment of chronic painful syndromes. This technique with local anesthetic is a safe procedure, his risk, though infrequent; include seizures, pneumothorax, spinal block and others. These complications can be minimized with adequate monitoring, surveillance and resources in order to diagnostic and treatment of complications. We present a case with spinal block following stellate ganglion blockade (AU)