Effects of bisphenol F, bisphenol S, and bisphenol AF on cultured human osteoblasts.

Bisphenol A (BPA) analogs, like BPA, could have adverse effects on human health including bone health. The aim was to determine the effect of BPF, BPS and BPAF on the growth and differentiation of cultured human osteoblasts. Osteoblasts primary culture from bone chips harvested during routine dental work and treated with BPF, BPS, or BPAF for 24 h at doses of 10-5, 10-6, and 10-7 M. Next, cell proliferation was studied, apoptosis induction, and alkaline phosphatase (ALP) activity. In addition, mineralization was evaluated at 7, 14, and 21 days of cell culture in an osteogenic medium supplemented with BP analog at the studied doses. BPS treatment inhibited proliferation in a dose-dependent manner at all three doses by inducing apoptosis; BPF exerted a significant inhibitory effect on cell proliferation at the highest dose alone by an increase of apoptosis; while BPAF had no effect on proliferation or cell viability. Cell differentiation was adversely affected by treatment with BPA analogs in a dose-dependent, observing a reduction in calcium nodule formation at 21 days. According to the results obtained, these BPA analogs could potentially pose a threat to bone health, depending on their concentration in the organism.

[Factors associated with the hospital at home workload: A Delphi consensus study]. / Factores relacionados con la carga de trabajo en hospitalización a domicilio: estudio de consenso Delphi.

OBJECTIVES: To identify and prioritize a list of factors that contribute to the workload of the hospital at home (HaH) professionals. MATERIAL AND METHODS: A qualitative methodology study performed between January and December 2019 in the 10 HAH units of the Basque Country. The data were obtained in 4phases: 1. Systematic literature search and review; 2. Expert group meeting; 3. Consensus method: Delphi technique (2 survey rounds) and nominal group meeting; 4. Meeting of the research team. RESULTS: In the systematic literature search and review 85 factors were initially identified. These were reduced to 38 after the 8-person expert group meeting, in which 10 new factors were added. After the 2 Delphi rounds (106 and 57 professionals, respectively), 17 factors were maintained and 12 remained in doubt. The latter were evaluated at the nominal group meeting, consisting of 13 professionals who decided to eliminate 5 factors, include 3, and keep 3 as doubt. After the 8-person research team meeting, 14 potential factors were finally selected. They are related to the place of residence, the health state and social situation of the patients, as well as the health care provided at home. CONCLUSIONS: The identified factors could serve for improving the organization and optimize the daily word of the HaH professionals.

Adjusted global antiphospholipid syndrome score (aGAPSS) is useful to predict relapses in patients with retinal vein occlusion.

BACKGROUND: A significant proportion of patients with retinal vein occlusion (RVO) are antiphospholipid antibodies (aPL) carriers. Relapsing disease occurs in nearly 10 % of cases and the role of aPL has not been established. The adjusted global antiphospholipid syndrome score (aGAPSS) was developed to assess the risk of clinical events in aPL carriers and its role in the management of RVO patients is unknown. OBJECTIVE: To analyze the values of aGAPSS in a large cohort of patients with RVO and population-based controls, and to assess its usefulness to predict RVO relapses. METHODS: Case-control study of RVO patients and population-based controls of similar age and sex. We have assessed and compared the aPL profile and the aGAPSS score in patients with and without relapsing disease and controls. RESULTS: Four-hundred and seventy-two RVO patients and 346 controls were included. Fifty-seven RVO patients had antiphospholipid syndrome (RVO-APS). Of them, 75.4 % had a high-risk profile compared to 3 % in controls (p = 0.0001). The median aGAPSS values were 8 [7-13], 3 [1-4], and 3 [0-4], in RVO-APS, RVO no-APS, and controls. Nineteen patients had had a recurrence of RVO before inclusion and 8 during the follow-up. APS was more prevalent in relapsing patients. In the adjusted multivariable regression model, the best predictor for RVO recurrence during the follow-up was an aGAPSS score ≥6 (OR 5.5, CI95% 1.3-23.7; p = 0.023). CONCLUSIONS: In patients with RVO, once the control of vascular risk factors has been optimized, the aGAPSS might help to identify those at risk of relapsing disease.

Oclusión venosa retiniana en pacientes menores de 50 años. Análisis de factores de riesgo vascular, trombofilia, hallazgos ecográficos carotídeos y etiologías poco frecuentes / Retinal vein occlusion in patients under 50 years. Analysis of vascular risk factors, thrombophilia, carotid ultrasound findings and uncommon aetiologies

Introducción La oclusión venosa retiniana (OVR) se ha relacionado con factores de riesgo vascular y trombofilia. Métodos Se trata de un estudio de cohorte prospectivo de todos los pacientes diagnosticados de OVR y remitidos a una clínica de medicina interna de un hospital universitario terciario durante un período de 10 años. Se analizaron variables clínicas, de laboratorio y ecográficas de troncos supraaórticos y se compararon según la edad. Resultados Se incluyeron unos 309 pacientes diagnosticados de OVR, 25 de ellos menores de 50 años. La prevalencia de hipertensión arterial, dislipidemia, diabetes mellitus, hiperhomocisteinemia y placa carotídea fue significativamente mayor en pacientes > 50 años que en los menores. Sin embargo, la prevalencia de trombofilia hereditaria fue mayor en el grupo más joven (32 vs. 11,4%; p = 0,005). Se observaron enfermedades poco frecuentes relacionadas con la OVR como hepatitis C, talasemia menor, enfermedad de Lyme, vasculitis y perlebitis en pacientes jóvenes sin factores de riesgo vascular. Conclusión Sugerimos realizar un estudio genético de trombofilia en pacientes con OVR menores de 50 años, siendo siempre recomendable un control exhaustivo de los factores de riesgo vascular en todos los pacientes con OVR. Además, sugerimos tener en cuenta las enfermedades poco frecuentes relacionadas con la OVR, especialmente en pacientes jóvenes sin factores de riesgo vascular (AU)

Introduction Retinal vein occlusion (RVO) has been related to vascular risk factors and thrombophilia. Methods This is a prospective cohort study of all patients diagnosed with RVO and referred to an Internal Medicine clinic of a tertiary teaching hospital during a 10-year period. Clinical, laboratory and supra-aortic trunks ultrasound variables were analysed and compared according to age. Results Some 309 patients diagnosed with RVO were included, 25 of them younger than 50 years. The prevalence of high blood pressure, dyslipidaemia, diabetes mellitus, hyperhomocysteinemia, and carotid plaque was significantly higher in patients>50 years than in those below. However, the prevalence of inherited thrombophilia was higher in the younger group (32.0 vs 11.4%; p = 0.005). Uncommon diseases related to RVO such as hepatitis C, thalassemia minor, Lyme disease, vasculitis, and periphlebitis were observed in young patients without vascular risk factors. Conclusion We suggest performing a genetic thrombophilia study in RVO patients younger than 50 years, while an exhaustive control of vascular risk factors is always recommended in all RVO patients. Moreover, we suggest bearing in mind uncommon diseases related to RVO, especially in young patients without vascular risk factors (AU)

Retinal vein occlusion in patients under 50 years. Analysis of vascular risk factors, thrombophilia, carotid ultrasound findings and uncommon aetiologies.

INTRODUTION: Retinal vein occlusion (RVO) has been related to vascular risk factors and thrombophilia. METHODS: This is a prospective cohort study of all patients diagnosed with RVO and referred to an Internal Medicine clinic of a tertiary teaching hospital during a 10-year period. Clinical, laboratory and supra-aortic trunks ultrasound variables were analysed and compared according to age. RESULTS: Some 309 patients diagnosed with RVO were included, 25 of them younger than 50 years. The prevalence of high blood pressure, dyslipidaemia, diabetes mellitus, hyperhomocysteinemia, and carotid plaque was significantly higher in patients >50 years than in those below. However, the prevalence of inherited thrombophilia was higher in the younger group (32.0% vs 11.4%; p = 0.005). Uncommon diseases related to RVO such as hepatitis C, thalassemia minor, Lyme disease, vasculitis, and periphlebitis were observed in young patients without vascular risk factors. CONCLUSION: We suggest performing a genetic thrombophilia study in RVO patients younger than 50 years, while an exhaustive control of vascular risk factors is always recommended in all RVO patients. Moreover, we suggest bearing in mind uncommon diseases related to RVO, especially in young patients without vascular risk factors.

Neuroendocrine pathways at risk? Simvastatin induces inter and transgenerational disruption in the keystone amphipod Gammarus locusta.

The primary focus of environmental toxicological studies is to address the direct effects of chemicals on exposed organisms (parental generation - F0), mostly overlooking effects on subsequent non-exposed generations (F1 and F2 - intergenerational and F3 transgenerational, respectively). Here, we addressed the effects of simvastatin (SIM), one of the most widely prescribed human pharmaceuticals for the primary treatment of hypercholesterolemia, using the keystone crustacean Gammarus locusta. We demonstrate that SIM, at environmentally relevant concentrations, has significant inter and transgenerational (F1 and F3) effects in key signaling pathways involved in crustaceans' neuroendocrine regulation (Ecdysteroids, Catecholamines, NO/cGMP/PKG, GABAergic and Cholinergic signaling pathways), concomitantly with changes in apical endpoints, such as depressed reproduction and growth. These findings are an essential step to improve hazard and risk assessment of biological active compounds, such as SIM, and highlight the importance of studying the transgenerational effects of environmental chemicals in animals' neuroendocrine regulation.

Stimulation of brown adipose tissue by polyphenols in extra virgin olive oil.

Obesity is one of the main public health problems of the 21st century resulting from an imbalance between calorie intake and energy expenditure. Currently, the search for new treatments against this pathology has become a priority. One of the therapeutic strategies against obesity could be the activation of brown adipose tissue through different molecules such as the phenolic compounds of extra virgin olive oil (EVOO). The objective of this review was to provide an update of scientific knowledge on the relationship between EVOO phenolic compounds and brown adipose tissue.According to this review, it has been demonstrated that extra virgin olive oil phenolic compounds can have beneficial effects on obesity by activating brown adipose tissue and enhance thermogenesis through different signaling pathways mediated by molecules such as AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor γ coactivator-1α (PGC1α) or sirtuin 1 (Sirt1).

Transgenerational inheritance of chemical-induced signature: A case study with simvastatin.

The hypothesis that exposure to certain environmental chemicals during early life stages may disrupt reproduction across multiple non-exposed generations has significant implications for understanding disease etiology and adverse outcomes. We demonstrate here reproductive multi and transgenerational effects, at environmentally relevant levels, of one of the most prescribed human pharmaceuticals, simvastatin, in a keystone species, the amphipod Gammarus locusta. The transgenerational findings has major implications for hazard and risk assessment of pharmaceuticals and other contaminants of emerging concern given that transgenerational effects of environmental chemicals are not addressed in current hazard and risk assessment schemes. Considering that the mevalonate synthesis, one of the key metabolic pathways targeted by simvastatin, is highly conserved among metazoans, these results may also shed light on the potential transgenerational effects of simvastatin on other animals, including humans.

El análisis de aguas residuales con fines epidemiológicos: presente y futuro en España / Wastewater-based epidemiology: present and future in Spain

El análisis de aguas residuales con fines epidemiológicos es actualmente una herramienta fiable y complementaria a las metodologías basadas en indicadores tradicionales para el control de diferentes sustancias entre las que cabe destacar las drogas. Si bien varios países europeos la utilizan como herramienta de trabajo para la monitorización de drogas de abuso, en España su uso se limita principalmente a estudios realizados por diferentes grupos de investigación, tal y como se describe en el caso práctico puesto de ejemplo en el artículo. Sin embargo, el potencial de la metodología ha quedado evidenciado en los estudios científicos llevados a cabo tanto a nivel español como internacional y, aunque son necesarios más estudios para llegar a conocer todo su potencial, se prevé pueda ser incorporada como herramienta de trabajo complementaria a las que habitualmente se utilizan. En este sentido, la Red Española de Análisis de Aguas Residuales (ESAR-Net), creada en 2017 y formada por diferentes grupos de investigación españoles, pretende contribuir al conocimiento y aplicación de esta metodología en España a través de actividades científicas y de divulgación

Wastewater-Based Epidemiology is currently a reliable and complementary tool to methodologies based on traditional indicators for the control of various substances such as drugs. Although several European countries use it as a working tool for the monitoring of drugs of abuse, in Spain its use is mainly limited to studies carried out by different research groups, as described in the case study used as an example in the article. However, the potential of the methodology has been demonstrated in the scientific studies carried out both at the Spanish and international level and, although more studies are necessary to get to know its full potential, it is expected that it could be incorporated as a complementary work tool to those that are usually used. In this sense, the Red Española de Análisis de Aguas Residuales (ESAR-Net), created in 2017 and formed by different Spanish research groups, aims to contribute to the knowledge and application of this methodology in Spain through scientific and outreach activities

Protocolo de sustitución de anticoagulantes y antiagregantes en las infiltraciones para el tratamiento del dolor crónico, atendiendo al riesgo hemorrágico y trombótico / Guideline for replacement of anticoagulants and antiagaging in infiltrations for the treatment of chronic pain, according hemorrhagic and trombotic risk

El dolor crónico es una de las principales causas de incapacidad e impotencia funcional en la sociedad actual. La mayor demanda y complejidad de las infiltraciones en las unidades de dolor crónico aumenta cada día. Por otro lado, las enfermedades cardiovasculares y cerebrovasculares son las que generan más morbimortalidad en nuestro medio. Por ello, uno de los problemas que nos encontramos, previo a la realización de las infiltraciones, es el aumento del número de pacientes que están bajo tratamiento antiagregante plaquetario (AAP) y/o anticoagulante. La toma de antiagregantes plaquetarios o anticoagulantes suscitan una gran preocupación en las infiltraciones que afectan al neuroeje, infiltraciones miofasciales profundas o bloqueos profundos, ya que estos procedimientos presentan un riesgo hemorrágico elevado. El objetivo de esta guía es mejorar la calidad y seguridad en la atención de los pacientes antiagregados y anticoagulados de cara a recibir una infiltración en la Unidad de Dolor, así como evitar derivaciones innecesarias a otros especialistas. Es preciso conocer el riesgo hemorrágico de los procedimientos que vamos a realizar, pero también los motivos por los que el paciente está antiagregado y anticoagulado y los límites de seguridad de cada fármaco, no solo para poder ser conscientes de las consecuencias de una suspensión inadecuada de estos tratamientos, sino para poder establecer una adecuada terapia puente con heparina de bajo peso molecular (HBPM) si estuviese indicada. Para ello los pacientes anticoagulados se dividen en dos categorías según la infiltración a realizar: los que precisan suspender los ACO y realizar terapia puente con heparina de bajo peso molecular (HBPM) y los que no. Los antivitamina K se suspenderían los 3-5 días previos a la infiltración. Los anticoagulantes directos (DACOS) entre 3-5 días, dependiendo del fármaco. La terapia puente de HBPM se iniciaría al día siguiente de la suspensión del anticoagulante. Contemplamos situaciones especiales, como la insuficiencia renal, que aumenta los intervalos de seguridad en la suspensión del fármaco para los anticoagulantes directos (DACOS) y precisa de variaciones en la pauta de HBPM para la terapia puente. La reintroducción de los DACOS se realizará a las 24 horas de la técnica sin necesidad de poner HBPM de manera simultánea. Junto con los antivitamina K se debe pautar a las 24 horas de la infiltración, y durante los 5 días posteriores, una HBPM hasta que el INR esté en rango terapéutico (realizándose el control de manera ambulatoria). Los pacientes en tratamiento con AAS tendrían dos categorías: técnicas que se pueden realizar manteniendo el AAS y las que no. El resto de antiagregantes tendrían tres opciones: técnicas que precisan suspenderlos para realizar las técnicas con intervalos de seguridad diferentes para cada fármaco, técnicas en las que sería necesario sustituirlos por AAS en función del riesgo trombótico y aquellas que no precisarían modificaciones de la pauta. El intervalo de suspensión de los AAP antes de la infiltración sería: AAS 3-4 días, clopidogrel 5-7 días, prasugrel 4-6 días y ticagrelor 3-5 días. La suspensión en el número menor del rango requerirá de una evaluación multidisciplinar del caso. Todas las recomendaciones sobre la suspensión de antiagregantes persiguen el objetivo de llegar a la prueba con los niveles de fármaco lo suficientemente bajos para no producir un sangrado con riesgo vital y, a la vez, que permita alcanzar los niveles terapéuticos de cada antiagregante plaquetario o anticoagulante lo más rápido posible tras la reintroducción. La sustitución de los AAP por HBPM a dosis terapéuticas es una posibilidad no completamente validada. En pacientes con antiagregante y anticoagulante se deberán seguir las indicaciones para cada fármaco de manera independiente. En situaciones muy concretas como la doble terapia antiagregante o triple terapia antitrombótica, lo más aconsejable es esperar a que el riesgo trombótico disminuya. Si la infiltración/bloqueo fuese mandatorio, aunque nos atrevamos a dar unas recomendaciones, lo más prudente es tomar una decisión consensuada multidisciplinar entre los equipo de Hematología/Hemostasia, Cardiología y Unidad del Dolor. En un principio se recomendaba esperar más de 12 meses antes de suspender la doble antiagregación en pacientes con stent farmacoactivo. Sin embargo, los stent de nueva generación permiten modificaciones de este margen de seguridad sobre el que nos deberá asesorar el cardiólogo intervencionista. Especial consideración merecen otros fármacos de consumo habitual que producen alteraciones de la hemostasia: los AINE y los inhibidores de la recaptación de serotonina (ISRS). Recomendamos solicitar un estudio de coagulación completa (AP, TTPA, fibrinógeno) a todos los pacientes que vayan a ser sometidos a infiltraciones de moderado o elevado riesgo hemorrágico previo a la infiltración y el día de la misma en aquellos pacientes en tratamiento con anticoagulantes

Chronic pain is one of the leading causes of disability and functional impotence in today's society. The increased demand and complexity of infiltrations in chronic pain units increases every day. On the other hand, cardiovascular and cerebrovascular diseases are the ones that generate more morbi-mortality in our environment. Therefore, one of the problems that we face, prior to the infiltration, is the increase in the number of patients undergoing antiplatelet therapy (AAP) and/or anticoagulant therapy. The intake of antiplatelet agents or anticoagulants is of great concern in order to offer the patient an infiltration that affects the neuroege, deep myofascial infiltrations or deep blockages, since these procedures present a high hemorrhagic risk. The objective of this guide is to improve the quality and safety of antiaggregated and anticoagulated patients in order to receive an infiltration in the Pain Unit, as well as to avoid unnecessary referrals to other specialists. It is necessary to know the hemorrhagic risk of the procedures that we are going to carry out, but also the reasons why the patients are antiaggregated and anticoagulated and the safety limits for laying off each drug, not only to be aware of the consequences of an inadequate suspension of these treatments but to be able to establish an appropriate bridging therapy with. There are also certain circumstances that may increase the risk of procedural bleeding (alterations in the anatomy of the spine, multiple punctures, not using scopia, aspiration of blood after puncture...). This may influence the reintroduction of antiplatelet and anticoagulant therapy, which will be routinely reintroduced within 24 hours of infiltration. The anticoagulated patients are divided into two categories according to the infiltration to be performed: those who need to discontinue anticoagulants and to perform low molecular weight heparin (LMWH) bridge therapy and those who do not. Anti-vitamin K would be discontinued 3-5 days prior to infiltration. Direct Anticoagulants (DACOS) between 3-5 days, depending on the drug. LMWH bridging therapy would begin the day after the anticoagulant suspension. We contemplate special situations such as renal failure, which increases the safety intervals in the suspension of the drug for Direct Anticoagulants (DACOS) and requires variations in the pattern of LMWH for bridge therapy. The reintroduction of DACOS deserves special mention. This is done within 24 hours of the technique without the need to put LMWH simultaneously. In addition to the anti-vitamin K, an LMWH should be administered within 24 hours of infiltration, and during the next 5 days, until the INR is within the therapeutic range (control performed on an outpatient basis). Thus patients on acetyl salicylic acid treatment would have two categories: techniques that can be performed while maintaining ASA and those that do not. The remaining antiplatelet agents would have three options: techniques that need to be suspended to perform the techniques with different safety intervals for each drug, techniques in which it would be necessary to replace them with AAS based on thrombotic risk and those that would not require modification of the schedule. The acetyl salicylic acid must be interrupted: ASA 3-4 days, Clopidogrel 5-7 days, Prasugrel 4-6 days and Ticagrelor 3-5 days (Suspension in the lower number of the range will require a multidisciplinary assessment of the case). All recommendations have the objective of getting to the infiltration with drug levels low enough not to produce life-threatening bleeding and at the same time allow the therapeutic levels of each platelet or anticoagulant antiplatelet to be reached as fast possible after reintroduction. The replacement of antiagregant by LMWH at therapeutic doses is a possibility that is not completely validated. In patients with antiaggregant and anticoagulant the indications for each drug should be followed independently. In very specific situations such as double antiagging therapy or triple antitromotic therapy, it is best to wait until the thrombotic risk decreases. If infiltration/blocking is mandatory it is prudent to make a consensual multidisciplinar decision among the Hematology/Hemostasis, Cardiology and Pain Unity teams. At first, it was recommended to wait more than 12 months before suspending the double antiplatelet in patients with drug-eluting stents. However, new-generation stents allow modifications of this safety margin on which the interventional cardiologist should advise us. Special consideration is given to other drugs of habitual consumption, produce hemostasis alterations: NSAIDs, serotonin reuptake inhibitors (SSRIs). We recommend to request a complete coagulation study (AP, APTT, fibrinogen) for all patients who will undergo infiltrations of moderate or high bleeding risk prior to infiltration and the day of the same in those patients receiving anticoagulants

Factores de riesgo vascular, fibrilación auricular no valvular y obstrucción venosa retiniana / Cardiovascular risk factors, nonvalvular atrial fibrillation and retinal vein occlusion

Objetivos. Analizar la importancia de los factores de riesgo vascular, los hallazgos ecográficos de los troncos supraaórticos, y la presencia de fibrilación auricular no valvular (FANV) anticoagulada en pacientes con obstrucción venosa retiniana (OVR) y en un grupo control. Pacientes y métodos. Estudio transversal de todos los pacientes con OVR remitidos consecutivamente a la consulta de Medicina Interna, comparándolos con un grupo control. Se analizaron variables clínicas, electrocardiográficas y ecográficas. Resultados. Se estudiaron 212 pacientes (114 varones y 98 mujeres) con OVR y 212 controles (95 varones y 117 mujeres) de edad similar. La hipertensión arterial, la dislipidemia y la diabetes mellitus fueron significativamente más prevalentes en los pacientes con OVR que en los controles (73,6 vs. 50%, 64,6 vs. 48,6%, y 27,8 vs. 12,3%, respectivamente). Se observaron lesiones arterioescleróticas en los troncos supraaórticos en el 55% de las OVR. Los pacientes con OVR y FANV tenían una mayor carga de factores de riesgo vascular que los controles con FANV. No hubo diferencias respecto a la razón internacional normalizada o a la utilización de anticoagulantes de acción directa entre casos y controles con FANV. Conclusiones. Los factores de riesgo vascular (en especial la hipertensión arterial) y la afectación arterioesclerótica de los troncos supraaórticos son muy prevalentes en la OVR. La anticoagulación no parece eficaz para prevenir la OVR (AU)

Objectives. To analyse the importance of cardiovascular risk factors, ultrasound findings in the supra-aortic trunk and the presence of anticoagulated nonvalvular atrial fibrillation (NVAF) in patients with retinal vein occlusion (RVO) and in a control group. Patients and methods. A cross-sectional study was conducted of all patients with RVO consecutively referred to the office of internal medicine, comparing them with a control group. We analysed clinical, electrocardiographic and ultrasound variables. Results. We studied 212 patients (114 men and 98 women) with RVO and 212 controls (95 men and 117 women) of similar ages. Arterial hypertension, dyslipidaemia and diabetes mellitus were significantly more prevalent in the patients with RVO than in the controls (73.6 vs. 50%, 64.6 vs. 48.6% and 27.8 vs. 12.3%, respectively). We observed arteriosclerotic lesions in the supra-aortic trunk in 55% of the patients with RVO. The patients with RVO and NVAF had a greater burden of cardiovascular risk factors than the controls with NVAF. There were no differences in terms of the international normalised ratio or in the use of direct anticoagulants between the cases and controls with NVAF. Conclusions. Cardiovascular risk factors (especially arterial hypertension) and arteriosclerotic involvement of the supra-aortic trunk are highly prevalent in RVO. Anticoagulation does not appear to be effective in preventing RVO (AU)

Ecotoxicological Evaluation of the UV Filters Ethylhexyl Dimethyl p-Aminobenzoic Acid and Octocrylene Using Marine Organisms Isochrysis galbana, Mytilus galloprovincialis and Paracentrotus lividus.

The growing concern regarding the negative effects of solar radiation on the skin has led to a drastic increase in the use of sunscreens containing in its composition up to 10% of aromatic chemicals, such as ethylhexyl dimethyl p-aminobenzoic acid (OD-PABA) and octocrylene (OC). The objective of this study was to evaluate the toxicity and to assess the environmental risk posed by these two ultraviolet filters, widely used in cosmetics and as plastic additives, in the marine environment. Several ecotoxicological bioassays were performed with three model organisms belonging to different trophic levels: the microalgae Isochrysis galbana, the mussel Mytilus galloprovincialis, and the sea urchin Paracentrotus lividus. The results show remarkable toxicity to marine species for both OD-PABA (EC10 values range 26,5-127 µg L-1) and OC (EC10 range 103-511 µg L-1). The cell division in the microalgae I. galbana was the most sensitive endpoint tested. To determine the environmental risk of these substances, the risk coefficient (RQ) was calculated. Due to the higher concentrations reported, OC showed remarkable risk (RQ = 0.27), whereas for OD-PABA the risk was low (RQ = 0.007).

Liquid chromatography quadrupole time-of-flight mass spectrometry identification and determination of tri- and hexaaryl chloro imidazoles in sewage sludge.

The identification and further quantification of 2-chloro-triarylimidazole (o-Cl-TAI) and its dimer (o-DCl-HABI) in sludge from a sewage treatment plant (STP) is reported for the first time. Liquid chromatography (LC) quadrupole time-of-flight (QTOF) mass spectrometry (MS) was used as analytical technique during screening and determination steps. Pollutants were identified following a post-run search strategy, applying the chlorine mass filter, and characterized by their accurate MS and product ion scan spectra. Finally, their identities were confirmed with authentic standards. The species (o-Cl-TAI) has been rated as potentially genotoxic and carcinogenic for mice and rats. Effects of sample preparation in the stability and the extraction efficiency of both compounds are discussed. Under final conditions, they were extracted from freeze-dried samples (0.5 g of sludge or biosolids dispersed with 2 g of C18 and packed into a polypropylene syringe) with 20 ml of methanol, which also flowed through a clean-up layer of Florisil and PSA sorbents (0.5 g each). This method attained quantitative extraction yields and limits of quantification between 4 and 10 ng/g. The pollutants o-Cl-TAI and o-DCl-HABI were ubiquitous in sludge and biosolids obtained in consecutive years from the investigated STP. Their concentrations varied from 0.02 to more than 13 µg/g (freeze-dried sample). Copyright © 2016 John Wiley & Sons, Ltd.

Cardiovascular risk factors, nonvalvular atrial fibrillation and retinal vein occlusion. / Factores de riesgo vascular, fibrilación auricular no valvular y obstrucción venosa retiniana.

OBJECTIVES: To analyse the importance of cardiovascular risk factors, ultrasound findings in the supra-aortic trunk and the presence of anticoagulated nonvalvular atrial fibrillation (NVAF) in patients with retinal vein occlusion (RVO) and in a control group. PATIENTS AND METHODS: A cross-sectional study was conducted of all patients with RVO consecutively referred to the office of internal medicine, comparing them with a control group. We analysed clinical, electrocardiographic and ultrasound variables. RESULTS: We studied 212 patients (114 men and 98 women) with RVO and 212 controls (95 men and 117 women) of similar ages. Arterial hypertension, dyslipidaemia and diabetes mellitus were significantly more prevalent in the patients with RVO than in the controls (73.6 vs. 50%, 64.6 vs. 48.6% and 27.8 vs. 12.3%, respectively). We observed arteriosclerotic lesions in the supra-aortic trunk in 55% of the patients with RVO. The patients with RVO and NVAF had a greater burden of cardiovascular risk factors than the controls with NVAF. There were no differences in terms of the international normalised ratio or in the use of direct anticoagulants between the cases and controls with NVAF. CONCLUSIONS: Cardiovascular risk factors (especially arterial hypertension) and arteriosclerotic involvement of the supra-aortic trunk are highly prevalent in RVO. Anticoagulation does not appear to be effective in preventing RVO.

Fijación de tórax inestable con placas y tornillos bioabsorbibles. Presentación de serie de casos / Thoracic inestability fixed with bioabsorbable screws and plates

Resumen: Antecedentes: El tórax inestable se trata con ventilación mecánica o inhaloterapia y analgesia. Poco se ha publicado sobre el uso de material bioabsorbible y su evolución en la fijación de tórax inestable. Métodos: Estudio descriptivo de pacientes con tórax inestable sometidos a fijación con placas y tornillos bioabsorbibles en un período comprendido de Febrero de 2009 a Diciembre de 2011. Resultados: Presentamos 18 casos con edades entre 33 y 74 años (media de 53), tres con tórax inestable bilateral; la fijación costal se realizó entre 1 y 21 días del accidente (media de 1.5). Se inició deambulación al día siguiente en 14 casos; la estancia postoperatoria fue de cuatro días (rango de 3 a 14). La frecuencia cardíaca de los pacientes previa a la cirugía era de 90 por minuto (rango 82 a 100) y bajó a 84 después de la fijación (rango 82 a 92); la frecuencia respiratoria preoperatoria era 26 por minuto (rango 22 a 28) y bajó a 22 por minuto (rango 20 a 26) en el postoperatorio. Conclusiones: El uso de material bioabsorbible para osteosíntesis costal no tiene efectos secundarios atribuibles al material en el corto plazo.

Abstract: Background: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. Methods: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. Results: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. Conclusions: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.

Studies on the formation of polymeric nano-emulsions obtained via low-energy emulsification and their use as templates for drug delivery nanoparticle dispersions.

Ethylcellulose nanoparticles have been obtained from O/W nano-emulsions of the water/polyoxyethylene 10 oleyl ether/[ethyl acetate+4wt% ethylcellulose] system by low energy-energy emulsification at 25°C. Nano-emulsions with droplet sizes below 200nm and high kinetic stability were chosen for solubilising dexamethasone (DXM). Phase behaviour, conductivity and optical analysis studies of the system have evidenced for the first time that both, the polymer and the drug play a role on the structure of the aggregates formed along the emulsification path. Nano-emulsion formation may take place by both, phase inversion and self-emulsification. Spherical polymeric nanoparticles containing surfactant, showing sizes below 160nm have been obtained from the nano-emulsions by organic solvent evaporation. DXM loading in the nanoparticles was high (>90%). The release kinetics of nanoparticle dispersions with similar particle size and encapsulated DXM but different polymer to surfactant ratio were studied and compared to an aqueous DXM solution. Drug release from the nanoparticle dispersions was slower than from the aqueous solution. While the DXM solution showed a Fickian release pattern, the release behaviour from the nanoparticle dispersions was faster than that expected from a pure Fickian release. A coupled diffusion/relaxation model fitted the results very well, suggesting that polymer chains undergo conformational changes enhancing drug release. The contribution of diffusion and relaxation to drug transport in the nanoparticle dispersions depended on their composition and release time. Surfactant micelles present in the nanoparticle dispersion may exert a mild reservoir effect. The small particle size and the prolonged DXM release provided by the ethylcellulose nanoparticle dispersions make them suitable vehicles for controlled drug delivery applications.

[Thoracic inestability fixed with bioabsorbable screws and plates]. / Fijación de tórax inestable con placas y tornillos bioabsorbibles. Presentación de serie de casos.

BACKGROUND: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. METHODS: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. RESULTS: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. CONCLUSIONS: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.

ANTECEDENTES: El tórax inestable se trata con ventilación mecánica o inhaloterapia y analgesia. Poco se ha publicado sobre el uso de material bioabsorbible y su evolución en la fijación de tórax inestable. MÉTODOS: Estudio descriptivo de pacientes con tórax inestable sometidos a fijación con placas y tornillos bioabsorbibles en un período comprendido de Febrero de 2009 a Diciembre de 2011. RESULTADOS: Presentamos 18 casos con edades entre 33 y 74 años (media de 53), tres con tórax inestable bilateral; la fijación costal se realizó entre 1 y 21 días del accidente (media de 1.5). Se inició deambulación al día siguiente en 14 casos; la estancia postoperatoria fue de cuatro días (rango de 3 a 14). La frecuencia cardíaca de los pacientes previa a la cirugía era de 90 por minuto (rango 82 a 100) y bajó a 84 después de la fijación (rango 82 a 92); la frecuencia respiratoria preoperatoria era 26 por minuto (rango 22 a 28) y bajó a 22 por minuto (rango 20 a 26) en el postoperatorio. CONCLUSIONES: El uso de material bioabsorbible para osteosíntesis costal no tiene efectos secundarios atribuibles al material en el corto plazo.

The role of coagulation disorders in patients with retinal vein occlusion.

BACKGROUND: The role of a hypercoagulable state in the pathogenesis of retinal vein occlusion (RVO) has not been conclusively established. AIM: To analyse the prevalence of thrombophilia in RVO. DESIGN: Prospective case-control study. METHODS: All the patients diagnosed with RVO were referred to an Internal Medicine clinic and compared with sex- and age-matched individuals from a population-based cohort. Demographic, clinical and laboratory variables (including a thrombophilia panel) were analysed. RESULTS: One hundred and seventy patients (93 men and 77 women; 68 ± 11 years) and 170 controls (80 men and 90 women; 67 ± 10 years) were included. RVO was peripheral in 113 cases. Genetic thrombophilia was detected in 13% of patients. Acquired thrombophilia was observed in 10% of cases and 4.7 % of controls (P < 0.01). Sixty-three percent of cases and 24.6% of controls had serum hyperhomocysteinemia (odds ratio [OR] 5.2, IC 95% 2.7-10.1; P < 0.0001) : In RVO patients aged <50 years (n = 11), 36.4% had genetic thrombophilia (P = 0.04), as well as 50% of those without vascular risk factors (n = 18; P = 0.01). Forty-one (24%) patients with RVO received antiplatelet agents and 13 (7.6%) were on anticoagulants due to preexistent atrial fibrillation. CONCLUSIONS: We suggest that, in patients with RVO, hyperhomocysteinemia and antiphospholipid syndrome should be ruled out. Moreover, a study of genetic thrombophilia should only be considered in those aged <50 years or without cardiovascular risk factors. Antiplatelet therapy with aspirin is probably the treatment of choice of RVO, to reduce the overall vascular risk. Anticoagulation should only be considered in patients with high-risk thrombophilia.

Highly sensitive electrochemical immunosensor for IgG detection based on optimized rigid biocomposites.

In this work we present the construction of immunosensors based on graphite-epoxy which incorporate RIgG to the composite matrix. In order to improve the electrochemical properties of the immunocomposite electrodes, characterization and optimization was carried out in terms of electrochemical impedance spectroscopy and cyclic voltammetry. Consequently, taking into the account the properties required by a sensitive electrode such as high electron-transfer rate, high signal-to-noise ratio and suitable sensitivity; the optimal proportion of the transducer material (graphite-epoxy ratio) was chosen using constant amount of RIgG. The optimum composition range values, which provide these requirements, were from 16% to 17% of graphite loading. Then, the analytical properties of these immunosensors were evaluated measuring RIgG by using a competitive assay and using alkaline phosphatase-labeled antibody. Amperometric measurements were performed using hydrogen peroxide as substrate. Moreover, it has been the first time that it has been performed an optimization of the antigen-antibody ratio used in the assay, being this reduced significantly.

Determination of the cardiac drug amiodarone and its N-desethyl metabolite in sludge samples.

For the first time, a procedure for the simultaneous determination of the iodinated drug amiodarone and its major metabolite, N-desethylamiodarone, in sludge from urban sewage treatment plants (STPs) is proposed. Matrix solid-phase dispersion (MSPD) followed by on-line cationic exchange clean-up, in modular configuration, was used as sample preparation technique. Liquid chromatography with tandem mass spectrometry (LC-MS/MS), based on a hybrid quadrupole time-of-flight (QTOF) system, was employed for the selective determination of target compounds. The optimized procedure provided exhaustive recoveries with little effect of the sample matrix in the efficiency of electrospray ionization (ESI). The overall recoveries of the method ranged between 95 and 111%, for samples spiked at different concentration levels. The achieved limits of quantification (LOQs) remained below 10ngg(-1) for both compounds, and the linear response range extended up to 2500ngg(-1). Amiodarone and N-desethylamiodarone were ubiquitous in sludge samples, from different STPs located in the Northwest of Spain, with maximum concentrations above 300ngg(-1) referred to the freeze-dried matrix. They were also present in stabilized sludge (mixed with lime and thermally dehydrated), which is mostly disposed in agriculture fields as fertilizer. Furthermore, mono-iodinated analogues of amiodarone and N-desethylamiodarone were also tentatively identified in some samples from their accurate MS and MS/MS spectra.