Occurrence of mycotoxins in talkan: a cereal-based food traditional for Turkic population.

The consumption of cereal contaminated with mycotoxins poses a serious health risk for humans and animals. The present work aims to evaluate the presence of mycotoxins in talkan, a cereal-based food commonly consumed by the Turkic population. The presence of mycotoxins was investigated in a total of 50 samples obtained from Kazakhstan. After a preliminary screening using various ELISA kits, mycotoxins were confirmed and quantified by HPLC-MS/MS method. More than 28% of the samples were positive for at least one mycotoxin. The calculated probably daily intake for adults and children was 20% above the tolerable daily intake for aflatoxin B1 and deoxynivalenol, while it was above 100% for zearalenone, indicating a high risk for the Kazakh population. A total of 12 samples exhibited concentrations above the European maximum level for ochratoxin A, zearalenone and deoxynivalenol, however, these values were within the limits established by the Russia-Kazakhstan-Belarus Customs Union (TR CU 015/2011).

Perinatal testicular torsion: ultrasound assessment and differential diagnosis. / Torsión testicular perinatal. Valoración ecográfica y diagnóstico diferencial.

Perinatal testicular torsion, defined as torsion occurring in the prenatal period or in the first month after birth, accounts for 10% of all cases of testicular torsion in pediatric patients. Most are extravaginal, and intravaginal torsion is rare. Its management is controversial, due to the low viability of the testis and the possibility of bilateral torsion. Ultrasonography is the method of choice to study testicular torsion. Combining B-mode and power Doppler imaging facilitates a fast reliable diagnosis. We review the ultrasonographic appearance of neonatal testicular torsion for each presentation, the differential diagnosis with other causes of increased scrotal volume in neonates, and its treatment.

Neonatal ovarian cysts: ultrasound assessment and differential diagnosis. / Quistes de ovario neonatales. Valoración ecográfica y diagnóstico diferencial.

Ovarian cysts are the most common abdominal cysts in female fetuses and newborn girls. Ultrasonography is the imaging technique of choice for diagnosing ovarian cysts because it makes it possible to differentiate them from other cystic lesions. Although most neonatal ovarian cysts regress in the first few months after birth, complications can occur during gestation or after birth. The manifestations of ovarian cysts on ultrasonography will depend on the complications. The management is controversial, although the current trend favors watchful waiting. We describe the different presentations of neonatal ovarian cysts with their complications and their patterns of findings on ultrasonography. We also discuss the differential diagnosis with other cystic abdominal lesions, and finally we discuss the therapeutic management of neonatal ovarian cysts.

A study on toxic and essential elements in rice from the Republic of Kazakhstan: comparing the level of contamination in rice from the European Community.

Selected toxic elements (total As, Cd, Cr, Hg, Pb, Sr, U and V) and essential elements (Co, Cu, Fe, Mn and Zn) were analyzed using an inductively coupled plasma mass spectrometry (ICP-MS) in unpolished and milled rice collected from Kazakhstan and milled rice from Spain and Portugal to evaluate the potential health risk to the population. Arsenic species (arsenite, arsenate, arsenobetaine, dimethylarsinate and monomethilarsonate) were analyzed using HPLC-IC-MS. From 146 samples analyzed, none of them exceeded the maximum limit set by the European Legislation for Cd or Pb or values recommended by the Codex Alimentarius. Concentrations of Sr, U and V were below LOD and those of Hg, Pb, Co and Cr between

[Acoustic radiation force impulse imaging elastography is efficacious in detecting hepatic fibrosis in children]. / La elastografía mediante técnica Acoustic radiation force impulse es eficaz en la detección de fibrosis hepática en el niño.

OBJECTIVE: To evaluate the diagnostic performance of acoustic radiation force impulse imaging (ARFI) in detecting significant hepatic fibrosis in children. MATERIAL AND METHODS: Our hospital's ethics committee approved the study and all patients or their representatives provided informed written consent. We included 96 children (50 boys, 46 girls; mean age, 8 y). We also studied 16 volunteers without liver disease as controls and 80 patients with diseases that can lead to fibrosis and cirrhosis of the liver. The final sample included 31 patients with biopsies and the 16 controls. All patients underwent abdominal ultrasonography including Doppler imaging and elastography with ARFI. The ARFI value, expressed as velocity (m/s) of shear wave propagation through the tissue, was calculated by averaging 16 measurements in both liver lobes. We used one-way analysis of variance to compare means between groups; we set statistical significance at P<.05. We used Student's t-tests and chi-square tests for categorical data. RESULTS: The ARFI value in children with fibrosis ≥ F2 was higher (1.80±0.45m/s) than in controls and higher than in patients with F0-F1 (1.38±0.22m/s). The difference was significant (P<.001) for detecting F ≥ 2. Steatosis was not related with the ARFI value (Student's t-test, P>.84). Necroinflammatory activity was strongly associated with the ARFI value (Student's t-test, P<.01). Fibrosis and necroinflammatory activity were strongly associated with each other (chi-square test, P<.0001). CONCLUSION: The speed of shear wave propagation is significantly associated with the degree of hepatic fibrosis in children.

Intestinal ultrasound in pediatrics. / Ecografía intestinal en pediatría.

Ultrasonography is the imaging technique of choice for studying the digestive tract in pediatric patients from the neonatal period to adolescence. Its dynamic character, absence of radiation, and scant preparation required make ultrasonography preferable to contrast-enhanced fluoroscopy, computed tomography, or magnetic resonance imaging. Technical advances in ultrasound, including high-resolution multifrequency probes, panoramic studies, color Doppler, Doppler with microvascularization, elastography, and contrast agents for use in children, have increased the sensitivity and specificity of this technique. Intestinal ultrasound is indicated for conditions with diverse etiologies and pathogenesis: congenital, infectious, inflammatory, tumor-related, and vascular. Knowledge of embryological development and the normal characteristics of the digestive tract help in identifying, recognizing, and interpreting the ultrasound findings of the different conditions in pediatric patients. This paper aims to show the indications for ultrasound studies of the digestive tract in children, the findings on these studies, and the management of the most common gastrointestinal conditions in pediatric patients.

Differentiation of farmed and wild turbot (Psetta maxima): proximate chemical composition, fatty acid profile, trace minerals and antimicrobial resistance of contaminant bacteria.

The proximate, cholesterol, fatty acid and trace mineral compositions in the flesh of farmed and wild turbot (Psetta maxima) were evaluated. Additionally, the potential influence of the use of antimicrobial agents in the bacteria carried by farmed turbot was investigated. For this purpose, a total of 144 Pseudomonas spp. and 127 Aeromonas spp. were isolated and tested for their susceptibility to 12 antimicrobials by a disk diffusion method. Farmed turbot contained higher fat, cholesterol and calories as well as lower moisture content than its wild counterpart. The fatty acid profile of farmed turbot included higher levels of myristic, pentadecanoic, palmitoleic, gadoleic, cetoleic, linoleic, linolenic, stearidonic, eicosadienoic and eicosapentaenoic acids, and lower levels of stearic, arachidonic, docosapentaenoic and docosahexaenoic acids than its wild counterpart. The proportions of polyunsaturated fatty acids and n-3/n-6 ratios were higher in wild turbot than in farmed turbot. With respect to trace minerals, no toxic levels were found, and higher amounts of Cd, Co, Cu, Fe, Mn, Pb and Zn, as well as lower amounts of Cr, were found in farmed turbot relative to wild turbot. The antimicrobial resistance of Pseudomonas spp. and Aeromonas spp. were quite similar, with only the trimethoprim-sulfamethoxazole resistance of Aeromonas spp. isolated from farmed turbot being higher than those isolated from wild turbot. In the case of ampicillin, Pseudomonas spp. isolated from wild turbot showed higher resistance levels than those of their counterparts isolated from farmed turbot. In conclusion, the nutritional parameters of wild turbot are more adequate with respect to nutritional recommendations, while no differences were observed in food safety derived from trace mineral concentrations or the antimicrobial resistance of bacteria isolated from wild and farmed turbot.

[Evaluation of carotid intima-media thickness in familial hypercholesterolemia in childhood]. / Evaluación del grosor del complejo íntima-media de la carótida en la hipercolesterolemia familiar durante la infancia.

INTRODUCTION: Familial hypercholesterolemia (FH) is characterized by exposure to severely elevated LDL-cholesterol from birth, which produces lipid deposits, which can be measured by means of intima-media thickness (IMT). SUBJECTS AND METHODS: The IMT and concentrations of cholesterol and its fractions, triglycerides, alipoproteins Apo-A1, Apo-B and endothelial risk factors (homocysteine and high sensitivity protein C ) were determined in 89 patients (44 males) from 2 to 19 years (9.54+/-3.91 years). IMT was measured by ultrasound using a 12MHz linear array transducer in both carotids to 1cm of the bulb. The IMT mean was compared with age, sex and analytical parameters using multiple regression analysis. RESULTS: The mean values were: IMT 0.334+/-0.088mm, total cholesterol 273.62+/-91.93mg/dl, LDL-cholesterol 204.21+/-86.16mg/dl, LDL/HDL 3.83+/-1.45, apoprotein A1 134.61+/-26.49mg/dl, apoprotein B 130.59+/-40.59mg/dl, homocysteine (median) 7.16mmol/dl, Protein C (median) 0.3mg/l. Using multiple regression analysis, only age was associated with IMT (P=0.049), a mean 0.005mm (95% CI: 0.000-0.010) being the annual increase: up to 12 years the increase in IMT was 0.002mm/year on (95% CI: -0.007-0,010) and then from that age it was 0.013mm/year (95% CI: -0.023-0.049). CONCLUSIONS: The measurement of the carotid IMT could become an objective parameter in the evaluation of the FH in childhood. In our study, it is only associated with age, the increase being most marked from 12 years onwards.

Non-traumatic spleen disorders in children. Assessment by imaging. / El bazo pediátrico no traumático. Valoración por imagen.

The spleen is considered a "forgotten organ" by most radiologists and paediatricians despite being affected in many clinical paediatric situations. While it is the organ most often affected in paediatric abdominal trauma, non-traumatic spleen disorders are less well known. The spleen is well visualised by any imaging technique: ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI); the former is used most often in children. Using imaging techniques to determine the features of splenic anomalies, both congenital and acquired, enables a correct diagnostic approach, avoids unnecessary surgical procedures or biopsies, and helps the clinician to prescribe appropriate treatment. Our aim was to show the behaviour of the spleen in children using the different imaging techniques: its normal anatomy, the principal anatomical variants and the most common spleen disorder correlating with clinical symptoms, serology and histology.

Calyceal diverticula in children: imaging findings and presentations. / Divertículos caliciales en niños: hallazgos radiológicos y formas de presentación.

A calyceal diverticulum consists of a cystic eventration in the renal parenchyma that is lined with transitional cell epithelium with a narrow infundibular connection with the calyces or pelvis of the renal collector system; thus, the term pyelocalyceal diverticulum would be more accurate. Very rare in pediatric patients, calyceal diverticula can be symptomatic and require treatment. Calyceal diverticula are underdiagnosed because they can be mistaken for simple renal cysts on ultrasonography. To determine the approach to their follow-up and management, the diagnosis must be confirmed by excretory-phase computed tomography (CT) or magnetic resonance imaging (MRI). This article aims to show the different ways that calyceal diverticula can present in pediatric patients; it emphasizes the ultrasonographic findings that enable the lesion to be suspected and the definitive findings that confirm the diagnosis on CT and MRI. It also discusses the differential diagnosis with other cystic kidney lesions and their treatment.

[Level of knowledge of Quality Commitment Campaign and of "do not do" recommendations amongst general practitioners, pediatricians and nurses Primary Care]. / Grado de conocimiento de la campaña Compromiso por la Calidad y de las recomendaciones no hacer entre médicos de familia, pediatras y enfermería de Atención Primaria.

BACKGROUND: To evaluate if the Quality Commitment Campaign (QCC) was sufficiently known among primary care professionals (PC), and second, to evaluate the knowledge about certain recommendations of what should not be done in PC. METHODS: A observational study was conducted. General practitioners (GP), pediatricians (PED) and nursing (NUR) participated. A direct question was asked about whether QCC was known and a set of dichotomous questions based on the "do not do" recommendations to assess their knowledge. A sample size of 288 professionals from each group was the minimum required for a sampling error of 5%, 95% confidence level and p=0.75. The field study was conducted with the collaboration of health services and professional and scientific organizations. Data were described by frequencies and mean (standard deviation), and compared by means of ?2/Fisher or ANOVA and t-test. RESULTS: A total of 1,904 professionals (936 GP, 682 PED and 286 NUR) answered. The QCC initiative was known by 828 (43.5%) professionals: 524 (56.0%) GP, 234 (34.3%) PED and 70 (24.5%) NUR (p<0.001). All the questions were correctly answered by 652 (69.7%) GP, 631 (92.5%) PED and 116 (40.6%) NUR. Significantly more mistakes (p<0.001) were made by those who did not know the QCC, worked in the private sector or were not considered responsible for overuse. Despite not knowing the QCC, 60% GP and 90% PED answered all the questions of the test correctly. CONCLUSIONS: NUR and GP could benefit from a greater diffusion of the QCC. As could those working in the private sector and those who believe that professionals have little responsibility for unnecessary overuse.

Multicystic dysplastic kidney: Assessment of the need for renal scintigraphy and the safety of conservative treatment. / Displasia renal multiquística: evaluación de la necesidad de la gammagrafía renal y seguridad del tratamiento conservador.

OBJECTIVES: To assess the need for implementing renal scintigraphy in the diagnosis of the multicystic dysplastic kidney (MCDK) and the safety of its conservative treatment. MATERIAL AND METHODS: A retrospective study of patients with unilateral MCDK was conducted at our centre from January 2005 to August 2015. We calculated the positive predictive value (PPV) of ultrasonography, taking renal scintigraphy and pathology as the gold standard. We calculated a survival curve according to the Kaplan-Meier method to assess the annual probability of spontaneous resolution of the multicystic kidney. RESULTS: Fifty-six patients were identified, 48 (85.7%) of whom had a prenatal diagnosis. Thirty eight (67.9%) of the patients were males, and the left side was affected in 33 (58.9%) of the patients. We observed associated urological abnormalities in 22 (39.29%) patients, with vesicoureteral reflux the most common (8, 14.29%). Seven patients (12.5%) developed renal failure. Forty-nine (87.5%) patients developed compensatory contralateral renal hypertrophy. Of the 33 patients who underwent surgery, the pathology results confirmed the MCDK diagnosis in 32. Compared with scintigraphy and pathology, the PPV of ultrasonography was 100% and 97%, respectively. The rate of spontaneous involution was 5.4% at 3 months of life, 11.3% at 2 years and 38.4% at 5 years. CONCLUSIONS: In our experience, the conservative treatment of MCDK, until at least 5 years of age, is safe. Our data suggest that performing scintigraphy is not required for these patients, which means lower radiation exposure, as well as financial savings.

[How do primary care patients perceive information for involving themselves in self-care?]. / ¿Cómo perciben los pacientes de las consultas de Atención Primaria la información para implicarse en su autocuidado?

BACKGROUND: Analyze if patients receive information from their GPs to engage in self-management (medication,physical exercise or diet). METHODS: A descriptive study in which 2,401 randomly selected, primary care patients were interviewed by telephone. A short scale of 6 questions was used to analyze if they received information for self-care. Statistics included analyzing differences according to age,sex, occurrence of security incidents, whether they regularly attended the physician's surgery and length of consultation time. RESULTS: A total of 2,350 patients responded (97.9%response rate). A total of 1,253 (34.6%) of respondents obtained 5 or more points on the scale (percentile 50).Receiving information about foreseeable prognosis increased satisfaction (OR 11.2 (95% 8.3-15.3). Consultation time length (p<0.01), regularly visiting physicians(p<0.01), and not suffering an adverse event (p<0.01)were associated with higher scores on the scale. CONCLUSIONS: Patients report they receive directions for the proper management of medication at home, but claim that they receive less information to engage in healthy behaviors.

Acyl-CoA: cholesterol acyltransferase in HT 29 cell subpopulations. Defect of activity in the undifferentiated cells.

The ACAT activity was studied on different subpopulations deriving from HT29 cells, a human colon carcinoma cell line. Grown on standard medium (25 mM glucose), about 95% of these cells are undifferentiated (G + cells). From this heterogeneous population, differentiated cells were selected by glucose deprivation and grown either on medium without glucose (G - cells) or in standard medium containing 25 mM glucose (G-Rev cells). The G- and G-Rev cells have the features of differentiated small intestine cells. The two types of differentiated cells (G- and G-Rev) exhibited similar ACAT activities and the kinetic characteristics of the enzyme were also similar. A time-course study showed increasing activity during the exponential phase and a decrease just after confluency. It was possible to stimulate the enzyme by micellar or lipoprotein cholesterol. In contrast, the ACAT activity was hardly detectable in undifferentiated G + cells. In addition, all the experimental conditions known to stimulate ACAT activity, and confirmed in the differentiated HT29 cells, were inefficient in the undifferentiated G + cells. Therefore, the different models derived from HT29 cells provide the opportunity to study cholesterol esterification as well as the consequences of its aberrances in intestinal cells.

[Biliary atresia: Retrospective clinical study]. / Atresia de vías biliares: estudio clínico retrospectivo.

OBJECTIVE: To gain further insight into the natural history of patients with biliary atresia. PATIENTS AND METHODS: We performed a retrospective, cross-sectional, descriptive, case series study. All patients with biliary atresia attended at the Pediatric Gastrointestinal and Hepatology Unit of La Fe Children's Hospital in Valencia (Spain) from January 1990 to December 2000 were included. RESULTS: Of 16 children followed-up, eight are currently stable, six have undergone liver transplantation and two died. The mean age at diagnosis was 47.5 days. The most frequent clinical manifestation was jaundice (87.5%) and the most common biochemical finding was raised gamma-glutamyltransferase (3-4 times its standard value), which appeared in 100 % of the patients. Abdominal ultrasonography was diagnostic in 85.7% of the patients. Nuclear scintiscan (DISIDA) showed a sensitivity of 100%. Portoenterostomy with intraoperative liver biopsy was performed in all patients. Patient age at surgery was a predictor of long-term outcome, with more favorable results in patients aged less than 65 days of life. CONCLUSIONS: Biliary atresia should be suspected as soon as possible, since early surgical treatment is the only therapeutic measure that can improve outcome.

[Epidemiology of cognitive deterioration in geriatric population of 'Casals d' Avis' in the city of Barcelona]. / Epidemiología de los trastornos cognitivos en la población geriátrica de los 'Casals d'Avis' de Barcelona ciudad.

The aim of the study is to carry out a clinico-epidemiological study of the part of Barcelona's population over the age of 65 that suffers from cognitive deterioration, users of 'Casal d'Avis' (Old-folks centres). 369 users of 'Casals d'Avis' were studied. A specific questionnaire was used to collect the following data: personal details, social and family situation, health profile and a quantification of their degree of cognitive degeneration using Lobo's cognitive test. The quantitative and qualitative variables were studied statistically, and the arithmetical average and standard deviation were found, as well as which bivariant hypothesis tests and multivariant analyses, using the logistic regression method, were carried out. The degree of cognitive deterioration is 8.67%. Age, female sex, being widowed or single, and illiteracy are associated with low scoring in the MEC. It is also associated with subjective loss of memory and hearing difficulties. The multivariant analyses are influenced by length of schooling, age and sex. Early detection of cognitive deterioration and the supply of resources and services oriented towards cognitive stimulation and social integration would, if well-planned, do away with the need for their confinement.

[Epidemiology of cognitive deterioration in the institutionalized geriatric population of the socio-sanitary centers in the city of Barcelona]. / Epidemiología de los trastornos cognitivos en población geriátrica internada en centros socio-sanitarios de Barcelona ciudad.

The aim of the study is to carry out a clinico-epidemiological study of the part of Barcelona's in-patients of 'Health-centers/Nursing-homes' elderly people that suffers from cognitive deterioration. 363 in-patients of 'Health-centers/Nursing homes' were studied. A specific questionnaire was used to collect the following data: Personal details, social and family situation, health profile and quantification of their degree of cognitive deterioration using Lobo's cognitive test. The quantitative and qualitative variables were studied statistically, and the arithmetical average and standard deviation were found, as well as which bivariant hypothesis tests and multivariant analyses, using the logistic regression method, were carried out. Adjusted degree of cognitive deterioration was 56%. The age, the fact that the patients were female, illiteracy and working as house-wives all made for low MEC ratings. Variables such as health, subjective memory loss, the presence of cerebral vascular pathology an hypercholesterolemia behaved in a similar fashion. Age, female sex, illiteracy and being a house-wife are associated with low scoring in the cognitive test, as well as subjective loss of memory, cerebral vascular pathology and hypercholesterolemia. The multivariant analyses are affected by: age and length of schooling. Were the in-patient group is concerned, functional remodelling of specific areas is indicated, and who have to be taken into care as a result of the seriousness of deterioration their dependence and their need for assistance.

Simultaneous determination of sulfonamides, penicillins and coccidiostats in pork by high-performance liquid chromatography-tandem mass spectrometry.

Veterinary drugs are widely and legally used to treat and prevent disease in livestock. However, drugs are also used illegally as growth-promoting agents. To protect the health of consumers, maximum residue limits (MRL) in food of animal origin have been established and are listed in Regulation 37/2010. According to this regulation, more than 300 drugs need to be controlled regularly in laboratories for residues of veterinary drugs. A cost-effective analytical method is very important and explains why the development of multi-residual methods is becoming popular in laboratories. The aim of this work is to describe a simple, rapid and economical high-performance liquid chromatography-tandem mass spectrometry method for the simultaneous identification and quantification of 21 veterinary drugs in pork muscle samples. The sample clean-up procedure is performed with acidified dichloromethane and does not require solid phase extraction. The method is applicable to nine sulfonamides and seven coccidiostats identified within 36 min. Calculated relevant validation parameters such as recoveries (from 72.to 126 %), intra-precision and intermediate precision (relative standard deviation below 40 %) and decision limits (below 7 µg Kg(-1)) were within acceptable range and in compliance with the requirements of Commission Decision 2002/657/EC.