Heavy Metal Bioaccumulation in Peruvian Food and Medicinal Products

To better query regional sources of metal(loid) exposure in an under-communicated region, available scientific literature from 50 national universities (undergraduate and graduate theses and dissertations), peer-reviewed journals, and reports published in Spanish and English were synthesized with a focus on metal(loid) bioaccumulation in Peruvian food and medicinal products utilized locally. The study considered 16 metal(loid)s that are known to exert toxic impacts on humans (Hg, Al, Sb, As, Ba, Be, Cd, Cr, Sn, Ni, Ag, Pb, Se, Tl, Ti, and U). A total of 1907 individual analyses contained within 231 scientific publications largely conducted by Peruvian universities were analyzed. These analyses encompassed 239 reported species classified into five main food/medicinal groups-plants, fish, macroinvertebrates and mollusks, mammals, and "others" category. Our benchmark for comparison was the World Health Organization (Codex Alimentarius) standards. The organisms most frequently investigated included plants such as asparagus, corn, cacao, and rice; fish varieties like trout, tuna, and catfish; macroinvertebrates and mollusks including crab and shrimp; mammals such as alpaca, cow, chicken eggs, and milk; and other categories represented by propolis, honey, lichen, and edible frog. Bioaccumulation-related research increased from 2 to more than 25 publications per year between 2006 and 2022. The results indicate that Peruvian food and natural medicinal products can have dangerous levels of metal(loid)s, which can cause health problems for consumers. Many common and uncommon food/medicinal products and harmful metals identified in this analysis are not regulated on the WHO's advisory lists, suggesting the urgent need for stronger regulations to ensure public safety. In general, Cd and Pb are the metals that violated WHO standards the most, although commonly non-WHO regulated metals such as Hg, Al, As, Cr, and Ni are also a concern. Metal concentrations found in Peru are on many occasions much higher than what has been reported elsewhere. We conclude that determining the safety of food/medicinal products is challenging due to varying metal concentrations that are influenced not only by metal type but also geographical location. Given the scarcity of research findings in many regions of Peru, urgent attention is required to address this critical knowledge gap and implement effective regulatory measures to protect public health.

Analysis of polychlorinated dibenzo-p-dioxins and dibenzofurans in stack gas emissions by gas chromatography-atmospheric pressure chemical ionization-triple-quadrupole mass spectrometry

A gas chromatography coupled to triple-quadrupole mass spectrometry (GC-(QqQ)MS/MS) including a soft-ionization through an atmospheric pressure chemical ionization (APCI) source based method was compared with the high resolution mass spectrometry (HRMS) standard reference method EN1948, for the analysis of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) in stack gas emissions. The stack emission samples were collected, both, by manual method sampling (from 6 to 8h) and by long-term sampling systems (sampling time of several weeks). This work presents the first comparison of GC-(QqQ)MS/MS with APCI source with the European Standard EN1948 technique for stack gas emissions. Sample concentrations ranged from 0.5 to 596pg I-TEQ/Nm³. Comparative results in all investigated samples showed relative errors that were within ±15%. These results make GC-(QqQ)MS/MS with APCI suitable for the quantitative analysis of dioxins in the studied samples and create a real alternative tool to the reference sector GC-HRMS instruments.

Baseline, Two-year, and Five-year Follow-up of Children and Adolescents with First-episode Psychosis: A Spanish Cohort

Background

Early-onset first-episode psychosis (FEP) and high functioning autism spectrum disorders (ASD) are complex neuro–developmental disorders that share symptomatology but it is not clear if they also share neurobiological abnormalities (Chisholm et al., 2015). We examined thickness, surface area and volume in a direct comparison of children and adolescents with FEP (onset before 18 years), high-functioning ASD, and healthy subjects.

Methods

Magnetic resonance imaging scans of 85 participants (30 ASD, 29 FEP, 26 healthy controls, age range 10–18 years) were obtained from the same MR scanner using the same acquisition protocol. The FreeSurfer analysis suite was used to quantify vertex-wise estimates of the metrics thickness, surface area, and volume.

Results

ASD and FEP had spatially overlapping insular deficits for each metric. The transdiagnostic overlap of deficits was greatest for volume (55% of all insular vertices) and smallest for thickness (18%). Insular thickness and surface area deficits did not overlap in ASD and overlapped only in 8% of all insular vertices in FEP.

Conclusions

Morphological insular deficits are common to FEP and high functioning ASD when compared to healthy participants. The pattern of deficits was similar in both disorders, i.e. a largely non-overlap of insular thickness and surface area. The non-overlap provides further evidence that these metrics represent two independent outcomes of corticogenesis, both of which are affected in FEP and ASD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Cranioplasty with bandaging. New forms of limitation of life support and organ donation

Most of transplanted organs are obtained from brain death (BD) donors. In neurocritical patients with catastrophic injuries and decompressive craniectomy (DC), which show a dreadful development in spite of this treatment, DC could be a futile tool to avoid natural progress to BD. We propose if cranial compressive bandage (cranioplasty with bandage) could be an ethically correct practice, similar to other life-sustaining treatment limitation (LSTL) common methods. Based on a clinical case, we contacted with the Assistance Ethics Committee and some bioethics professionals asking them two questions: 1) Is ethically correct to perform a cranioplasty with bandage in those patients with LSTL indication? 2) Thinking in organ donation possibility, is this option preferable? Conclusions 1) Cranioplasty with bandage could be considered an ethically acceptable LSTL practice, similar to other procedures. 2) It facilitates organ donation for transplant, which provides value-added because of its own social good. 3) In these cases, it is necessary to know previous patient's will or, in absentia, to obtain family consent after a detailed procedure report.

Analytical approach and occurrence for the determination of mass concentration of PCDD/PCDF and dl-PCB in flue gas emissions using long-term sampling devices

In this work, a reliable methodology for the simultaneous analysis of PCDD/PCDF and dioxin-like PCB (dl-PCB) in flue gas emissions collected using continuous sampling devices is proposed. The analytical scheme followed the minimum requirements described in the EU standard EN-1948:1,2,3,4 according to samples containing large amounts of dioxins and dl-PCBs or samples collected over a long period of time of about 4 weeks. Parameters, such as reproducibility, precision, limits of detection (LOD), limits of quantification (LOQ), extract aliquot size, analytical blanks, extraction efficiency, as well as the amount of internal standards required for an accurate determination, were assessed. The findings demonstrate the suitability of the proposed analytical scheme for the analysis of PCDD/PCDF and PCB in samples collected using long-term sampling devices. The analysis of five different 5% v/v sample aliquots reported %RSD values lower than 10% for all of the 29 congeners at both low and high levels. Similarly, %RSD values were 3.2 and 2.0 for the low level samples and 0.9 and 1.1%RSD for the high level extracts for PCDD/PCDF and dl-PCB, respectively expressed in total TEQ units. Re-extraction provided values less than 3%, expressed in TEQ. Based on blank analyses, LOD values of 100 pg I-TEQ for PCDD/PCDF and 10 pg WHO-TEQ for dl-PCB were achieved when 5% v/v aliquots were analyzed. Finally, the proposed analytical approach was tested with samples from a wide range of combustion processes such as hazardous and municipal waste incinerators, as well as cement kilns (with and without waste co-incineration).

[Ethics of the cardiopulmonary resuscitation decisions]

Cardiopulmonary Resuscitation (CPR) must be attempted if indicated, not done if it is not indicated or if the patient does not accept or has previously rejected it and withdrawn it if it is ineffective. If CPR is considered futile, a Do-Not-Resuscitate Order (DNR) will be recorded. This should be made known to all physicians and nurses involved in patient care. It may be appropriate to limit life-sustaining-treatments for patients with severe anoxic encephalopathy, if the possibility of clinical evolution to brain death is ruled out. After CPR it is necessary to inform and support families and then review the process in order to make future improvements. After limitation of vital support, certain type of non-heart-beating-organ donation can be proposed. In order to acquire CPR skills, it is necessary to practice with simulators and, sometimes, with recently deceased, always with the consent of the family. Research on CPR is essential and must be conducted according to ethical rules and legal frameworks.

Caracterización fenotípica del genofondo avícola criollo de San andrés, Pinar del río, Cuba

El objetivo de este trabajo fue estimar por el método de observación la frecuencia de aparición de algunos rasgos de apariencia fenotípica de la gallina Criolla (Gallus gallus) en tres zonas del valle San Andrés del municipio La Palma, en la provincia de Pinar del Río, para aportar a la caracterización fenotípica de este genofondo avícola criollo. Como resultado se identificaron 28 caracteres agrupados en 8 rasgos de apariencia fenotípica (color del plumaje, tipo de plumaje, tipo de cresta color de los tarsos, presencia de patas plumosas, color de la piel, color del pico y color de las orejuelas). Los resultados de este trabajo han orientado el desarrollo de otras investigaciones con el propósito de evaluar la adaptabilidad y productividad de este genofondo avícola y su posible asociación con los rasgos de apariencia fenotípica encontrados.

Caracterización fenotípica del genofondo avícola criollo de San andrés, Pinar del río, Cuba

El objetivo de este trabajo fue estimar por el método de observación la frecuencia de aparición de algunos rasgos de apariencia fenotípica de la gallina Criolla (Gallus gallus) en tres zonas del valle San Andrés del municipio La Palma, en la provincia de Pinar del Río, para aportar a la caracterización fenotípica de este genofondo avícola criollo. Como resultado se identificaron 28 caracteres agrupados en 8 rasgos de apariencia fenotípica (color del plumaje, tipo de plumaje, tipo de cresta color de los tarsos, presencia de patas plumosas, color de la piel, color del pico y color de las orejuelas). Los resultados de este trabajo han orientado el desarrollo de otras investigaciones con el propósito de evaluar la adaptabilidad y productividad de este genofondo avícola y su posible asociación con los rasgos de apariencia fenotípica encontrados.

Baseline levels of dioxin and furan emissions from waste thermal treatment in Colombia

Background data of polychlorinated dibenzodioxin and dibenzofuran (PCDD/Fs) emissions from the incineration sector in Colombia are presented. Monitoring was carried out during a two-year period, 2003-2005. Twelve plants were sampled for stack gas emissions of dioxins and total solid particulate (TSP). Additionally, PCDD/Fs in several fly ash samples were analyzed. Most incinerators burned industrial refuse materials and medical residues. A wide range of PCDD/Fs emission levels were found. In particular, levels ranging from 6.9 to 343.8 ng I-TEQ/N m(3) were determined in plants without any air pollution control system (APCS). In contrast, 0.5-39.2 ng I-TEQ/N m(3) levels were found in plants with APCS while 8.5-67.5 ng I-TEQ/g were measured in fly ash samples. TSP values ranged from 14 to 448 mg/N m(3). This study also evaluated the impact of implementing different control systems in an incinerator. Finally, for comparison purposes several samples were analyzed by both high resolution gas chromatography coupled to high resolution mass spectrometry (HRGC-HRMS) and high resolution gas chromatography coupled to ion-trap low resolution mass spectrometry-mass spectrometry (HRGC-IT LRMS/MS). Overall, I-TEQ values deviated about 20-30% between both techniques.

[Quality of care for the dying in a hospital]

Aim. To analyse the accounts of the relatives of patients who died during one year in a hospital in Navarre, within a study of the quality of care for the dying. Method. A telephone interview was conducted with the person dearest to the patients who had died in the course of one year in the hospital. The TOOLKIT survey, previously validated, was used to this end. In all cases a maximum of three calls was made to establish contact with the person to be interviewed. The calls were made between three and six months following the death of the patient. The first part of the interview was aimed at providing information about the aim of the study and informed consent was requested. Four fields were analysed: physical and emotional comfort, shared decision making, respect and dignity, and care of the carers. The interview ended with an open question: Do you wish to add anything else? Results. The number of persons interviewed was 327. For the 712 deceased in the hospital who met the requirements, 320 persons could not be located and another 65 refused to be interviewed. Many complaints were gathered concerning the quantity and quality of information and the manner and time of its provision. There were also complaints concerning respect for the wishes of the patient, the management of pain, dyspnoea and personal treatment received. The lack of emotional support perceived by the relatives is also important. Conclusions. Besides the numerical variables contained in the survey, we believe that the narrative that a survey can contain provides key information for the analysis of care quality.

[The living will]

The importance of decision making that is informed and shared between the patient and the health professional caring for him/her is essential for the quality of care and its results. Living wills are no more than a concrete expression of this reality. Their legal acceptance has meant recognition of respect for the autonomy of patients. However, the laws passed contain some incongruities and the health practice related to these documents suffers from numerous practical and ethical problems on which reflection is invited. The article concludes by recommending the adoption of measures aimed at strengthening the advance planning of health care, a question that requires profound changes in the training of professionals and in the policies of the health institutions.

Assessment of polychlorinated dibenzo-p-dioxins and dibenzofurans in sludges according to the European environmental policy

The amount of sewage sludge generated in Europe is expected to surpass the 10 million tons/year in 2006 as a result of the waste water treatment process according to the Water Policy in European Union. Sewage sludge is what is left behind after water is cleaned in waste treatment plants and is characterized for this high content in nitrogen and phosphorous that could be of great importance in agriculture as fertilizer or soil conditioner. On the other hand, pollutants like metals and organic contaminants are usually removed from water and are accumulated in the sewage sludge, reaching the food chain if their concentrations are not below the safe limits established by the European legislation. The latter issue is of great concern nowadays and in this sense, different works alert against the use of the sewage sludge in agriculture arguing that serious illnesses, even resulting in death as well as adverse environmental impacts are associated to the application of sewage sludge. This work is a continuation of a former comprehensive survey on of priority organic pollutant in sludges for agricultural purposes carried out by our group in Catalonia and this time is focused on the polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F), one of the most toxic group of organic compounds listed in the Work Document on Sludge which is the reference tool in this field in Europe and is also included in the Stockholm Convention. Eighty eight samples were collected from the end of 2003 to April 2006 and the concentrations detected were lower than the 100 ng/kg I-TEQ limit recommended by the European legislation (EC, 2000). Thus, sewage sludges generated in Catalonia do not represent a threat to human health if they are used as fertilizers in agriculture.

[Medicine and conscientious objection]

Conscientious objection to democratically accepted laws in democratic societies is a fact, both among citizens and among professionals. Due respect for laws is a prima facie duty in these societies. But democratic justice must at the same time respect peoples' conscience for it constitutes the ethical identity of individuals. And both law and ethics are necessary - although neither of them is sufficient - for its realization. The problem of conscientious objection among healthcare professionals is analysed from this standpoint and the conclusion is that objection is not an absolute right to exemption from several duties, but that the responsibility of the professional and of the institutions towards the citizenry must always be taken into account. Some solutions are suggested that try to protect both the professionals and the citizens in a bi-directional way.

Dioxin emissions from thermal waste management in Medellín, Colombia: present regulation status and preliminary results

Preliminary results of a study undertaken to characterize dioxin and furan releases from waste incineration plants operating in Medellín-Colombia are presented. Emission and fly ash samples were collected from representative plants burning medical and industrial residues to characterize PCDD/PCDF levels. Analyses were carried out following European standards for stationary gas emissions EN-1948:1996 and US EPA 1613 (fly ashes). Final extracts were analyzed by both high resolution gas chromatography coupled to high resolution mass spectrometry (HRGC-HRMS) and high resolution gas chromatography coupled to ion trap tandem mass spectrometry (HRGC-ITMS/MS). Preliminary results revealed emission levels of 1-30.3 ng I-TEQ/Nm3 depending on whether or not an air pollution control system (APCS) was installed. Fly ashes contained 8.5-68 ng I-TEQ/g. Critical issues that should be addressed in an assessment and in developing waste management plans in Colombia are discussed.

Polychlorinated dibenzo-p-dioxins, dibenzofurans and 'dioxin-like' PCBs in flue gas emissions from municipal waste management plants

The aim of this work is to give representative data on polychlorinated dibenzo-p-dioxins (PCDD), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyl (PCBs) from stack gas emissions of an urban solid waste management plant which has to comply with the limit of 0.1 ng I-TEQ/Nm3. In particular, the study is focused on 29 target compounds, the seventeen 2,3,7,8-PCDDs/Fs, four non-ortho PCBs and eight mono-ortho PCBs which configure so-called 'dioxin-like' PCBs (DL-PCBs). To this end, emission measurements were performed during one year over the three operating combustion lines in a selected waste management plant. In general, accurate methodology allowed characterizing all target compounds in almost all the samples analyzed. In addition, a typical pattern for DL-PCBs is reported. The pattern presented PCB #118 to be the highest, nevertheless the figures demonstrated DL-PCBs contribution to the total TEQ around 3% being PCB #126 the most important congener due to its TEF of 0.1. Finally, remarkable differences were achieved in comparison with both environmental and biological samples such as soils, sediments, human milk or fish since these matrices may present DL-PCB contribution to the total TEQ up to 77%.

[Some ethical aspects of donation and transplantation]

Ethical and legal consensus in our country bases the practice of donations and transplants on different ethical principles, which are contained in the legislation, closely conforming to the four principles of principialist bioethics: autonomy, beneficence, non-maleficence, and justice. The level of donations achieved in our milieu might, in fact, be related to a strict respect for these principles by the health professionals, as well as to the excellent organisation of the transplant world. Many scientific, technical and ethical challenges have had to be met to reach the present state of the transplant. And there are many current challenges. The article only analyses some of these due to their technical, ethical and social repercussions: organ transplants involving a live donor, the public request for organs, the organ market, the transplant of non-vital organs (basically the face transplant), the use of stem cells and the banks of umbilical cord cells. The aim of the article is to state the ethical problems raised by these new practices, in order to lay the foundations for a moral deliberation that must necessarily involve the whole of society.

Priority organic pollutant assessment of sludges for agricultural purposes

A comprehensive characterization of five of the seven priority organic pollutants listed in the draft of the "Working document on sludge" [EU, 2000. Working Document on Sludge 3rd Draft. Unpublished, 19 p] has been carried out during 2001-2003 in sludge samples from Catalonia (NE Spain). One hundred and thirty-nine samples belonging to 20 Waste Water Treatment Plants (WWTPs), seven sludge treatment (thermal drying) and three composting sludge plants were taken in order to determine the concentration of polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs), di-2-(ethyl-hexyl)-phthalate (DEHP), nonylphenol and nonylphenol ethoxylates with one or two ethoxy groups (NPE), polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs). PCDD/F concentrations were in general lower than the 100 ng I-TEQ/kg limit suggested in the above-mentioned document. In the same way, 98.5% for PCBs, 97% for PAH and 92.8% for DEHP of the samples presented concentrations lower than 0.8 mg/kg dm, 6 mg/kg dm and 100 mg/kg dm, respectively. In contrast, the vast majority of samples contained NPE concentrations much higher than 50mg/kg dm limit. The values ranged from 14.3 to 3150 mg/kg dm (median value=286.6 mg/kg) being composted sludge samples the less contaminated ones (17.9-363.4 mg/kg dm; median value=89.3 mg/kg). Special attention should be paid to the Catalan sludge NPE contamination owing to the high levels detected.

Short human occupations in the Middle Palaeolithic level I of the Abric Romani rock-shelter (Capellades, Barcelona, Spain)

This paper presents a multidisciplinary study on the size of the occupied surfaces, provisioning strategies and behaviour planning at the Romani rock-shelter, using the Middle Palaeolithic record of the level i. This level is dated around 46.000 BP through U/Th ages. A behavioural interpretation is proposed, which emphasises the activities and the systemic value of the archaeological artefacts and structures. Occupation patterns are identified on the basis of the accumulations formed by human activities. These archaeological accumulations, consisting of artefacts and hearths, are easily defined visually as spatial units. The relationships between these accumulations, established by means of refitted remains, indicate that differences can be established between: 1) small and medium-sized occupation surfaces; 2) restricted and diversified provisioning strategies. This variability suggests that different modes of occupation are represented in the same archaeological level. The human activities reveal the generalization of fire technology. In almost all sizes of the occupation surfaces, the exploitation of vegetal resources near the Abric Romani marks the threshold of the restricted provisioning strategy. Limited use and fragmented knapping activities are recorded in the lithic assemblage. Faunal remains show differential transport. The exploitation of lithic, faunal and vegetal resources characterizes the diversified provisioning strategy. The small occupation surfaces and restricted provisioning strategies suggest short settlements in the Abric Romani. This shorter occupation model complements the longer diversified provisioning strategy recorded in both small and medium-sized occupied surfaces. The selection of precise elements for transport and the possible deferred consumption in the diversified provision strategy suggest an individual supply. In this respect, Neanderthal occupations in the Romani rock-shelter show a direct relation to: 1) hunting strategic resources; 2) high, linear mobility.

Behaviour of pesticides in a water/sediment system under laboratory and field conditions

Experiments were conducted in order to evaluate the behaviour of some pesticides commonly used in rice production. At a laboratory scale, but exposed to the environmental conditions, a known concentration of pesticides in water flowed through a cement channel over a sediment layer, at a constant flow rate. The collected water was homogenised and analysed by gas chromatography/HPLC to assess the concentration of each pesticide. Under these conditions, the reduction of each pestcide concentration in water depends on the nature of it and on the water flow rate. The lower the flow rate, the grater the reduction in the concentration of pesticides in the water that ran over the sediment layer. Experiments were also carried out under field conditions, using a 1200 m length, 2 m width and 0.3 m depth rice field channel. A pesticide mixture of known concentration was poured on the flowing water and mixed thoroughly. After the arrival of this contaminated water at preestablished sampling points down the stream, the concentration of each pesticide in water was determined. The longer the distance of the sampling points downstream from the starting point, the lower the pesticide concentration found. Only a few pesticides were detected at the 1200 m sampling point, but at very low concentration. The others were not detected. It was pointed out that the channel length was the most important factor in the reduction of the pesticide concentration in the flowing water. The influence of the flow rate on this reduction could not be clearly related as in the laboratory experiments.

Determination of antifouling pesticides and their degradation products in marine sediments by means of ultrasonic extraction and HPLC-APCI-MS

A method has been developed for the simultaneous determination of antifouling pesticides and some of their degradation products, e.g. dichlofluanid, diuron, demethyldiuron, 1-(3,4-dichlorophenyl)urea, sea-nine, Irgarol 1051 and one of its metabolites (2-methylthio-4-tert-butylamino-s-triazine) in marine sediments. The determination of these compounds in sediment samples was performed by means of methanolic ultrasonic extraction then clean-up on an Isolute ENV+ solid phase extraction (SPE) cartridge. The resulting extract was then analyzed by reversed-phase high-performance liquid chromatography coupled with atmospheric-pressure chemical-ionization mass spectrometry in negative and positive ion modes (HPLC-APCI-MS). Recovery ranged from 54-109% for the antifouling agents and their degradation products. The determination limits for the different compounds varied between 0.2 and 1.6 microg kg(-1) dry sediment. The analytical procedure was successfully applied to the determination of these pesticides and their degradation products in marine sediment samples from different marinas of the Catalan coast. The compounds detected were: diuron, dichlofluanid, demethyldiuron, sea-nine, and Irgarol 1051. The highest concentrations were those of diuron and Irgarol 1051--136 and 88 microg kg(-1), respectively.

Occurrence of antifouling biocides in the Spanish Mediterranean marine environment

A compilation of the results of a monitoring program of the recently used antifouling pesticides diuron (3-(3,4-dichlorophenyl)-1,1-dimethylurea), Irgarol 1051 (2-methylthio-4-tertiary-butylamino-6-cyclopropylamino-s-teiazine), seanine 211 (4,5-dichloro-2-n-octyl-4-isothazolin-3-one), chlorothalonil (2,4,5,6-tetrachloro-isophthalonitrile), dichlofluanid (N'-dimethyl-N-phenylsulphanamide), TCMTB ((2-thiocyanomethylthio) benzothiazole), and three degradation products demethyldiuron (3-(3,4-dichlorophenyl)-1-methylurea),3,4-dichlorophenylurea and 2-methylthio-4-tert-butylamino-s-triazine (Irgarol degradation product) that was carried out between April 1996 and February 2000 in enclosed seawaters from Catalonia and Almería (Spanish Mediterranean coast) is reported. Nine points were sampled along the Catalan coast: Barcelona Olympic port, Masnou, Blanes, Sant Carles de la Ràpita, Tarragona, Cambrils and Salou marinas as well as the Cambrils and Tarragona fishing harbors and in marinas and ports from Almeria: Aguadulce port, Almería port, Almerimar fishing harbour and Almerimar marina. The analytical methodologies were based on Solid Phase Extraction followed by liquid chromatography (LC) or gas chromatography (GC) coupled to a mass spectrometry (MS) or -Diode Array Detector. The main pollutants found in the sampled points were diuron and Irgarol 1051 that were detected at concentrations up to 2.19 micrograms l-1 and 0.33 microgram l-1, respectively. On the other hand, seanine 211 was found at the highest concentration (up to 3.7 micrograms l-1) during the summer of 1999. Low concentrations of dichlofluanid and the above mentioned degradation products were detected for the first time in the Spanish coasts. Chlorothalonil, TCMTB were not found at concentrations higher than 1 and 20 ng l-1 respectively which were the limit of determination (LOD) of the method for these compounds. In general the contamination at the different marinas is higher at the end of spring and in summer where the boating activity is also higher. This paper shows for the first time that the contamination by the new antifouling pesticides in Spanish coastline, basically marinas and fishing harbours, is permanent along the whole calendar year. So, preventive actions by the harbour authorities will be needed in the near future in order to monitor and control the levels and effects of the new antifouling biocides in the marine environment.

Factors associated with tuberculin reactivity in two general hospitals in Mexico

OBJECTIVE

To identify risk factors associated with tuberculin reactivity in healthcare workers (HCWs).

DESIGN

Cross-sectional survey of tuberculin reactivity (2 TU of purified protein derivative (PPD) RT23, using the Mantoux two-step test).

SETTING

Two general hospitals located in a region with a high prevalence of tuberculosis and high bacille Calmette-Guerin (BCG) coverage.

PARTICIPANTS

Volunteer sample of HCWs.

RESULTS

605 HCWs were recruited: 71.2% female; mean age, 36.4 (standard deviation [SD], 8.2) years; 48.9% nurses, 10.4% physicians, 26.8% administrative personnel; mean time of employment, 10.9 (SD, 6.7) years. PPD reactivity (> or =10 mm) was found in 390 (64.5%). Multivariate analysis revealed an association of tuberculin reactivity with occupational exposure in the hospital: participation in autopsies (odds ratio [OR], 9.3; 95% confidence interval [CI95], 2.1-40.5; P=.003.), more than 1 year of employment (OR, 2.4; CI95, 1.1-5.0; P=.02), work in the emergency or radiology departments (OR, 2.0; CI95, 1.03-3.81; P=.04), being physicians or nurses (OR, 1.5; CI95, 1.04-2.11; P=.03), age (OR, 1.04; CI95, 1.02-1.07 per year of age; P<.001), and BCG scar (OR, 2.1; CI95, 1.2-3.4; P=.005).

CONCLUSIONS

Although the studied population has a high baseline prevalence of tuberculosis infection and high coverage of BCG vaccination, nosocomial risk factors associated with PPD reactivity were identified as professional risks; strict early preventive measures must be implemented accordingly.

Part-per-trillion level determination of antifouling pesticides and their byproducts in seawater samples by off-line solid-phase extraction followed by high-performance liquid chromatography-atmospheric pressure chemical ionization mass spectrometry

A new method for the simultaneous determination of antifouling pesticides and some of their byproducts such as dichlofluanid, diuron and its byproducts [demethyldiuron and 1-(3,4-dichlorophenyl)urea], (2-thiocyanomethylthio)ben: zothiazole, chlorothalonil, Sea-nine 211, Irgarol 1051 and one of its byproducts (2-methylthio-4-tert.-butylamino-s-triazine) in seawater was developed. The extraction of these compounds from the filtered seawater samples was performed off-line with different solid-phase extraction sorbents using (I) a 500 mg graphitized carbon black cartridge (ENVI-Carb) and (II) 200 mg polymeric cartridges (LiChrolut EN and Isolute ENV+) and passing 500 ml of the sample through these cartridges. The detection was carried out by reversed-phase high-performance liquid chromatography coupled with atmospheric pressure chemical ionization mass spectrometry both in the negative and positive ion modes. The recovery ranged from 76 to 96% for the whole antifouling group with the ENVI-Carb cartridges and the detection limit was at the part-per-trillion level except for TCMTB. The method utilizing the polymeric cartridge proved to be very useful, time saving and with good recoveries when only Irgarol and its byproduct, Sea-nine 211 and diuron and its byproducts, have to be analyzed. The different cartridges were applied to the analysis of these pesticides in different marinas of the Catalan coast; diuron, dichlofluanid, Sea-nine 211, Irgarol as well as demethyldiuron and the Irgarol byproduct being the must ubiquitous pollutants. Maximum concentration levels were 2-3.5 microg/l of diuron and Sea-nine 211, respectively.

[Scheduled biliary surgery and antibiotic prophylaxis. Is its use always justified?]

AIM

Evaluate the need to give prophylactic antibiotic therapy in patients that undergo elective surgery for cholelithiasis.

METHODS

Prospective study in 35 patients the underwent surgery for cholelithiasis, without infectious risk factors. All of them, the hemocultives, endotoxin and Tumor Necrosis Factor has been evaluated along the surgical process.

RESULTS

The hemocultives were in all the patients negatives. The levels of Tumor Necrosis Factor decreased along the surgical process, without modifications of endotoxin levels. There were no significant differences in either of the points of the analysis.

CONCLUSIONS

Biliary surgery in patients that undergo elective surgery for cholelithiasis, without infectious risk factors, is a clean surgery, and so, in this patients is not indicated systematically an antibiotic prophylaxis.