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METHODS: This was a pre/post-observational study examining patients' emotions before and during elective knee or hip replacement surgery for osteoarthritis in seven European Union countries to identify factors related to better emotional status at discharge. INSTRUMENTS: In addition to demographic data, information was collected on quality of life (EuroQoL five-dimension questionnaire), hospital expectations (Knowledge Expectations of Hospital Patients Scale), symptoms, and experienced emotions. ANALYSIS: Total negative emotions scores at baseline and discharge were transformed into median values. Multivariate analysis identified the baseline factors related to better emotional status at discharge. RESULTS: Patients (n = 1,590), mean age 66.7 years (SD = 10.6), had a significant reduction in the frequency of total negative emotions at discharge as compared with baseline. The multivariate model showed better health status (odds ratio [OR] = 1.012; p =.004), better emotional status at baseline (≥24 points), and shorter duration of hospital stay (OR = 0.960; p =.011) as independent factors associated with better emotional status at discharge (OR = 4.297; p =.001). CONCLUSIONS: Patients undergoing elective knee or hip replacement surgery for osteoarthritis improve their emotional status during hospitalization, with fewer negative emotions at discharge. Good emotional status, feeling of higher health status at baseline, and shorter hospitalization were independently associated with better emotional status at discharge. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Exposure to lead and cadmium is a public health problem due to the broad exposure to these toxic substances among the general population. The objective of this study is to determine blood lead and cadmium concentrations in a working population drawn from six university hospitals in Madrid, Getafe, Cartagena, Santiago de Compostela, Santander and Palma de Mallorca (Spain) and to identify associated factors. Materials and methods: 951 individuals participated in the study and were administered the standardized PESA® questionnaire regarding exposure to lead and cadmium. The blood lead and cadmium concentrations were measured by electrothermal atomization atomic absorption spectrometry with Zeeman background correction in Perkin-Elmer spectrometers, guaranteeing the transferability of the results. Results: The median overall blood lead concentration was: 1.6μg/dL (IQR: 0.9–2.7) and that of cadmium was: 0.21μg/L (IQR: 0.10–0.50). There were significant differences in lead levels between men (2μg/dL) and women (1.5μg/dL), postmenopausal (2.6μg/dL) and premenopausal women (1.1μg/dL), and between participants who cooked in earthenware (2.1μg/dL) and those who did not (1.5μg/dL). The median of cadmium in women (0.24μg/L) was higher than in men (0.11μg/L) and was also higher in subjects who smoked (0.70μg/L) than in non-smokers (0.13μg/L). Conclusions: A reduction in blood lead and cadmium levels was observed with respect to previous studies carried out in Spain. Nevertheless, the results suggest there are certain factors which increase risk such as age, gender, menopause, age of housing, cooking in lead-glazed earthenware and exposure to cigarette smoke. [Copyright &y& Elsevier]

Abstract: Introduction: Trace elements may play an important role in bipolar disorders. The objective of this study is to determine serum copper and zinc, blood lead and cadmium and urine lead, cadmium and thallium concentrations in patients diagnosed with bipolar disorders and to compare these levels with those of a healthy control group. Materials and methods: A total of 25 patients diagnosed with bipolar disorder and 29 healthy subjects participated in this study. Serum copper and zinc concentrations were measured using flame atomic absorption spectrometry; the blood lead and cadmium concentrations were measured by electrothermal atomization atomic absorption spectrometry with Zeeman background correction; urine lead, cadmium and thallium concentrations were measured by inductively coupled plasma mass spectrometry. Results: Median blood and urine lead and cadmium levels were significantly higher among the bipolar patients than among the control group: Blood lead (μg/dL): patient median: 3.00 (IQR: 1.40–4.20); control median (μg/dL): 2.20 (IQR: 0.90–3.00) p =0.040. Blood cadmium (μg/L): patient median: 0.39 (IQR: 0.10–1.15); control median: 0.10 (IQR: 0.10–0.17) p <0.001. The median of cadmium (μg/L) in patients who smoked (1.20 IQR: 0.44–2.30) was higher than that in non-smokers (0.12 IQR: 0.10–0.34) p <0.001. There was a statistically significant increase (p =0.001) in zinc levels among patients in the manic phase (mean 111.28, SD: 33.36μg/dL) with respect to the control group (mean 86.07, SD: 12.39μg/dL). Conclusions: The results suggest that there could be higher levels of some toxic trace elements in the group of patients with bipolar disorder than in the healthy control group. [Copyright &y& Elsevier]