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Objetivo: Evaluar la efectividad y las complicaciones del tratamiento con litotricia extracorpórea por ondas de choque (LEOC) en litiasis coraliformes. Diseño: Estudio observacional retrospectivo de litiasis coraliformes tratadas con LEOC en el Hospital Regional Universitario de Málaga entre los años 1990 y 2010. Resultados: Se incluyeron 157 pacientes sometidos a LEOC de litiasis coraliforme, 136 mujeres y 21 hombres. El número medio de sesiones para la fragmentación fue de 3,39± 1.94, el número de ondas de 10066.67±6182.96, la intensidad media de 16,24±12.37, la energía acumulada media de 402.69±182.07 y el tiempo de resolución de 7.59±7.97 meses. De los pacientes analizados, 106 quedaron libres de litiasis y 51 presentaron fragmentos residuales pequeños; sólo 12 tuvieron recidiva litiásica. La mortalidad fue del 0%. Las complicaciones según Clavien-Dindo fueron un 10% de tipo IIIb, 18% tipo IIIa y 3,31% tipo II. El coeficiente de efectividad de Clayman fue de 0,49 si consideramos retratamiento cuando se necesita más de una sesión y 0,71 si se consideran todas las sesiones como un único tratamiento. Limitaciones del estudio: Al tratarse de un estudio observacional retrospectivo, las conclusiones obtenidas son relativas, dado que existe heterogeneidad entre pacientes, en lo referente a morfología de la vía urinaria, tamaño y composición de las litiasis. Originalidad o valor: LEOC en pacientes con múltiples comorbilidades, es una alternativa a la cirugía. Conclusiones: Aunque la LEOC no es el tratamiento de elección para los cálculos coraliformes, es una opción válida en casos determinados, siempre en función de la disponibilidad del centro y/o experiencia del urólogo.

Our objective was to determine outcomes of severe chest trauma admitted to the ICU and the risk factors associated with mortality. An observational, prospective, and multicenter registry of trauma patients admitted to the participating ICUs (March 2015–December 2019) was utilized to collect the patient data that were analyzed. Severe chest trauma was defined as an Abbreviated Injury Scale (AIS) value of ≥3 in the thoracic area. Logistic regression analysis was used to evaluate the contribution of severe chest trauma to crude and adjusted ORs for mortality and to analyze the risk factors associated with mortality. Overall, 3821 patients (39%) presented severe chest trauma. The sample’s characteristics were as follows: a mean age of 49.88 (19.21) years, male (77.6%), blunt trauma (93.9%), a mean ISS of 19.9 (11.6). Crude and adjusted (for age and ISS) ORs for mortality in severe chest trauma were 0.78 (0.68–0.89) and 0.43 (0.37–0.50) (p < 0.001), respectively. In-hospital mortality in the severe chest trauma patients without significant traumatic brain injury (TBI) was 5.63% and was 25.71% with associated significant TBI (p < 0.001). Age, the severity of injury (NISS and AIS-head), hemodynamic instability, prehospital intubation, acute kidney injury, and multiorgan failure were risk factors associated with mortality. The contribution of severe chest injury to the mortality of trauma patients admitted to the ICU was very low. Risk factors associated with mortality were identified.

La actual pandemia de COVID-19 ha generado una serie de cambios en las rutinas diarias de las personas, incluidos niños y adolescentes, de una forma sin precedentes, lo que constituye un desafío mundial en salud pública. El aislamiento social ha sido una medida profiláctica para evitar la propagación del virus; sin embargo, ha generado impactos negativos en la salud física y emocional de padres, cuidadores, niños y adolescentes alrededor del mundo. El objetivo del presente estudio fue evaluar los efectos del confinamiento provocado por la pandemia del COVID-19 a nivel del estado nutricional, patrones dietéticos y de comportamiento de niños y adolescentes de educación básica primaria de una pequeña localidad de Colombia. Se evaluaron parámetros antropométricos como IMC Z-score, perímetro de cintura y relación cintura/talla en 266 escolares y adolescentes. Se aplicó un cuestionario con características sociodemográficas, clínicas y de estilo de vida y el KIDMED para conocer aspectos nutricionales. Un total de 102 estudiantes (38⋅3 %) fueron clasificados con estado nutricional alterado, siendo 39 (14⋅7 %) clasificados con sobrepeso y 36 (13⋅5 %) con obesidad. La prevalencia de alta adherencia a la dieta mediterránea fue del 12 %, IC 95 % (0⋅08, 0⋅16). El sobrepeso fue más frecuente en mujeres (26/39, 66⋅7 %; P = 0⋅0439), y la obesidad fue discretamente más frecuente en hombres (19/36, 52⋅7 %; P = 0⋅7193). Observamos una situación nutricional, dietética y comportamental preocupante en los niños y adolescentes estudiados durante el confinamiento asociado a la pandemia de COVID-19. Esto devela la necesidad de establecer estrategias y/o políticas públicas en nuestra localidad que ayuden a promover un adecuado desarrollo biopsicosocial del paciente pediátrico y su grupo familiar. The current COVID-19 pandemic has generated a series of changes in the daily routines of people, including children and teenagers, in an unprecedented way, which constitutes a global challenge in public health. Social isolation has been a prophylactic measure to prevent the spread of the virus; however, it has generated negative impacts on the physical and emotional health of parents, caregivers, children and teenagers around the world. The objective of the present study was to evaluate the effects of confinement caused by the COVID-19 pandemic at the level of nutritional status, dietary and behavioural patterns of elementary school children and teenagers in a small town of Colombia. Anthropometric parameters such as BMI Z-score, waist circumference and waist/height ratio were evaluated in 266 school children and teenagers. A questionnaire with socio-demographic, clinical and lifestyle characteristics and the KIDMED were applied to learn about nutritional aspects. A total of 102 students (38⋅3 %) were classified as having altered nutritional status, being 39 (14⋅7 %) classified as overweight and 36 (13⋅5 %) with obesity. The prevalence of high adherence to the Mediterranean diet was 12 %, 95 % CI (0⋅08, 0⋅16). Overweight was more prevalent in women (26/39, 66⋅7 %; P = 0⋅0439), and obesity was discreetly more frequent in men (19/36, 52⋅7 %; P = 0⋅7193). We observed a worrying nutritional, dietary and behavioural situation in the children and teenagers studied during the confinement associated with the COVID-19 pandemic. This unveils the need to establish strategies and/or public policies in our town that help to promote an adequate biopsychosocial development of the paediatric patient and their family group

To analyze factors associated with the development of early and late multiorgan failure (MOF) in trauma patients admitted to the intensive care unit (ICU).Spanish Trauma ICU Registry (RETRAUCI). Data collected from 52 trauma ICU between March 2015 and December 2019. We analyzed the incidence, outcomes, and the risk factors associated with early (72 h) or late (beyond 72 h) MOF in trauma ICU patients. Multiple logistic regression analysis was performed to analyze associated factors.After excluding patients with incomplete data, 9,598 trauma ICU patients constituted the study population. Up to 965 patients (10.1%) presented with MOF, distributed by early MOF in 780 patients (8.1%) and late MOF in 185 patients (1.9%). The multivariate analysis showed that early MOF was associated with: ISS ≥ 16 (OR 2.80), hemodynamic instability (OR from 2.03 to 43.05), trauma-associated coagulopathy (OR 2.32), and acute kidney injury (OR 4.10). Late MOF was associated with: age65 years (OR 1.52), hemodynamic instability (OR from 1.92 to 9.94), acute kidney injury (OR 4.22), and nosocomial infection (OR 17.23). MOF was closely related to mortality (crude OR (95% CI) 4.77 (4.22-5.40)).Multiorgan failure was recorded in 10% of trauma ICU patients, with early MOF being the predominant form. Early and late MOF forms were associated with different risk factors, suggesting different pathophysiological pathways. Early MOF was associated with higher severity of injury and severe bleeding-related complications and late MOF with advanced age and nosocomial infection.

Datura species are well known because of their high concentration of tropane alkaloids, which has led to poisoning episodes when Datura is accidentally mixed with edible crops. Therefore, the European Union has set a maximum level in cereal-based infant food products of 1 µg kg−1 for atropine and scopolamine. However, the occurrence of these compounds in other commodities has become a global concern. Spinach and derived products can be contaminated with Datura innoxia leaves. In this study, we tested frozen spinachs and spinach-based infant food products. The determination was carried out by UHPLC–MS/MS after applying the QuEChERS method as sample treatment. The LOQs were below 0.016 µg kg−1, achieving satisfactory results in terms of precision, accuracy, and matrix effects. The obtained results (ranging between 0.02 and 8.19 µg kg−1) were close to the maximum level set by the European Union for 24% of the samples tested.

espanolObjetivo: Identificar, evaluar y sintetizar la mayor evidencia disponible sobre el efecto del masaje en la ictericia en neonatos a termino tratados o no con fototerapia. Metodo: Se desarrollo una revision siguiendo la declaracion PRISMA. Para ello se realizouna exhaustiva busqueda sistematica en las bases de datos PubMed, Cuiden, Scopus, Scielo y Cnki de los articulos publicados entre enero del 2009 y junio del 2018. Los estudios seleccionados fueron sometidos a una evaluacion de la calidad metodologica mediante la escala PEDro. Resultados: Un total de 10 trabajos cumplian los criterios inclusion y fueron incorporados a la revision. Estos presentaban una calidad metodologica moderada (xˉ=7,3). Los diferentes estudios mostraban un incremento de la frecuencia defecatoria y una disminucion de los niveles de bilirrubina en el grupo intervencion. En los pacientes tratados con fototerapia, la duracion de la hiperbilirrubinemia era menor en el grupo experimental. Segun los autores se podia justificar por un aumento de la actividad gastrointestinal debido a una estimulacion vagal gracias al masaje. Conclusion: A pesar de la escasa evidencia existente, la masoterapia se establece como una herramienta eficaz, segura y economica para la prevencion y tratamiento de niveles elevados de bilirrubina en neonatos a termino. EnglishObjective: To identify, assess and synthesise the best available evidence on the effect of massage on jaundice in term neonates treated or not with phototherapy. Method: A review was developed following the PRISMA statement. For this purpose, an exhaustive systematic search in the PubMed, Cuiden, Scopus, Scielo and Cnki databases of the articles published between January 2009 and June 2018 was carried out. The selected studies underwent an evaluation of methodological quality using the PEDro scale. Results: A total of 10 papers met the inclusion criteria and were incorporated into the review. These were of moderate methodological quality (xˉ=7.3). The different studies showed an increase in defecatory frequency and a decrease in bilirubin levels in the intervention group. In patients treated with phototherapy, the duration of hyperbilirubinemia was shorter in the experimental group. According to the authors, an increase in gastrointestinal activity due to vagal stimulation by massage could be justified. Conclusion: Despite limited evidence, massage therapy is established as an effective, safe and economical tool for the prevention and treatment of elevated bilirubin levels in term neonates.

Resumen Introduccion Comparamos el Geriatric Trauma Outcome score (GTOS) con la probabilidad de supervivencia empleando la metodologia TRISS (PS-TRISS) en pacientes traumaticos ancianos ingresados en las Unidades de Cuidados Intensivos (UCI) participantes en el registro de traumatismo en UCI (RETRAUCI). Metodos Analisis retrospectivo del RETRAUCI. Los datos cuantitativos se expresan como mediana (rango intercuartil), los datos categoricos como numero (porcentaje). Analizamos la validez del GTOS y la PS-TRISS para la prediccion de supervivencia. La discriminacion se evaluo mediante curvas receiver operating characteristics. La calibracion de los modelos se analizo mediante el test de bondad de ajuste de Hosmer-Lemeshow. Un valor de p Resultados La cohorte incluyo a 1.417 pacientes ≥ 65 anos. Mediana edad 75,5 (70,5-80,5) anos, varones 1.003 (68,2%), mediana Injury Severity Score 18 (13-25). Ventilacion mecanica, 61%. Las caidas fueron el mecanismo de lesion en 659 pacientes (44,8%). Mortalidad hospitalaria: 18,2%. El area bajo la curva para PS-TRISS fue 0,69 (IC del 95% 0,66-0,73) y para GTOS 0,66 (IC del 95% 0,62-0,70); p Conclusiones En nuestra muestra de pacientes traumaticos ancianos la precision de GTOS fue inferior a la de la metodologia TRISS en la prediccion de la supervivencia hospitalaria. Ambos scores tuvieron una mala calibracion en la poblacion anciana.

In this work, a new method based on nanoflow LC with high-resolution MS was developed for the determination of eight pesticides in pollen and nectar samples, including neonicotinoid insecticides and other selected pesticides commonly found in bees and beeswax. Detection was undertaken with a hybrid quadrupole-Orbitrap mass spectrometer (Q Exactive™) equipped with a commercial nanospray ion source. The extraction of pesticides from pollen samples was performed by a modified micro-QuEChERS method scaled down to Eppendorf tubes, whereas nectar samples were simply diluted with a water–methanol (95 + 5, v/v) solution. Good linearity (>0.999 in all cases) was obtained between 0.05 and 500 µg/kg and between 0.04 and 400 µg/kg for pollen and nectar, respectively. Recovery rates in pollen ranged from 85 to 97%, with RSDs

To evaluate the association of 64 obesity-related polymorphisms with pediatric-onset type 2 diabetes and other glucose- and insulin-related traits in Mexican children. Case–control and case–sibling designs were followed. We studied 99 patients with pediatric-onset type 2 diabetes, their siblings (n = 101) without diabetes, 83 unrelated pediatric controls and 137 adult controls. Genotypes were determined for 64 single nucleotide polymorphisms, and a possible association was examined between those genotypes and type 2 diabetes and other quantitative traits, after adjusting for age, sex and body mass index. In the case–pediatric control and case–adult control analyses, five polymorphisms were associated with increased likelihood of pediatric-onset type 2 diabetes; only one of these polymorphisms (CADM2/rs1307880) also showed a consistent effect in the case–sibling analysis. The associations in the combined analysis were as follows: ADORA1/rs903361 (OR 1.9, 95% CI 1.2; 3.0); CADM2/rs13078807 (OR 2.2, 95% CI 1.2; 4.0); GNPDA2/rs10938397 (OR 2.2, 95% CI 1.4; 3.7); VEGFA/rs6905288 (OR 1.4, 95% CI 1.1; 2.1) and FTO/rs9939609 (OR 1.8, 95% CI 1.0; 3.2). We also identified 16 polymorphisms nominally associated with quantitative traits in participants without diabetes. ADORA/rs903361, CADM2/rs13078807, GNPDA2/rs10938397, VEGFA/rs6905288 and FTO/rs9939609 are associated with an increased risk of pediatric-onset type 2 diabetes in the Mexican population.

To estimate the heritability, parental transmission and environmental contributions to the phenotypic variation in type 2 diabetes mellitus and metabolic syndrome-related traits in families of Mexican children and adolescents.We performed a cross-sectional study of 184 tri-generational pedigrees with a total of 1160 individuals (99 families with a type 2 diabetes mellitus proband before age 19). The family history of type 2 diabetes mellitus in three generations was obtained by interview. Demographic, anthropometric, biochemical and lifestyle information was corroborated in parents and offspring. We obtained correlations for metabolic traits between relative pairs, and variance component methods were used to determine the heritability and environmental components.The heritability of early-onset of type 2 diabetes mellitus was 0.50 (p1.0e-7). The heritability was greater than 0.5 for hypertension, hypoalphalipoproteinemia, hypercholesterolemia, body mass index, waist circumference, blood pressure, 2-h insulin, and cholesterol (p0.001). In contrast, we observed a high environmental correlation (0.50) for blood pressure, HbA1c and HDL-cholesterol after multivariate adjustment (p0.05). Several traits, such as type 2 diabetes mellitus and insulin resistance, were significantly correlated only through the mother and others, such as hypertriglyceridemia, were significantly correlated only through the father.This study demonstrates that type 2 diabetes mellitus and metabolic syndrome-related traits are highly heritable among Mexican children and adolescents. Furthermore, several cardiometabolic factors have strong heritability and/or high environmental contributions that highlight the complex architecture of these alterations.

Background There is evidence of associations of single-nucleotide polymorphisms (SNPs) with type 2 diabetes (T2D) and related glycemic traits in adults, but there is a little information about such associations in youths. Objective The aim of this study was to evaluate the associations of SNPs in the TCF7L2, SLC16A11, and ABCA1 genes with T2D and related glycemic traits in Mexican children and adolescents. Subjects A total of 99 families with children with T2D (n = 327) and 83 families with children without the disease (n = 212). Methods The associations between SNPs of TCF7L2 (rs7903146 and rs12255372), SLC16A11 (rs13342232), and ABCA1 (rs9282541) with T2D were analyzed. We also evaluated the effects of SNPs on quantitatively related glycemic traits after adjusting for age, sex, and the presence of overweight or obesity. Results The G allele of SLC16A1 /rs13342232 was associated with T2D in adults (adjusted odds ratio [ORadj] = 1.89; 95% confidence interval [CI]: 1.18; 3.06) and children (ORadj = 1.94; 95% CI: 1.25; 3.00). In addition, the combined analysis of case-control and case-parent trio was also significant (OR = 1.43; 95% CI: 1.12; 1.74). After adjusting for known confounding factors, we found a significant association between TCF7L2/rs122555372 and C-peptide (β = −0.76, P = .005) in patients with diabetes and between fasting glucose (β = 2.05, P = .039) and homeostatic model assessment of β-cell function (β = −32.14, P = .025) levels in individuals without diabetes. Conclusions The results suggest that SLC16A1 /rs13342232 might be involved in the risk of pediatric-onset T2D in Mexican families. Moreover, TCF7L2/rs122555372 was associated with pancreatic reserve in patients with T2D and with fasting glucose and β-cell function in individuals without diabetes.

Digital, Obesity is currently considered a global epidemic, and its implications in mortality and morbidity in a paediatric patient and in adulthood are increasingly important. The objective of this article is to review in detail the definition of obesity according to age group, and, in turn, the epidemiology of this entity worldwide and in South America. Available evidence about pathophysiology and, additionally, associated comorbidities are reported in some of the most important and clinically relevant body systems. The recommendations on pharmacological and nonpharmacological management through changes in lifestyle and relevant aspects of bariatric surgery in the paediatric population are also described., Ciencias Médicas y de la Salud

Background Few studies have investigated the safety and efficacy of anti-PD-(L)1 antibodies in metastatic urothelial carcinoma (mUC) in daily clinical practice. Knowledge about the influence of baseline clinical and analytical factors on therapy outcomes is scarce. Patients and methods We conducted a multicenter retrospective study involving 119 previously treated or untreated mUC patients under anti-PD-(L)1 therapy in a real-world scenario. The objectives of this study were to confirm the safety and efficacy of anti-PD-(L)1 monotherapy and to identify pretreatment factors influencing therapy outcomes. In addition, an independent prognostic model for overall survival (OS) was developed and internally validated. Results Median OS was 7.8 months [95% confidence interval (CI), 5.4-10.4], median progression-free survival (PFS) was 2.80 months (95% CI, 2.4-3.4), disease control rate (DCR) was 40% (95% CI, 31-49), and overall response rate (ORR) was 24% (95% CI, 15-31). Presence of peritoneal metastases was associated with poor OS [hazard ratio (HR) = 2.40, 95% CI, 1.08-5.33; P = 0.03]. Use of proton-pump inhibitors (PPI) was associated with poor OS (HR = 1.83, 95% CI, 1.11-3.02; P = 0.02) and PFS (HR = 1.94, 95% CI, 1.22-3.09; P = 0.005), and lower DCR (OR = 0.38, 95% CI, 0.17-0.89; P = 0.03) and ORR (OR = 0.18, 95% CI, 0.02-1.60; P = 0.002). The three risk category prognostic model developed included Eastern Cooperative Oncology Group performance status, PPI use, albumin level, presence of liver metastases, and presence of peritoneal metastases variables and was associated with higher risk of death (HR = 3.00, 95% CI, 1.97-4.56; P = 0.0001). Conclusions This study confirms anti-PD-(L)1 monotherapy as a safe and effective treatment option in daily clinical practice for mUC patients. It also describes the presence of peritoneal metastases as an independent prognostic factor for OS and underlines the association between PPI use and worse therapeutic outcomes. Finally, it proposes a new easy-to-use risk-assessment model for OS prediction., Highlights • Monotherapy with anti-PD-(L)1 antibodies is a safe and effective treatment option in mUC. • Peritoneal metastases represent an independent prognostic factor in mUC. • The use of PPI correlates with poor therapeutic outcomes. • A new three risk category prognostic model enables OS prediction.

RESUMEN Describir la presencia de un granuloma inflamatorio crónico en un gallo Jacab colombiano y su posible relación con la aplicación de fármacos en esta especie, en Montería, Córdoba 2019. Un gallo Jacab (Gallusgallus domesticus), de 2 años de edad ingresa a cirugía en la clínica veterinaria "Julio E. Cuervo", por presentar un nódulo de 2 cm en la región alar izquierda, de dos meses de evolución, se tomaron imagen radiológica latero lateral, evidenciando una lesión de 2 cm de diámetro en la región escapulo-humeral, se realizó extirpación quirúrgica bajo anestesia inhalada con Isoflurano 2 CAM y se envió a evaluación histopatológica. El diagnóstico patológico describe una neoformación móvil, indolora y consistencia firme, color pardo amarillenta, de 1,5 cm de diámetro, los cortes muestran una lesión, constituida por proliferación de fibras elásticas y fibroblastos fusiformes e histiocitos, con reacción inflamatoria linfoplasmocitoria de aspecto granulomatosa, tratándose de un granuloma inflamatorio crónico. ABSTRACT To describe the presence of a chronic inflammatory granuloma in a colombian Jacab cock and its possible relation with the application of drugs in this species in Montería, Córdoba 2019. A 2-year-old Jacab (Gallus gallus domesticus) enters the veterinary clinic "Julio E. Cuervo", presenting a 2 cm nodule in the left wing region, having already two months of evolution, lateral radiological imaging lateral, evidencing an injury of 2 cm diameter in the scapulohumeral region, surgical removal was performed under inhalation of anesthesia with isoflurane 2 CAM and sent to histopathological evaluation. The pathological diagnosis describes a firm, painless neoplasm with firm consistency, yellowish brown color and diameter of 1.5 cm. The lesions show consistent proliferation of elastic fibers and fusiform fibroblasts and histiocytes with granulomatous lymphoplasmacytic inflammatory reaction, diagnosis suggest a chronic inflammatory granuloma.

espanolIntroduccion: La obesidad es una pandemia mundial; 3 de cada 10 adolescentes en Mexico la padecen. En la obesidad morbida, el manejo conservador es un fracaso y la cirugia bariatrica es el unico tratamiento util. No hay experiencia en Me- xico y los reportes internacionales son aislados. Metodo: Analisis de las repercusiones metabolicas, efecto sobre la comor- bilidad y complicaciones, en adolescentes con obesidad morbida operados con manga gastrica de 2011 a 2015. Resultados: De 54 pacientes con obesidad morbida, 10 cumplieron criterios; 5 varones; edad de 14.3 ± 1.4 anos; peso de 117.3 ± 15.2 kg; indice de masa corporal basal de 43.71 ± 4.1; cintura de 130.3 ± 6.8 cm; 8 con dislipidemia; 6 con sindrome metabolico; 5 con esteatosis hepatica; 4 con hipertension; 3 con diabetes tipo 2. Complicaciones: 2 atelectasias, 1 fistula, 1 neumonia, 1 colelitiasis; ninguno con carencia nutricional. Disminucion del peso al ano del 33% y a los 2 anos del 23%. Disminucion de la grasa del 22.4%. Aumento de agua corporal del 36.1%. Perdida del exceso de peso significativa p = 0.001. A los 2 anos, remision de esteatosis grave y de diabetes, el perfil lipidico mejoro, la hipertension arterial persistio solo en uno. Discusion: Lo mas destacado es la mejoria o curacion de la comorbilidad, con curacion de la diabetes, la hipertension y la dislipidemia, que dara mejor pronostico a estos ninos. Conclusiones: La manga gastrica es util en adolescentes con obesidad morbida, con mejoria de la comorbilidad grave. Se requiere un mayor seguimiento. EnglishIntroduction: Obesity is a world pandemic; in Mexico 3 out of 10 adolescents suffer from it. Conservative management of morbid obesity is not effective and bariatric surgery is the only useful therapy. International pediatric bariatric surgery series are scarce and in Mexico there is limited experience. Method: We analyze the metabolic repercussions, comorbidities and complications in our series of Mexican adolescents with morbid obesity who underwent a gastric sleeve between 2011 and 2015. Results: 54 morbid obese adolescents were included, 10 fulfilled criteria for surgery. 5 were male, mean age 14.3 ± 1.4 years, weight 117.3 ± 15.2 kg, initial body mass index 43.71 ± 4.1, waist 130.3 ± 6.8 cm, 8 dyslipidemia, 6 metabolic syndrome, 5 liver steatosis, 4 hypertension, 3 type-2 diabetes. Complications: 2 atelectasis, 1 fistula, 1 pneumonia, 1 cholelithiasis; no patient developed nutritional deficits. Weight loss of 33% one-year after surgery and 23% at 2 years. Body fat de- creased 22.4% and water content increased 36.1%. Excess weight loss was significant p = 0.001. Two-years after surgery severe steatosis and diabetes had subsided, lipid profile improved and only one patient remained hypertensive. Discussion: Our results demonstrate that all serious comorbidities associated to morbid obesity were improved (diabetes, dyslipidemia and hypertension) and will confer a better prognosis for these children. Conclusions: Gastric sleeve is useful in morbid obese adolescents. Longer follow-up is needed.

Objective To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design A multicenter nationwide registry. Retrospective analysis. November 2012–May 2017. Setting Participating ICUs. Patients Trauma patients aged ≥80 years. Interventions None. Main variables of interest The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p-value Results The mean patient age was 83.4 ± 3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5 ± 11.1, with a mean ICU stay of 7.45 ± 9.9 days. The probability of survival based on the TRISS methodology was 69.8 ± 29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. Conclusions Very elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury.

BACKGROUND AND OBJECTIVE Genetics play a very strong role in the development of pediatric-onset type 2 diabetes (T2D); however, little information exists about specific common single nucleotide polymorphisms (SNPs) associated with T2D in this age group. The aim of the study was to analyze the association and parental transmission of 64 obesity-related SNPs with pediatric-onset T2D in Mexican families. METHODS A total of 57 pedigrees containing 171 probands with pediatric-onset T2D and 119 unrelated controls older than 18 years were included. The participants were genotyped for 64 polymorphisms. Association of each variant with pediatric-onset T2D was analyzed through a parent-offspring transmission disequilibrium test (TDT) and in a case-control comparison by χ2 analysis. RESULTS Five SNPs exhibited associations with pediatric-onset T2D in the combined case-parent trio and case-control analysis: LINGO/rs10968576 (odds ratio [OR] 1.82, P = 0.003), POC5/rs2112347 (OR 1.96, P = 2.4E-5), RPS10-NUDT3/rs206936 (OR 1.40, P = 0.023), GLIS3/rs7034200 (OR 2.34, P = 1.2E-6), and VEGFA/rs6905288 (OR 1.58, P = 0.015). The first three were also associated with obesity status. The SNPs POC5/rs2112347 and RPS10-NUDT3/rs206936 were significantly associated through the maternal allele and GLIS3/rs7034200 through the paternal allele (P < 0.05). CONCLUSIONS These findings suggest that certain SNPs associated with obesity and other metabolic traits may also be involved in risk of pediatric-onset T2D in Mexican families. We also identified preferential transmission of parental alleles in some variants.

Objective In the following study, we observe the progress of various invasive calculi treatments that have taken place in our hospital in the last 15 years. Materials and methods We extracted data from our hospital database on patients who underwent extracorporeal shock wave lithotripsy (ESWL), endoscopic surgery and open surgery. We analyzed how the incidence of these treatments has evolved over the last 15 years. We also studied the number of publications in PubMed that reference invasive calculi treatments. Results From January 1998 to December 2012, a total of 10,947 patients were treated instrumentally for lithiasis, 9695 of whom (90.4%) underwent ESWL and 1034 of whom underwent endoscopic or open surgery (9.6%). The incidence of lithotripsy treatments reached its maximum in 2006, with a progressive reduction thereafter. The incidence of endoscopic surgery increased progressively until 2009 and then leveled off. We can see how in recent years there has been a clear increase in the number of studies that have covered endoscopic surgery, with a decreasing number covering ESWL. Conclusions In our community, ESWL remains the most widely used invasive treatment for calculi. In recent years, there has been a reduction in the number of ESWL treatments and an increase in the number of endoscopic treatments, with open surgery showing a clearly decreasing trend.

Resumen Objetivo En el siguiente trabajo se revisa la evolucion de los diferentes tratamientos invasivos de la litiasis que se ha producido en nuestro hospital en los ultimos 15 anos. Material y metodo Se han extraido de la base de datos de nuestro hospital los pacientes intervenidos de litotricia extracorporea por ondas de choque (LEOC), de cirugia endoscopica y de cirugia abierta y se ha analizado como ha evolucionado la incidencia de estos tratamientos en los ultimos 15 anos. Asi mismo se ha estudiado el numero de publicaciones en PubMed que hacen referencia a los tratamientos invasivos de la litiasis. Resultados Desde enero de 1998 hasta diciembre de 2012 se han tratado instrumentalmente de litiasis un total de 10.947 pacientes, 9.695 pacientes (90,4%) de LEOC y 1.034 pacientes de cirugia (9,6%), endoscopica o abierta. La incidencia de tratamientos con litotricia ha tenido su maximo en 2006, presentando posteriormente una disminucion progresiva. La incidencia de la cirugia endoscopica ha aumentado progresivamente hasta 2009 para luego mantenerse. Vemos como en los ultimos anos existe un aumento claro de los articulos que tratan de cirugia endoscopica, disminuyendo los trabajos de LEOC. Conclusiones La LEOC sigue siendo en nuestro medio el tratamiento invasivo para la litiasis mas empleado. En los ultimos anos ha habido una disminucion de los tratamientos de LEOC y un aumento de los tratamientos endoscopicos, presentando la cirugia abierta una clara tendencia a la baja.

Two representative substances of the so-called emerging compounds group (ECs), N,N-diethyl-m-toluamide (DEET) and nortriptyline hydrochloride, were selected to be subjected to ozonation processes, which constitute promising technologies for the removal of hazardous pollutants. The kinetic study provided ozonation rate constants, with an average value of 0.123 ± 0.003 L·mol–1·s–1 for DEET, which remained almost unaffected with the pH; while values varying from 2.40 × 103 to 472 × 103 L·mol–1·s–1 for nortriptyline were deduced in the pH range 2–11. Because of the ionic nature of nortriptyline, the specific rate constants of the protonated and neutral species were determined, the values obtained being 2.1 × 103 and 4.3 × 105 L·mol–1·s–1, respectively. By means of liquid chromatography time-of-flight mass spectrometry analysis, the main byproducts formed in the ozonation reactions were identified (14 for DEET and 27 for nortriptyline), and the evolution of their concentrations with reaction time were establis...

In this work, the implementation of isotope dilution mass spectrometry (IDMS) using minimal labeling and isotope pattern deconvolution (IPD) is evaluated as a strategy for the minimization of matrix effects during trace determination of β 2 -agonists in complex matrices by liquid chromatography electrospray ionization mass spectrometry (LC–ESI-MS). First, the parameters affecting the measurement of isotopic composition of organic compounds by liquid chromatography electrospray ionization high resolution mass spectrometry with a time-of-flight analyzer were evaluated using as a case of study three different β 2 -agonists: clenbuterol, clenproperol and brombuterol. Then, a calibration graph-free IDMS methodology was evaluated in order to overcome matrix effects in LC–ESI-MS in complex samples. In this procedure singly 13 C-labeled analogues of clenbuterol, clenproperol and brombuterol were employed in combination with IPD. Using this approach accurate and precise results were obtained in the simultaneous quantification of β 2 -agonists in human urine and bovine liver, even at the sub ng g −1 and particularly in spite of the previously reported matrix effects. Recovery rates in the range of 97–114% in fortified human urine and from 95% to 111% in fortified bovine liver were obtained with RSD (%) of independent recovery experiments always lower than 6%. These results demonstrate that the proposed methodology based on the use of 13 C 1 -labeled standards and IPD is a reliable approach for accurate LC–MS quantitation of small molecules and compatible with full-scan high-resolution mass spectrometry.

Clenbuterol, terbutaline and salbutamol are B2-agonists drugs included in the list of banned substances of the World Anti Doping Agency (WADA) prohibited in and out of competition. In this article, the excretion of urinary metabolites of clenbuterol, terbutaline and salbutamol have been studied using liquid chromatography electrospray time-of-flight mass spectrometry (LC-TOFMS), after a single therapeutic dose administration in rats. Urine collected was processed with solid-phase extraction prior to LC-TOFMS analyses using electrospray in the positive ion mode and pseudo MS/MS experiments from in-source collision induced dissociation (CID) fragmentation (without precursor ion isolation). The strategy applied for the identification of metabolites was based on the search of typical biotransformations with their corresponding accurate mass shift and the use of common diagnostic fragment ions from the parent drugs. The approach was satisfactory applied, achieving the identification of 11 metabolites (5 from clenbuterol, 4 from salbutamol and 3 from terbutaline), 4 of them not previously reported in urine. Novel metabolites identified in rat urine included N-oxide-salbutamol, hydroxy-salbutamol, methoxy-salbutamol glucuronide and terbutaline N-oxide, which are all reported here for the first time.

Type 4 retinol binding protein (RBP4) is a novel adipocytokine that has been related with insulin resistance (IR). In pediatric population, RBP4 levels are higher in obese subjects compared with lean subjects. In adults with type 2 diabetes (T2D) a positive correlation has been found between RBP4 levels and hepatic steatosis (HS). There is scarce information on RBP4 levels in children and adolescents with T2D. The aim of our study was to evaluate RBP4 levels in T2D adolescents and its association to HS.

ResumenObjetivoEstimar la concordancia en el diagnóstico de la hipertrofia ventricular izquierda electrocardiográfica (HVI-ECG) en sujetos hipertensos entre médicos de atención primaria (AP) y un cardiólogo experto.DiseñoEstudio transversal y multicéntrico.EmplazamientoCentros de AP de Andalucía.Participantes120 médicos de AP que mediante muestreo aleatorio seleccionaron a pacientes de 35 o más años con hipertensión arterial de al menos 6 meses de evolución.Mediciones principalesSe recogieron datos demográficos, de factores de riesgo y de enfermedades cardiovasculares. La HVI-ECG se evaluó aplicando los criterios de voltaje de Cornell, producto de Cornell y de Sokolow-Lyon. Los investigadores de AP realizaron una primera lectura y un cardiólogo, una segunda ciega.ResultadosSe estudió a 570 pacientes (media±desviación estándar de edad, 65±11 años; mujeres, 54,5%); la prevalencia de HVI-ECG fue del 13,7% (intervalo de confianza [IC] del 95%, 10,8-16,6; el 12,6% por Cornell y el 1,6% por Sokolow-Lyon). La concordancia en el diagnóstico de HVI-ECG entre el médico de AP y el cardiólogo fue 0,378 (IC del 95%, 0,272-0,486; desacuerdos en el 15,5% de los casos). Los investigadores de AP subestimaron levemente la prevalencia de HVI-ECG por Cornell y la sobreestimaron levemente por el criterio de Sokolow-Lyon; también fue baja la concordancia para cada uno de ellos (Cornell: κ=0,367; IC del 95%, 0,252-0,482; Sokolow-Lyon: κ=0,274; IC del 95%, 0,093-0,454).ConclusionesLa concordancia entre el diagnóstico de los médicos de AP y el cardiólogo es baja. Los resultados de este estudio indican la necesidad de mejorar la medición electrocardiográfica entre los médicos de AP; la utilización de sistemas informatizados podría ser una buena opción.AbstractObjectiveTo assess the agreement between Primary Care (PC) doctors and a cardiology specialist in diagnosing left ventricular hypertrophy in the electrocardiograph (LVH-ECG) in hypertensive patients.DesignCross-sectional, multicentre study.SettingAndalusian Primary Care Centres.ParticipantsA total of 120 PC doctors who using a random sample selected patients of 35 years or more with AHT of at least 6 months of progression.Primary variablesDemographic data, risk factors and cardiovascular diseases were recorded. The LVH-ECG was evaluated by applying Cornell voltage criteria, Cornell and Sokolow-Lyon product. The PC researchers read the ECG first and the cardiologist made a second reading blind.ResultsA total of 570 patients (mean±SD of age, 65±11 years; 54.5% females); the LVH-ECG prevalence was 13.7% (95% CI, 10.8-16.6; 12.6% by Cornell and 1.6% by Sokolow-Lyon). The agreement in the diagnosis between the PC doctors and the cardiologist was 0.378 (95% CI, 0.272-0.486; disagreements in 15.5% of cases). The PC doctors slightly underestimated the LVH-ECG prevalence by Cornell and slightly overestimated it by the Sokolow-Lyon criteria. The agreement was also low for all of them (κ=0.367; 95% CI, 0.252-0.482, for Cornell, and κ=0.274; 95% CI: 0.093-0.454 for Sokolow-Lyon).ConclusionsThe agreement between the diagnosis by the PC doctors and the cardiologist was low. The implications of this study suggest the need to improve the reading of ECG among PC doctors. The use of computerised systems could be a good option.

Resumen Objetivos el objetivo del estudio PREHVIA ha sido estimar la prevalencia de hipertrofia ventricular izquierda evidenciada en el electrocardiograma (HVI-ECG) y de fibrilacion auricular (FA) en pacientes con hipertension arterial (HTA) de Andalucia, y evaluar la relacion de estas variables con la enfermedad cardiovascular (ECV). Pacientes y metodos se realizo un estudio transversal con seleccion de centros de salud segun la distribucion de la poblacion andaluza por provincias y habitat, y seleccion aleatoria de pacientes incluidos en la muestra. Se recogieron los antecedentes y los medicos participantes y un cardiologo experto valoraron la HVI-ECG aplicando los criterios de Cornell (voltaje y producto) y de Sokolow-Lyon. Se valoro la asociacion con la HVI o la ECV mediante modelos de regresion logistica. Resultados en 570 pacientes (edad media de 65 anos, un 54,5% de mujeres, un 50,6% con obesidad y un 28,2% con diabetes), la prevalencia de HVI-ECG fue del 13,7% (intervalo de confianza [IC] del 95%, 10,8–16,6%). El 12,6% cumplio el criterio de Cornell y el 1,6% el de Sokolow-Lyon. Un 5,1% presento FA (IC del 95%, 3,9–7,5%) y el 22,1% (IC del 95%, 18,4–25,4%) tenia antecedente de ECV. En el analisis multivariante, la HVI-ECG se relaciono con el sexo femenino (odds ratio=5,10; IC del 95%, 2,44–10,64) y la presencia de ECV (odds ratio=2,18; IC del 95%, 1,09–4,12). La ECV se relaciono independientemente con la edad avanzada, el sexo masculino y la FA, y con menos fuerza con un filtrado glomerular bajo y la diabetes mellitus. Conclusiones en hipertensos de Andalucia la prevalencia de HVI-ECG es considerablemente inferior a la hallada en otros estudios, mucho mayor en mujeres y a expensas principalmente del criterio de Cornell. La prevalencia de FA es del 5,1% y la de ECV similar a la de estudios previos. Se observa una asociacion independiente entre HVI-ECG y ECV, y entre ECV y FA.

A procedure for rapid quantitative analysis of pharmaceutical powders is described. Powdered samples were measured in a rotating cell in order to avoid sub-sampling problems by increasing the irradiated area. Quantitative determination of sulfathiazole and sulfanilamide, using a simple univariate calibration model is proposed. Even though both antibacterials are of the same chemical family (sulfonamides), the richness of structural information contained in the Raman spectra allowed their determination using the area of two selected bands (1255 and 1629 cm−1 for sulfathiazole and sulfanilamide, respectively). Relative standard deviation (R.S.D.) values (n = 10) of 3.35% and 3.46% for sulfathiazole and sulfanilamide, respectively, demonstrate the good reproducibility of the measurement technique with the rotating cell. The method was successfully applied to the analysis of synthetic mixtures and commercial pharmaceutical powders. The procedure is suitable to be applied to pharmacopoeial uniformity of content testing of batches.

A sensitive and selective flow-through optosensor implemented with photochemically induced fluorescence (PIF) is proposed for the simultaneous determination of mixtures sulfamethoxazole/sulfanilamide and sulfathiazole/sulfanilamide. The resolution was accomplished by placing in the flow system a minicolumn filled with an appropriate solid support. Whereas one of the sulfonamides is not retained in the minicolumn and is determined by measuring its native fluorescence on the solid surface of the sensing microbeads in the detection area, the other one is retained and, after its elution, it is photochemically converted into a strongly fluorescent photoproduct which is transitorily retained on the sensing support in the flow cell and monitored. Linear calibration graphs were obtained over a concentration range of 2-3 orders of magnitude. The detection limits for the determination of sulfamethoxazole, sulfanilamide and sulfathiazole are 8.1, 2.9 and 5.7 ng mL(-1), respectively. The method was applied to pharmaceuticals, milk and human urine. The recovery of sulfamethoxazole from pharmaceuticals was 102.5% indicating no interference from trimethoprim which is not photochemically active. The recoveries for urine and milk samples fortified with sulfonamides at levels between 0.1 and 0.7 microgmL(-1) agreed within 95.0-107.5% of spiked levels.

A flow injection-solid-phase spectroscopy (FI-SPS) system implemented with photochemically induced fluorescence (PIF) is described for the rapid and very sensitive determination of reserpine in biological fluids and pharmaceutical formulations. An intensively fluorescent photoproduct is in-line generated, retained on C18 silica gel in the detection area and monitored at 394/489 nm (lambdaex/lambdaem). After the establishment of the appropriate working variables, the system is calibrated at two different injection volumes, 100 and 800 microL, achieving detection limits of 0.33 and 0.05 ng mL(-1), respectively. The RSD for reserpine at 2 ng mL(-1) (800 microL) was 1.5% (n=10). The sampling rates were 46 and 43 h(-1) for each injection volume, respectively. The potential interference of some common species coexisting with reserpine in the analysed samples was also studied. The procedure was successfully applied to commercial formulations, urine and serum without any previous treatment of samples. Recoveries ranged from 94.9 to 100.2%.

A combined approach based on solid-phase optosensing and multicommutation principles has been applied to develop a method for the simultaneous analysis of two pharmaceuticals (naproxen and salicylic acid) in biological fluids. The multicommuted flow-through optosensor was based on direct native fluorescence measurements of both analgesics using a non-polar sorbent (C 18 silica gel) as a solid sensing zone. The flow system was controlled by Java-written home-made software and designed using three-way solenoid valves for an independent automated manipulation of sample and carrier solutions. Using an optimized sampling time, the method was calibrated in the range of 1 - 25 and 5 - 200 ng mL -1 . The obtained detection limits were 0.3 and 1.3 ng mL -1 for naproxen and salicylic acid, respectively, with RSD (%) values of better than 2% for both analytes. The proposed methodology was successfully applied to urine, serum and pharmaceutical preparations. Recovery percentages ranging from 96.1 to 104% were obtained for both analytes.

This article describes a multicommutated flow injection-solid phase spectroscopy system implemented with photochemically induced fluorescence for the determination of flufenamic acid (FFA). A strongly fluorescent photoproduct is generated when FFA is irradiated online under UV light in a strong sulfuric medium. The photoproduct generated is retained on C(18) silica gel (which fills the detection area of the flow cell) and directly monitored on the active solid support at 258/442 nm (lambda(ex)/lambda(em)). After maximum signal recording, the sensing zone is regenerated by eluting the retained photoproduct with an appropriate H(2)SO(4)/MeOH solution. The sensor, completely automated, is based on the use of three-way solenoid valves conveniently operated by a homemade multicommutation software written in Java language. The system is calibrated at 10 and 60s for sampling time, showing detection limits of 1.28 x 10(-9) and 5.33 x 10(-10) molL(-1) and sampling rates of 38 and 28 h(-1), respectively, with relative standard deviations of 0.9 and 1.2%. The applicability of the method is demonstrated for the determination of FFA in human serum, human urine, and a pharmaceutical preparation without any pre-treatment. Good recovery levels were achieved between 90.5 and 103.7%.

Objectives To describe the clinical and epidemiological profile of the patients in the Burn Unit of the Hospital Universitario San Vicente de Paul (HUSVP) de Medellin, Colombia, from 1994–2004. Methods Retrospective descriptive study of all pediatric and adult burn patients. The following were recorded: age, gender, cause, extent and severity of the burns, time in the hospital, operations, complications and death rate. Statistica 6.0 (Stafsoft Inc.) was used. Results Two thousand three hundred and nineteen patients were admitted, 66.8% were males and 62.9% were less than 15 years old. Burns caused by scalding were the most frequent (45.9%) followed by flames (38.5%) The average burn area was 26.9%. Average hospital stay was 26.9 days. In 2004, 40.4% of the patients required surgery; 13.4% of the patients had complications. 7.4% of the patients died, with an average burn area of 62%; burns caused by flames accounted for 63% of the deaths. Conclusions There is a continuing improvement in hospital stay, survives burn sizes, with figures comparable to others without access to a tissue bank or skin cultivation.

For the first time, the combination of multicommutation concept with flow-through multioptosensors is exploited and a biparameter multicommutated UV sensor is developed. A very easy-operated and automated sensing device is proposed here and demonstrated to be useful in the routine analysis by applying it to the determination of two widely used pharmaceuticals chosen as model analytes: salicylamide and caffeine. The particulated solid phase used performs two functions: (a) states selectivity conditions by itself in the flow cell and (b) provides appropriate separation of the analytes in the on-line precolumn, thus making possible the sequential arrival of the analytes to the detection zone. Both carrier and eluting solutions chosen allow (with a very simple solenoid valve configuration and operation) the transitory signals to be developed in a completely automated device. Drastic reduction of carrier and eluting solutions used are achieved as compared to typically FIA optosensor configuration. The sensor responds linearly in the range 2–30 and 1–14 μg ml −1 for SLC and CF, with detection limits of 0.33 and 0.15 μg ml −1 , respectively. Solution savings between 50 and 85% were obtained when comparing to typical flow injection analysis (FIA).

The use of a flow through solid phase terbium-sensitized luminescence system is described for the determination of the widely used fluoroquinolone norfloxacin. A chelate between the terbium ion and the analyte is formed online previously to the sample injection into the carrier stream. Then the chelate is transported towards the flow-through cell, where it is retained on a cationic Sephadex resin packed in the cell, developing the corresponding luminescence signal. Afterwards, an ethylenediaminetetraacetic acid solution was used as eluting agent, in order to regenerate the sensing zone. The system has been satisfactorily applied to the determination of norfloxacin in human urine and serum, without the need of a pre-treatment. The response was linear in the range 10–150 ng ml −1 . The detection and quantification limits were 1.5 and 5 ng ml −1 , respectively and the R.S.D. 1.82%.

A bead injection spectroscopy-flow injection analysis (BIS-FIA) system for the spectrophotometric detection of promethazine and trifluoperazine is developed. The sensor is based in the oxidation of the phenothiazines by Fe(III) which is later determined by formation of the complex between Fe(II) and Ferrozine, [FeFz 3 ] 4− . Immediately, this complex is retained on a homogeneous bead suspension of Sephadex QAE A-25 resin (500 μl) which has been injected previously in the system to fill a commercial flow-cell (Hellma 138-OS). The use of BI with respect to the use of a reusable flow-through sensor is justified because the complex is so strongly retained on the beads that the regeneration of the solid support becomes extraordinarily difficult in the proposed method. At the end of the analysis, beads are automatically discarded from the flow-cell, by reversing the flow, and transported out of the system. The analytical signals are measured at a wavelength of 567 nm, corresponding to the absorbance of the complex. Using a sample volume of 600 μl, the analytical signal showed a very good linearity in the range 0.5–8.0 μg ml −1 and 0.5–10.0 μg ml −1 , with detection limits of 0.09 and 0.14 μg ml −1 for promethazine and trifluoperazine, respectively. R.S.D.s (%) lower than 2% were obtained for both analytes. The proposed method is highly selective in the presence of other species that are normally encountered with these analytes. The sensor was satisfactorily applied to pharmaceutical preparations.

A simple flow injection UV spectrophotometric sensing device was developed for the determination of ciprofloxacin. The method is based on its transient retention and concentration on Sephadex SP C-25 cation-exchange gel beads packed in the flow cell and the continuous monitoring of its native absorbance on the solid phase at 277 nm. The procedure is carried out without any derivatisation. Formic acid/NaOH 1.75 M at pH 2.2 is used as carrier solution in a simple monochannel FIA manifold. When the analytical signal reached the maximum value, ciprofloxacin was eluted from the solid support by the carrier solution itself. The response of the sensor was linear in the concentration range 0.5-10 microg ml(-1) with an RSD (%) of 0.79, a detection limit (3sigma criterion) of 0.035microg ml(-1) and a sampling rate of 16 h(-1). Application to the analysis of pharmaceutical samples testifies the utility of this sensor.

A simple and inexpensive method for the determination of ciprofloxacin has been developed using solid-phase spectrophotometry. The intrinsic absorbance of ciprofloxacin fixed on a dextran-type cation-exchange resin, Sephadex SP C-25, was measured directly at 277 and 380 nm after packing the gel beads in a 1-mm cell. Using a sample volume of 10 ml, the calibration graph was linear over the range 0.05–0.3 μg ml−1 with a R.S.D. of 1.11% (n=8). The sensitivity obtained is 40 times higher than that of the corresponding solution method. The method was applied to the determination of ciprofloxacin in pharmaceutical preparations and was validated by standard addition.

For the first time, a bead injection spectroscopy–flow injection analysis (BIS–FIA) system with spectrophotometric detection in a commercially available flow cell (Hellma 138-OS) is developed. The flow cell is filled by injecting in the flow system a homogeneous bead suspension of an appropriate solid support previously loaded with the chromogenic reagent. The solid beads work as a flow-through chemical sensing microzone integrating on-line separation/reaction/detection, developing the analytical signal when the injected sample containing the analyte reaches the beads. At the end of the analysis, the beads are discarded by reversing the flow and instantaneously transported out of the system. These systems can be specially recommended in those flow-through optosensors in which the species of interest is so strongly retained on the solid sensing microzone that the regeneration of the solid beads becomes extraordinarily difficult. They can be considered as belonging to the third generation of FI microanalytical techniques which use renewable sensing solid surface, so avoiding the need for a reversible sensing mechanism. To demonstrate the utility of this technique, a single BIS–FIA system is developed to determine: (a) directly Fe(II); (b) Fe(III) or total iron (Fe(II)+Fe(III)), using a previous reduction; and (c) indirectly ascorbic acid. Ferrozine (Fz) is the bead loaded chromogenic reagent, the analytical signal corresponding to the absorbance of the complex [Fe(II)Fz 3 ] 4− . Sampling frequencies of 16 and 13 h −1 , and R.S.D.(s) ( n =10) of 4.02 and 4.19% were obtained with 100 and 1000 μl of Fe(II) solution, respectively. The system was applied to the determination of (a) iron in wine; water and pharmaceuticals; and (b) ascorbic acid in fruit juices, pharmaceuticals and conservative liquids, obtaining satisfactory results.

For the first time, a multiparameter-responding flow-through system with solid phase UV spectrophotometric detection (a multiparameter optosensor) is described for the simultaneous determination of a mixture of three active principles (paracetamol, caffeine and propyphenazone) using univariate calibration. Quantitation is based on the direct intrinsic UV absorbance measurements of the analytes when they reach the sensing zone (C18 silicagel) placed in the flow cell of the FIA system. Because of the strong spectral overlap showed by these analytes, a temporary sequentiation in their arrival to the sensing zone is required from one only injection. It is achieved by means of an on-line simultaneous retention of two of them (caffeine and propyphenazone) on a minicolumn filled with C18 silica-gel placed before the solid phase UV transductor, while paracetamol passes through the minicolumn and develops its transitory signal. Then, caffeine and propyphenazone are successively eluted from the column using two different methanol/water solutions (10% and 50% v.v respectively) and reach sequentially the sensing zone, developing their respective signals. Thus, with a single injection very good linear responses were obtained in the ranges 25–350 (paracetamol), 5–75 (caffeine) and 15–150 (propyphenazone) µg mL−1. Detection limits ranging from 0.65 to 7.5 µg mL−1 were found. Application of the detector to the successfully determination of the analytes in commercial pharmaceuticals was demonstrated.

A flow-through sensor based on integration of spectrophotometric detection and the different kinetics of retention/elution of analytes on a solid support is proposed for the simultaneous determination of sulfamethoxazole (SMZ) and trimethoprim (TMP). The solid support (Sephadex SP C-25) fills both, a microcolumn placed on-line and the sensing microzone. The intrinsic absorbance of both compounds is monitored directly on the solid phase at 269 nm and so, no derivatization step is required. Using two alternate solutions, 10(-4) M hydrochloric acid and 0.20 M NaAc/HAc (pH 5.0) buffer, the sensor responds linearly in the measuring range of 50-250 and 10-70 microg ml(-1) with detection limits of 9.5 and 0.6 microg ml(-1) (500 microl of sample volume) for SMZ and TMP, respectively. The main advantages of the sensor are simplicity, rapidity and low reagents consumption. Its application to SMZ and TMP determination in synthetic samples and pharmaceutical preparations is demonstrated. The results obtained by the proposed method were compared with those obtained by a standard HPLC method.

A novel and sensitive flow-through method with solid phase UV spectrophotometric transduction is proposed for the direct determination of phenols: phenol, 1-naphthol, 2-naphthol, 3,4-dimethylphenol and 2,4-dichlorophenol were used as test phenol compounds. The device consists of a monochannel system using Sephadex QAE A-25 resin as packing material of the detection microzone placed inside a flow-through cell on which phenols are temporarily retained. Intrinsic absorbances are monitored at 237 nm for phenol, 242 nm for 2-naphthol and 3,4-dimethylphenol, and 247 nm for 1-naphthol and 2,4-dichlorophenol. The sample is transported by a alkaline carrier solution which acts as desorbing the solution itself. The determination of phenols was carried out for 40 and 600 µL of sample volume. The sensitivity is higher by a factor of 10 than that provided by a conventional flow injection analysis method. The detection limits were found to be close to 1 ng mL−1 in some cases (using 600 µL of sample volume). The relative standard deviations (n=10) ranged between 1.5 and 3.2% (40 µL) and 1.1 and 2.2% (600 µL). The proposed method has shown good results in its application to waters, making this method suitable for phenol monitoring.

A continuous and simple UV-photometric flow-through biparameter-sensing device has been developed for the simultaneous determination of paracetamol and caffeine at 275 nm. The sensor is based on temporary sequentiation in the arrival of the analytes to the sensing zone by on-line separation using C18 bonded phase beads (the same as that used in the sensing zone) placed into a minicolumn just before the flow cell. The sample containing these compounds is injected into the carrier solution; paracetamol is determined first because it passes through the minicolumn, while caffeine is strongly retained in it. Then, caffeine is conveniently eluted from the precolumn and develops its transitory signal. Using 200 microl of a sample and deionized water as a carrier, the analytical signal showed a very good linearity in the ranges of 10-160 microg ml(-1) and 3.5-50 microg ml(-1) with detection limits of 0.75 and 0.56 microg ml(-1) for paracetamol and caffeine, respectively. If deionized water with the pH adjusted at 12 was used as a carrier solution, these parameters were 25-400 and 4-55 microg ml(-1) with 2.0 and 0.50 microg ml(-1) as the detection limits, respectively. The biparameter optosensor was satisfactorily applied to the simultaneous determination of these two analytes in pharmaceuticals.

A rapid, sensitive and simple spectrophotometric method for the determination of amiloride in pharmaceutical preparation and urine is described in this paper. The method is based on the sorption of amiloride on a cation-exchange resin (Sephadex SP C-25) at pH 4.0 and the direct measurement of its intrinsic UV absorbance in the solid phase at 362 nm (the maximum absorption wavelength) and 412 nm (wavelength at which only the solid support absorbs light). The calibration graphs were linear from 0.8 to 7, 0.08 to 0.7 and 0.02 to 0.15 µg mL−1 with detection limits of 0.2, 0.02 and 0.006 µg mL−1 for 10, 100 and 500 mL sample volumes, respectively. The relative standard deviations for ten independent determinations were better than 3.46%. The one step method was satisfactorily applied to the rapid determination of amiloride in pharmaceutical preparations and urine without any pre-treatment of the samples.

A method for the simultaneous determination of codeine and pyridoxine was developed, based on the measurement of their native fluorescence signals, by using first-derivative spectrofluorimetry to resolve the mixture. Codeine was measured at λem = 309 nm, and pyridoxine was measured at λem = 450 nm. Instrumental parameters were optimized, and the emission spectra were recorded between 275 and 475 nm, at λex = 255 nm and excitation and emission slit widths of 2.5 and 10 nm, respectively. Systematic studies on the influence of species usually present along with the analytes (such as caffeine, ascorbic acid, paracetamol, and thiamine) were also performed. The calibration graphs were linear over the ranges of 0.5–7.0 and 0.1–1.0 μg/mL for codeine and pyridoxine, respectively, and the relative standard deviations (n = 10) were about 3%. The method was successfully applied to the determination of codeine and pyridoxine in solutions of synthetic mixtures and in synthetic and semisynthetic pharmaceutical formulations.

A flow injection analysis system with solid phase spectrophotometric transduction has been developed for the assay of different sulfonamides: sulfanilamide (SN), sulfacetamide (SC), sulfamethoxazole (SM) and sulfadiazine (SD). The sensor consists in a monochannel system using Sephadex QAE A-25 resin as a microsensing zone (inside a flow-through cell) where sulfonamides are temporarily retained. The measurements of the intrinsic absorbance of sulfonamides were made at 263 nm for SC, SD and SM, and 258 nm for SN. Using a NaOH (10−3 mol l−1)/NaCl (0.02 mol l−1) solution as carrier, the determination of sulfonamides was carried out for 40 and 600 µl of sample volume, being the carrier itself the desorbing solution. The detection limits were found to be less than 0.1 and 0.02 µg ml−1 for both sample volumes, respectively, and the linear dynamic range extended between 1–45 µg ml−1 (40 µl) and 0.2–10 µg ml−1 (600 µl). The relative standard deviations (n = 10) lower than 2.3%. A study of the potentially ...