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The mercury content of 25 samples of fish and seafood products most frequently consumed in Spain was determined. A simple method comprising cold vapour and atomic absorption spectrometry was used to determine separately inorganic and organic mercury. In all samples inorganic mercury content was below 50 µg kg-1. There was wide variability, among not only the mercury levels of different fish species, but also for different samples of the same species - with the methylmercury content ranging from below 54 to 662 µg kg-1. The highest mean methylmercury content was found in fresh tuna. Based on an average total fish consumption of 363 g/person week-1, the methylmercury intake was estimated to be 46.2 µg/person week-1. Therefore, the mercury intake of Spanish people with a body weight ≤ 60 kg is lower than the Joint FAO/WHO Expert Committee on Food Additives (JECFA) provisional tolerable weekly intake (PTWI) of 1.6 µg kg-1 body weight, but exceeds the US National Research Council (NRC) limit of 0.7 µg kg-1 body weight week-1 based on a benchmark dose. [ABSTRACT FROM AUTHOR]

Background: Quality control procedures vary considerably among the providers of equipment for home mechanical ventilation (HMV). Methods: A multicentre quality control survey of HMV was performed at the home of 300 patients included in the HMV programmes of four hospitals in Barcelona. It consisted of three steps: (1) the prescribed ventilation settings, the actual settings in the ventilator control panel, and the actual performance of the ventilator measured at home were compared; (2) the different ventilator alarms were tested; and (3) the effect of differences between the prescribed settings and the actual performance of the ventilator on non-programmed readmissions of the patient was determined. Results: Considerable differences were found between actual, set, and prescribed values of ventilator variables; these differences were similar in volume and pressure preset ventilators. The percentage of patients with a discrepancy between the prescribed and actual measured main ventilator variable (minute ventilation or inspiratory pressure) of more than 20% and 30% was 13% and 4%, respectively. The number of ventilators with built in alarms for power off, disconnection, or obstruction was 225, 280 and 157, respectively. These alarms did not work in two (0.9%), 52 (18.6%) and eight (5.1%) ventilators, respectively. The number of non-programmed hospital readmissions in the year before the study did not correlate with the index of ventilator error. Conclusions: This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation. [ABSTRACT FROM AUTHOR]

For any healthy individual, thirst is an appropriate sign to drink water, except for babies, sportsmen, and most of ill and elderly people. In these instances, it is convenient to schedule appropriate times to drink water since great demands and the physiological mechanisms that determine thirst in these situations may condition water unbalances with important consequences for health and the physical and intellectual performance. The human body has a number of mechanisms that allow keeping constant the water content by adjusting intakes and wastes. Water balance is determined by intake (consumed water, beverages, and water contained in foods) and wastes (urine, stools, the skin, and expired air from the lungs). Failure of these mechanisms and subsequent impairments in water balance may produce severe disarrangements that may threaten somebody's life. In the present document, we analyze the evidence regarding the factors conditioning water needs in the different life stages and physiological situations, as well as the consequences of water unbalance under different situations. A proper hydration may be achieved by feeding and the use of water and other liquids. Although water is the beverage by excellence and represents the ideal way of restoring the losses and getting hydrated, we should be aware that, from the very beginning, we have sought other liquid sources with hydration properties. In the last decades we have increased the consumption of different beverages, with a proliferation of sugar-containing beverages. Since excessive sugar consumption has been related to obesity and other chronic conditions, it is evident that the use of these caloric beverages should be rationalized, especially in children. In this document all the considerations regarding hydration are presented and different recommendations are exposed. [ABSTRACT FROM AUTHOR]

Abstract: The existence of reliable data on the composition of foods is critical for a variety of purposes. There is a growing requirement for food composition data to be compatible at international level through computerised databases and nutritional analysis software. The work on data harmonisation and its application in European food composition databases (FCDBs) is being undertaken by the European food information resource network of excellence (EuroFIR) project. Spanish EuroFIR partners have set up a working group (BDECA) to create a unified FCDB. In the first stage, BDECA has made possible the compilation of food’s data obtained from different Spanish food composition tables. The foods incorporated in this table constitute the information necessary for the generation of the database as the second objective. The classification and description of all foods included in our database had been carried out previously using the multilingual system through facetted classification LanguaL Thesaurus. [Copyright &y& Elsevier]

An outbreak of SARS-CoV2 infection in a Barcelona prison was studied. One hundred and forty-eight inmates and 36 prison staff were evaluated by rt-PCR, and 24.1% (40 prisoners, two health workers and four non-health workers) tested positive. In all, 94.8% of cases were asymptomatic. The inmates were isolated in prison module 4, which was converted into an emergency COVID unit. There were no deaths. Generalised screening and the isolation and evaluation of the people infected were key measures. Symptom-based surveillance must be supplemented by rapid contact-based monitoring in order to avoid asymptomatic spread among prisoners and the community at large.

There are significant logistical challenges to providing respiratory support devices, beyond simple oxygen flow, when centres run out of supplies or do not have these devices at all, such as in low resource settings. At the peak of the COVID-19 crisis, it was extremely difficult to import medical equipment and supplies, because most countries prohibited the medical industry from selling outside of their own countries. As a consequence, engineering teams worldwide volunteered to develop emergency devices, and medical experts in mechanical ventilation helped to guide the design and evaluation of prototypes. Although regulations vary among countries, given the emergency situation, some Regulatory Agencies facilitated expedited procedures. However, laboratory and animal model testing are crucial to minimize the potential risk for patients when treated with a device that may worsen clinical outcome if poorly designed or misused., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To assess the prevalence of obstructive sleep apnea (OSA) in patients with mild-moderate Alzheimer's Disease (AD) and to evaluate cognitive characteristics according to the severity of OSA., Methods: Patients with mild-moderate AD, recruited prospectively from a cognitive impairment unit, underwent overnight polysomnography. OSA was defined as an apnea-hypopnea index > 5/h. AD severity was assessed using the Mini-Mental State Examination and extensive neuropsychological battery. Epworth Sleepiness Scale and APOE status were analyzed., Results: The cohort included 128 patients with a median [IQR] age of 75.0 [72.0;79.2] years and 57.8% were women. OSA was diagnosed in 116 subjects (90.6%). The distribution of mild, moderate and severe severity of OSA was 29 (22.7%), 37 (28.9%) and 50 (39.1%), respectively. Regarding sleep symptoms, the cohort showed normal values of daytime sleepiness (median EES score 5 [3, 8]), while nycturia (89.1%) and snoring (71.1%) were the most common symptoms. Participants with severe OSA included a higher proportion of older men, were associated with snoring and sedentariness. No significant differences in cognitive assessment were found between patients with and without severe OSA in any of the domains. The prevalence of APOE ε4 was not significantly different between patients with and without severe OSA., Conclusion: There was a high prevalence of OSA in patients with mild-moderate AD. OSA was not associated with sleepiness or worse cognitive function. APOE ε4 was not related to the presence or severity of OSA. Further longitudinal studies will be required to evaluate whether OSA impairs cognitive evolution in AD patients.

Background: Large variation in diagnostic procedures and treatment recommendations may hinder the management of obstructive sleep apnea (OSA) and also compromise correct interpretation of the results of multicenter clinical trials, especially in subjects with non-severe OSA. The aim of this study was to analyze the therapeutic decision-making between different sleep physicians in patients with AHI<40events/h., Methods: Six experienced senior sleep specialists from different sleep centers of Spain were asked to make a therapeutic decision (CPAP treatment) based on anonymized recordings of patients with suspected OSA that has previously performed a sleep study. The clinical data was shown in an online database and included anthropometric features, clinical questionnaires, comorbidities, physical examination and sleep study results. Intra- and inter-observer decision-making were analyzed by the Fleiss' Kappa statistics (Kappa)., Results: A total of 720 medical decisions were taken to analyze the agreement between sleep professionals. Overall intra-observer evaluation reliability was almost perfect (Kappa=0.83, 95% CI, 0.75-0.90, p<0.001). However, overall inter-observer concordance decreased to moderate agreement (Kappa=0.46, 95% CI, 0.42-0.51, p<0.001). Nevertheless, it was especially low when considering AHI<15events/h., Conclusions: This study demonstrates a good intra-observer concordance in the therapeutic decision-making of different sleep physicians treating patients with low/moderate OSA. However, when analyzing inter-observer agreement the results were considerably worse. These findings underline the importance of developing improved consensus management protocols., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)

For any healthy individual, thirst is an appropriate sign to drink water, except for babies, sportsmen, and most of ill and elderly people. In these instances, it is convenient to schedule appropriate times to drink water since great demands and the physiological mechanisms that determine thirst in these situations may condition water unbalances with important consequences for health and the physical and intellectual performance. The human body has a number of mechanisms that allow keeping constant the water content by adjusting intakes and wastes. Water balance is determined by intake (consumed water, beverages, and water contained in foods) and wastes (urine, stools, the skin, and expired air from the lungs). Failure of these mechanisms and subsequent impairments in water balance may produce severe disarrangements that may threaten somebody's life. In the present document, we analyze the evidences regarding the factors conditioning water needs in the different life stages and physiological situations, as well as the consequences of water unbalance under different situations. A proper hydration may be achieved by feeding and the use of water and other liquids. Although water is the beverage by excellence and represents the ideal way of restoring the losses and get hydrated, we should be aware that, from the very beginning, we have sought other liquid sources with hydration properties. In the last decades we have increased the consumption of different beverages, with a proliferation of sugar-containing beverages. Since excessive sugar consumption has been related to obesity and other chronic conditions, it is evident that the use of these caloric beverages should be rationalized, especially in children. In this document all the considerations regarding hydration are presented and different recommendations are exposed.

Because infant cereals are an important component of the infant diet from the fourth month of life onwards and therefore contribute to the dietetic intake of metals by infants, cadmium and lead were measured in samples of cereals commercially available in Spain. For this purpose an electrothermal atomic absorption (ET-AAS) method for determining cadmium and lead in these products was studied. The ET-AAS instrumental conditions and temperature/time furnace program were selected. The analytical parameters of the method (linearity, detection and quantification limits and precision) show its usefulness in measuring cadmium and lead in infant cereal products. The method was applied to eight different types of infant cereals from four different manufacturers, in all 29 different infant cereal products commercially available in Spain. The cadmium and lead contents of milk-free infant cereals range from 6.6 to 35.8 ng/g and from 36.1 to 305.6 ng/g, respectively, while the ranges corresponding to milk-added infant cereals are 2.9-40.0 ng/g for cadmium and 53.5-598.3 ng/g for lead. The cadmium and lead contents of cereal products of the same type from different manufacturers is responsible for the large confidence intervals and made it impossible to detect significant differences among the different products. Given the values found for lead and the correlation between chronic exposure to low lead doses and neuropsychological damage in early childhood, efforts should be made to reduce lead contamination.

The selenium content of Spanish human milk samples and different milk-based and soy-based infant formulas has been estimated by using a flow injection hydride atomic absorption spectrometric method after microwave digestion of the organic matter. Mean values of 11.4 +/- 3.7 and 10.7 +/- 4.6 ng/ml for colostrum and transitional milk, 8.4 +/- 3.4 and 5.3 +/- 1.9 ng/ml for mature milk at 1 month and up to 2 months respectively, was obtained. These values are close to those reported by others authors in Europe, and lower than the ones from the US, Japan and Korea. Selenium contents of the analyzed infants' formulas ranged from 2.7 to 9.6 ng/ml and from 1.8 to 7.5 ng/ml for soy and milk-based infant formulas, respectively. The variability in selenium contents is large, although mean values are close to the ones given in other European countries. Selenium contents are not usually given on the product. The selenium intakes were estimated assuming that infants fed only human milk. The intakes ranged from 2.0 to 8.4 micrograms/day and from 3.4 to 12.9 micrograms/day for colostrum and transitional milk, respectively, and from 2.6 to 10.3 micrograms/day for mature milk at 1 month, and from 1.2 to 8.3 micrograms/day for milk up to 2 months. The analyzed infant formulas provide significantly less selenium than the 10 micrograms/day corresponding to the recommended daily allowance for infants from 0 to 6 months.

The selenium content in the blood of pregnant women in the Valencian Community, Spain was determined until the end of gestation in order to assess its evolution and detect possible differences in relation to the values corresponding to non-pregnant women of fertile age. A total of 158 blood samples were obtained from 137 pregnant women. Samples were classified as: (a) first; (b) second; and (c) third trimester. Selenium was determined by a flow injection hydride atomic absorption spectrometric method (Seronorm whole blood was used as a quality control check). The selenium values obtained for the three trimesters followed a Gaussian distribution. The intervals for mean found were: (a) 75.7-85.5 micrograms/l; (b) 72.6-81.4 micrograms/l; and (c) 69.9-77.5 micrograms/l. Although a tendency to decrease was observed, no statistical significant differences between the three trimesters of the gestational period were observed. When we compare the values obtained with the blood selenium content of women of fertile age in the Valencian community (87.8-98.8 micrograms/l) by using an ANOVA test, statistically significant differences are found between the selenium values of women of fertile age and those corresponding to pregnant women. The differences, however, are very small and can be partially explained by the level of hemodilution during pregnancy, however, reference values of blood selenium contents in pregnant women should be taken into account.

In order to assess the reference values for selenium nutritional status, adequate indicators (selenium concentration and glutathione peroxidase activity) were determined in whole blood and blood derivates of a healthy population (n = 287) from the province of Valencia, Spain. The reference population was selected by applying preestablished criteria. Selenium in whole blood and plasma was measured by graphite furnace atomic absorption spectrometry (GFAAS), with a deuterium correction, after addition of Pd/Mg(NO3)2 as the matrix modifier and appropriate dilution. Accuracy was checked by means of a reference material (Seronorm Trace Metals serum and whole blood). The population's reference intervals for selenium content at a 95% confidence level were: 53.03-108.96 and 66.71-119.4 mg/L for plasma and whole blood selenium concentration respectively. GPX activity was measured using a modification of the Paglia and Valentine method, and the reference intervals obtained ranged from 196 to 477 U/L in plasma, from 49 to 93 U/gHb in erythrocytes and from 52 to 96 U/gHb in whole blood. The only statistically significant differences detected between men and women are for to the GPX activity in whole blood. The results obtained are in the range of values found by others authors in healthy populations residing in different European countries.

The calcium, magnesium, sodium, potassium and iron content of a total of 22 different infant formulas marketed in Spain were measured by atomic spectrometry, and the mineral intake of infants fed exclusively with these formulas was estimated. The contents (mg/100kJ) are in the following ranges: Ca, 14-24; Mg, 1.1-2.8; Na, 5.6-9.8; K, 19-35; Fe, 0.02-0.50. These values coincide with those recommended by the Codex and European Society for Paediatric Gastroenterology and Nutrition (ESPGAN), and do not exceed the limits established by the European Union (EU). The mean values and ranges of estimated intakes for each formula type and period of infancy (0-1, 1-2, 2-3, 3-4 and 4-5 months) expressed in mg element/kg body weight are tabulated. The mean Ca, Mg, Na, K and Fe daily intakes of infants (0-5 months) fed with infant formulas meet the recommended values (RDA), except for the iron intake when non-iron supplemented formulas were used.

The differential pulse anodic stripping voltammetry (DPASV) method described is based on the one reported by Hasse et al., but adapted to normal laboratory conditions. The values obtained in the estimation of the analytical parameters (linearity, detection and quantification limits, precision and accuracy) show that in the conditions described the method is sensitive enough, reliable and useful for determining these elements in infant formulas. A comparison between DPASV and atomic absorption spectroscopy (AAS) methods in the conditions described here shows that the former is less sensitive but that they are similar in precision. The cadmium, copper, lead and zinc contents of different types of infant formulas marketed in Spain are reported.

A duplicate diet meal study was carried out with a group of university students living in a hostel, in order to estimate the intake of Zn, Cd, Co, Cu, Fe, Mn, Ni and Pb. Zn, Cu, Fe, Mn and Ni were determined by flame atomic absorption spectrophotometry and Cd, Co and Pb by graphite furnace atomic absorption spectrophotometry after a nitric acid wet digestion procedure. The estimated intake values from the contents of breakfast, lunch, dinner and drinks were compared with the values of the Provisional Tolerable Daily Intake (PTDI) in the case of Cd and Pb, Recommended Dietary Allowances (RDA) of Co, Fe and Zn and Estimated Safe and Adequate Dietetic Daily Intake (ESADDI) of Cu and Mn. Neither excessive intake of Pb and Cd nor deficiencies in Zn, Co, Fe, Mn or Ni were observed, but Cu intake was lower than the ESADDI.

The WHO Expert Committee on Food Contaminants has pointed out the need of determining the content of foods in trace elements in order to ascertain their contribution to the total intake of oligoelements through the diet. Since the contents in trace elements depend on the environmental features, it is necessary to carry out systematic determinations of trace elements in foods of local origin in order to know the exposure level of population. This work intends to study the cobalt contribution through the diet. The element intake is calculated from the cobalt content in raw foods after elimination of the non-eatable moiety by flame atomic absorption spectroscopy, after formation of a chelate with ammonium pyrrolidine dithiocarbamate (APDC) and extraction with 4-methyl-2-pentanone (MIBK) according to a procedure developed and verified in a previous paper.