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Although the mean environmental lapse rate (MELR) value (a linear decrease of −6.5 °C/km) is the most widely used, near‐surface (i.e., non‐free atmosphere) air temperature lapse rates (NSLRs; measured at ~1.5 m height) are variable in space and time because of their dependence on topography and meteorological conditions. In this study we conducted the first analysis of the spatial and temporal variability of NSLRs for continental Spain and their relationship to synoptic atmospheric circulation (circulation weather types [CWTs]), focusing on major mountain areas including the Pyrenees, Cantabrian, Central, Baetic, and Iberian ranges. The results showed that the NSLR varied markedly at spatial and seasonal scales and depended on the dominant atmospheric conditions. The median NSLR values were weaker (less negative) than the MELR for the mountain areas (Pyrenees −5.17 °C/km; Cantabrian range −5.22 °C/km; Central range −5.78 °C/km; Baetic range −4.83 °C/km; Iberian range −5.79 °C/km) and for the entire continental Spain (−5.28 °C/km). For the entire continental Spain the steepest NSLR values were found in April (−5.80 °C/km), May (−5.58 °C/km), and October (−5.54 °C/km) because of the dominance of northerly and westerly advections of cold air. The weakest NSLR values were found in July (−4.67 °C/km) and August (−4.78 °C/km) because of the inland heating, and in winter because of the occurrence of thermal inversions. As the use of the MELR involves the assumption of large errors, we propose 1 zonal, 12 monthly, 11 CWTs, and 132 hybrid monthly–CWTs NSLRs for each of the mountain ranges and for the entire continental Spain. More regional studies are urgently needed to accurately assess the NSLR as a function of atmospheric circulation conditions. [ABSTRACT FROM AUTHOR]

Food safety regulations require the control of the presence of protozoa in meats destined for human consumption. Wild boar (Sus scrofa) meat may constitute a source of zoonoses. A 23.8% (688/2881) seroprevalence of anti-Toxoplasma gondii antibodies and 72.2% (662/910) Sarcocystis sarcocysts prevalence were detected among wild boars hunted in Southwestern areas of Spain. Identity of Sarcocystis spp. was performed by RFLP-PCR and sequencing, detecting S. miescheriana (7/8) and the zoonotic S. suihominis (1/8). Risk assessment studies of these coccidian in meats destined to human consumption are needed. [ABSTRACT FROM AUTHOR]

This work intends to check the efficiency of the 3-PG model (Physiological Principles in Predicting Growth) (Landsberg and Waring in For Ecol Manag 95:209-228, ) in the simulation of biomass growth for a natural Mediterranean maritime pine forest with two canopy layers comprising different species ( Pinus pinaster Ait. subsp. mesogeensis and Quercus ilex L. subsp. ballota) in the Cuenca Mountains, Spain, that had previously been subject to thinning. We assigned a dominant ( P. pinaster Ait.) and a subdominant ( Quercus ilex L.) component, individually parameterised. The competition between dominant and subdominant layers was simulated with specific modifications to the input solar radiation, precipitation, evapotranspiration and available soil water without any structural change to the model. Data from three study sites were used: control (C, no thinning over 30 years), treatment 1 (T1, light thinning, with thinning operations carried out in January 2004) and treatment 2 (T2, moderate thinning, with thinning operations carried out in January 2002). The data were divided into two sets: (1) A model data set from C site was used to parameterise 3-PG, and (2) an independent testing data set from the T1 and T2 sites was used to test growth predictions made by 3-PG. We report successful outcome its parameterisation, obtaining accurate predictions compared to the long-term field measurements acquired from thinned stands. Results show that the current implementation of the 3-PG slightly over- and underestimated biomass components for both pine and oak after thinning. However, values for the coefficient of efficiency (EC) were very high for both species (0.85-0.99). According to the results, the 3-PG may provide a feasible tool for estimating biomass growth and guiding forest management in natural Mediterranean maritime pine forest stands. [ABSTRACT FROM AUTHOR]

Abstract: The selection of the best management option for contaminated sediments requires the biological assessment of sediment quality using bioindicator organisms. There have been comparisons of the performance of different test species when exposed to naturally occurring sediments. However, more research is needed to determine their suitability to be used interchangeably. The sensitivity of two amphipod species (Ampelisca brevicornis and Corophium volutator) to sediments collected from four different commercial ports in Spain was tested. For comparison the lugworm, Arenicola marina, which is typically used for bioaccumulation testing, was also tested. Chemical analyses of the sediments were also conducted. All species responded consistently to the chemical exposure tests, although the amphipods, as expected, were more sensitive than the lugworm. It was found that C. volutator showed higher vulnerability than A.brevicornis. It was concluded that the three species can be used interchangeably in the battery of tests for integrated sediment quality assessment. [Copyright &y& Elsevier]

Phytoestrogens are natural components of plants consumed by humans. The hormonal activity of these substances has long been known. Variousin vitrotests have demonstrated the agonistic or antagonistic estrogenic activity of some phytoestrogens. The objective of this study was to estimate the supply of isoflavones in the diet of a healthy adult female population and to assess its estrogenic effect. The diet was assessed by questionnaire and the estrogenicity of the estimated isoflavone content was tested by E-screen, finding a mean total estrogenic capacity of 0.129 × 10−10eq.E2(12.9 pmol day–1), corresponding to a daily isoflavone intake of 265.8 μg day–1. This study offers a preliminary insight into the phytoestrogen content of the diet of a healthy active population of Spanish women. The effects of this additional hormonal burden are highly controversial, and this approach to estimating dietary phytoestrogen intake of specific populations may help to elucidate its implications for human health. [ABSTRACT FROM AUTHOR]

There are still considerable uncertainties about soil functioning in semi-arid Mediterranean ecosystems. Hence, studies that have focused on Juniperus species in thermophilic Mediterranean woodlands are practically non-existent. This study provides a survey of the effects of (i) woodland maturity (mature and young woodlands), (ii) vegetation cover ( Juniperus thurifera L. trees, Rosmarinus officinalis L. shrubs and semi-wooded grasslands) and (iii) growing season (spring, summer and autumn) on soil enzymatic activity (urease, alkaline phosphatase and β-glucosidase) and microbiological characteristics (microbial biomass C (MBC), basal respiration (Br), and microbial and metabolic quotients) in thermophilic Spanish Juniper woodlands. The results showed that mature woodland maintained a greater enzymatic and microbiological activity than the more productive young woodland. The advanced communities of Juniperus trees and Rosmarinus shrubs exhibited greater enzymatic and microbial activity than grassland areas. Soil biological characteristics were strongly affected by the season. Significant β-glucosidase activity and Br were observed in the summer, as a consequence of the greater organic matter availability for microbes, despite the reduced soil moisture availability. Thus, foliar abscission in trees and shrubs and withering in grasslands seem to control soil biological activity. Hence, we hypothesize that microbial communities that are adapted to drought exist. In contrast, the presence of greater N and P content in summer seems to reduce the urease and phosphatase activities. In addition, the more advanced communities ( Juniperus and Rosmarinus covers, especially in mature woodland) showed an inherent trend towards efficiency in C utilization throughout the growing seasons, thus increasing the MBC at the end of the growing season. [ABSTRACT FROM AUTHOR]

The aim of this work was to examine the effect of pine forests on the soil microbial community along an altitudinal gradient in the Cuenca Mountains, Spain. Six experimental forest areas and two tree diversity levels (monospecific and mixed pine forest) were selected according to the following types: (i) at lower altitudes (up to 960 m above sea level), a monospecific Spanish black pine ( Pinus nigra Arn. ssp salzmannii) forest stand and a mixed forest stand (maritime pine ( Pinus pinaster Ait.) and Spanish black pine); (ii) at medium altitudes (up to 1350 m), a monospecific Spanish black pine forest stand and a mixed forest stand (Scots pine ( Pinus sylvestris L.) and Spanish black pine); and (iii) above 1670 m, a monospecific Spanish black pine forest stand and a mixed forest stand (Scots pine and Spanish black pine). Soil moisture and temperature and different forest stand variables such as tree species composition, tree height, basal area and shrub cover were measured. Physicochemical soil properties including texture, pH, carbonates, total organic carbon, organic matter, electrical conductivity, N, P, soil enzyme activities, soil respiration and soil microbial biomass carbon were analysed at the selected forest areas and tree diversity levels. Results showed that soil moisture and temperature differed significantly across the altitudinal gradient. Carbon:nitrogen ratio, total carbonates, total organic carbon, phosphorus and total N values also differed at each experimental area but tree diversity level was not an influential factor. Soil respiration, microbial biomass carbon and enzyme activities tended to be less at low altitudes whereas no differences were found between monospecific and mixed pine forests across the altitudinal gradient. This work suggests that the soils of the Cuenca Mountains may be more sensitive to some physical and chemical site-specific aspects such as soil temperature and moisture than changes in tree stand composition (when considering only pine species). In addition, differences in soil physicochemical properties found at each experimental area may also act as additional factors for regulating enzymatic activities. [ABSTRACT FROM AUTHOR]

In 1994, six large fires occurred along a climate gradient in Eastern Spain. Ten-year-old trees were selected in the plots established for each location affected by fire. Each selected tree was measured for height and trunk diameter, the number of female strobili and cones, and grouped into four types. A geographical gradient was determined to study growth by latitude and variations in reproductive characteristics. Height and diameter values decreased southwards with the exception of the lowest-density tree location, where trunk diameters were similar to those in northern locations. Strobilus and cone production were higher in lower tree density locations owing to intraspecific competition and higher availability of water, nutrients and light. Serotiny levels were highest in southern locations, although lower percentages were found in the southern locations with low tree density. The number of reproductive trees was higher with lower tree density. The reproductive phase was reached in the lowest tree density site (also low site quality) and nearly reached in the most northern locations (high tree density as well as high site quality). Results showed a geographical gradient based on growth and reproduction dynamics, where serotiny levels are higher in southern locations. Density was shown to be a significant factor influencing overall pine stand development. [ABSTRACT FROM AUTHOR]

The Nerja area (S Spain), on the northern edge of the Alboran basin, underwent palaeogeographic, sedimentary and geomorphic changes during the Pliocene and Pleistocene, that were controlled by tectonics and by eustatic–climatic variations. The existence of NW–SE fault lines and the particular lithology of the area played a fundamental role in differentiating two sectors of divergent geomorphic evolution: the NE sector, which forms part of the Sierra Almijara, and the SW sector, in the area of Nerja.The NE sector contains outcrops of Alpujarride marbles and is characterised as a continental domain that has been permanently emerged and subjected to uplifting at intervals, under which the relief becomes progressively steeper.Today, the SW sector is constituted of Alpujarride schists and Plio–Quaternary sediments. This sector was partially affected by the marine transgression of the early Pliocene, during which time alluvial fans developed; distally, these are connected to littoral and shallow marine environments. During the early Zanclian, a tectonic event separated the Pliocene sediments into two lithostratigraphic units that rest unconformably but without any significant sedimentary interruption. As a consequence of this event, some fluvial courses changed direction. Towards the end of the early Zanclian, falling sea levels led to the emergence of the Nerja region. During the late Pliocene, marine sediments were restricted to the innermost areas of the Alboran Sea, but continental deposits did not develop, probably due to the warm, humid climate that did not favour clastic sediment supply. Another tectonic event in the Pliocene tilted the sediments of the Zanclean II unit in the western sector. During the cold period in the final Pliocene and in the basal Pleistocene, a pediment developed over the Pliocene units and the Alpujarride basement. Three phases of sedimentation of alluvial fans took place during the Pleistocene, becoming progressively more limited towards the SW. The deposition phases are separated by stages of erosion and trenching of the fluvial network, mainly occurring during periods of low sea levels. Another tectonic pulse has been identified, in the mid-Pleistocene, between the first and the second generation of fans, which caused further changes in the direction of some fluvial courses. [Copyright &y& Elsevier]

Provides information on a study which compared the incidence of lower-extremity amputations in diabetic and nondiabetic subjects in area 7 of Madrid, Spain. Estimates done on the prevalence of diabetes; Definition of the terms minor and major amputation.

The objective of this study was to compare the usefulness of two methods to evaluate diet quality in young people in Southern Spain: a new Mediterranean Diet Pattern (MDP) and a modification of the Diet Quality Index-International (DQI-I) for the Mediterranean area. The study population was 3190 schoolchildren aged 8-15 yrs. The questionnaires used were first validated (Bland-Altman plot and Wilcoxon tests) in a randomized sample. The DQI gives a more detailed evaluation of food components, whereas the MDS gives global information on food groups but includes foods characteristically consumed in the Mediterranean region. Highly similar results were obtained using the MDP and the adapted DQI-I, which appear to be equally useful to evaluate diet quality in a Mediterranean population. The fact that we selected the same types of food for both indices may explain the similar overall evaluations. According to these results, both methods appear to be equally appropriate for evaluating diet quality in a Mediterranean population. [ABSTRACT FROM AUTHOR]

Objective: It has been considered a study of nutritional menus offered at noon School in Granada. Balanced diet in children and youth will enable the prevention of diseases in adulthood. Comparing the menus prepared on school and the services offered by catering. Material and methods: The menus are aimed at 5,399 children from Granada, analyzed 354 school menus from 29 centres, public and private schools. Eleven colleges have their own kitchen, while 18 had hired a catering service. The amounts provided in each menu were estimated using standardized photographs of different sizes ration identified by those responsible for the dining room or by weighing Served directly from the ration. Nutritional assessment was determined by software, and the statistical treatment with the program SPSS v. 15.0. Results: There were statistically significant differences in the intakes of energy and nutrients from the menus developed in the centres and catering services. In the catering firms, the available energy and nutrition is similar, and in the menus prepared at the centres, there are significant differences in relation to some nutrients, depending on whether public school or private. Conclusions: The energy, protein and lipid is high and low input from carbohydrates. It is the frequency of excessive consumption of meat and derivatives. To balance the diet of school, it is necessary to complement the menu of midday meals with the rest of the day. [ABSTRACT FROM AUTHOR]

Introduction: The phytoestrogens are naturally occurring compounds that are part of many foods of plant origin and could therefore modulate aspects related hormones, such as type of antioxidant reactions, learning about intakes of these compounds in different populations clarify important aspects on their responses on the human body. Objective: To evaluate the exposure of phytoestrogens through diet, in a sample of women of all ages belonging to the university community (teachers, students and administrative), residents in the province of Granada, Spain. Material and method: 52 adult females, aged between 20 and 63 years completed a questionnaire individually Frequency of Food Consumption (FFQ) composed of a total of 144 foods. It weighted the total daily consumption of phytoestrogens standardizing these values referring to the daidzein as substance pattern (mg/day). Statistical analysis was performed using SPSS 15.0 (SPSS Inc., Chicago, IL, USA), with a level of significance of p < 0.05. Results: The results show that the total intake of phytoestrogens was (0.89 mg/day), and most of phytoestrogens was consumed in the form of lignanos. The total consumption of isoflavones, was 0.12 mg/day, of lignanos was 1.32 mg/day intake coumestrol was not significative. A linear regression analysis determined the equation to calculate intake phytoestrogens took into account 9 food groups (R: 0.918; p < 0.001). Discussion: Average intake of phytoestrogens in Spain, is comparable to intakes reported by similar studies in Germany, England and the United States (< 1 mg/ day). Conclusions: There were no significant differences in the intake of phytoestrogens, when comparing results by age, educational level, marital status or physical activity. The intake of phytoestrogens (mg/day) can be estimated from the intake (g/day) from 9 food groups. [ABSTRACT FROM AUTHOR]

Introduction: To perform a balanced diet adapted to the needs of the different life stages is important for a correct peopleís physical and psychological growth, preventing disease, and obtaining an optimal health status. The industrialized society is characterized by unbalanced energy balance due to an increase of energy intake through foods and decreased energy waste with increased SFA consumption. Objective: To assess average dietary intake and how certain demographical and socio-economic factors have an influence on dietary habits of a sample of schoolchildren from Granada city. Methods: The study population comprises 3,190 children and adolescents schooled at Granada city, with ages comprised between 8 and 15 years. A previously validated specific questionnaire was created including lifestyle habits, dietary habits, 24-hour recall, and frequency of foods consumption. Results and discussion: The average caloric ingestion in this population is higher than the predicted average waste recommended by WHO, with higher energy values being found in males. The caloric profile found in our sample is clearly unbalanced. The main protein sources were meats and dairy products. There were high intakes of SFA, PUFA, and cholesterol, markedly surpassing the recommended values. Vitamin E intake did not reach the daily recommended values. With regards to dietary habits, the study population spends less than 30 minutes for breakfast and about half an hour for lunch and dinner, those spending more time for meals having the highest energy and proteins intake. [ABSTRACT FROM AUTHOR]

Abstract: Bisphenol-A (BPA), material for polycarbonate and epoxy resin synthesis, has been detected in canned food, among other food containers. In mammal studies, BPA transferred from mother to fetus, caused abnormality of reproductive organs, and advanced female puberty. BPA from canned food and microwave containers was analyzed using high performance liquid chromatography and gas chromatography-mass spectrometry. Population was cohort of mother–son pairs established at Granada University Hospital. Frequency of food consumption (including canned food) was studied with a semi-quantitative questionnaire. The most frequently consumed products were fish and juice cans, consumed 1–3 times/week by 34.7% and 22.3% of the study population, respectively. The women made little use of polymer microwave containers, 52.8% never using them and 45.9% using them <3 times/month. Estimated mean (standard deviation) intake of BPA was 1.1(0.839) microgram/day. No relationship was found between BPA exposure and maternal socio-demographic variables or newborn characteristics. This study offers the first estimate of BPA dietary intake by pregnant women in Southern Spain. The consumption of canned foods and drinks by these women means that their exposure was lower than EFSA estimates for the European population. Nevertheless it remains of concern, given the proven undesirable effects of low-level exposure and higher susceptibility of pregnant women. [Copyright &y& Elsevier]

Abstract: Since the appearance of DDT, increasingly potent insecticides have been developed to overcome the resistance developed by insects to successive products. Pesticides are also used in public health programs to control disease vectors. Despite legislation to control the use of certain products, they repeatedly appear in the adipose tissue, milk and serum of human populations. The present study determined the presence of organochlorine molecules in the adipose tissue, serum, and umblical cord of women giving birth by cesarean section in order to establish a possible correlation in organochlorine molecule content between these biological compartments and to examine fetal exposure to molecules with hormonal effects. Presence of nine organochlorines was detected by GC/ECD and confirmed by GC/MS. Highly significant differences (p <0.000) were observed between adipose tissue and maternal serum in concentrations of lindane, HCB, DDE, DDD, and endosulfan but not (p >0.5) in concentrations of endosulfan II or endosulfan sulfate. Only DDE concentrations differed (p <0.001) between maternal serum and umbilical cord serum. An association between pp''DDE and op''DDT was observed in maternal serum (p <0.094). An association in pp''DDE and pp''DDD content was found between adipose tissue and umbilical cord serum, and in pp''DDT content between adipose tissue and maternal serum. Results obtained indicate that exposure can be measured solely in serum when relatively high concentrations of pesticides are present. [Copyright &y& Elsevier]

Introduction: We analysed the frequency of atrial fibrillation (AF) delayed diagnosis and the factors associated with it in newly diagnosed patients., Methods: This was a descriptive, cross-sectional, multicentre study. Data were collected from newly diagnosed patients with AF through medical records review and interviews during cardiology, internal medicine, primary care and emergency department consultations in Spain., Results: A total of 201 physicians participated in the study (64.2% cardiologists, 21.4% internists). 948 patients (58% men; mean age 72.8 years) were included. In 41.8% of patients, AF was classified as paroxysmal at diagnosis, 30.9% as persistent and 27.3% as permanent. The diagnosis was coincidental in 37%. It was considered that a delayed diagnosis occurred in 49.3% of patients. This delay was associated with the presence of permanent or persistent AF, older age or valvular disease. 74.8% of patients had some contact with the healthcare system in the preceding year. The diagnosis could have been established between 1 and 6 months earlier in 50.7% of cases and more than six months earlier in 20.1%. 54.4% of the patients had experienced AF compatible symptomatology previously. Of these, 32.6% had a consultation without a diagnosis., Conclusions: In a significant proportion of AF cases, there is a diagnostic delay. Many people with compatible symptoms neither seek consultations nor contact the healthcare system facilities. Consequently, the opportunity for early diagnosis is lost., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Objectives: To describe the use of ventricular assist devices (VAD) in children in Spain and to identify variables related to survival., Methods: This is an observational cohort study of all children younger than 18 years of age who underwent an initial implantation of a VAD at any of the 6 paediatric heart transplant centres from May 2006 to December 2020. Subjects were identified retrospectively from each hospital's database., Results: Paracorporeal VADs were implanted in 118 children [pulsatile (63%), continuous (30.5%) or both types (5.9%)]. Small children (<0.7 m2 of body surface area) comprised the majority of this cohort (63.3%). Overall, 67% survived to VAD explantation, and 64.9% survived to hospital discharge. Non-central nervous system haemorrhage (39%) and stroke (38.1%) were the most common complications. Body weight <5 kg, congenital heart disease, pre-implantation bilirubin >34 μmol/l and bridge to decision strategy were associated with a higher mortality at hospital discharge and in the long-term. Interagency registry for mechanically assisted circulatory support (INTERMACS) status 1 and cardiac arrest prior to VAD implantation were related to long-term mortality, whereas pre-implantation renal replacement therapy and extracorporeal membrane oxygenation were not related to mortality., Conclusions: In Spain, 67% of the VAD-supported children have been bridged to heart transplantation or to recovery. Body weight lower than 5 kg, congenital heart disease diagnosis, cholestatic liver dysfunction, bridge to decision as VAD strategy, INTERMACS-1 status and cardiac arrest were pre-implantation variables related to mortality, whereas pre-implantation renal replacement therapy and extracorporeal membrane oxygenation were not., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Background: The aging world population is accelerating rapidly. Physical self-concept (PSC) is one of the psychosocial factors with the greatest influence on an individual's well-being and health. The traditional Mediterranean dietary pattern (MDP) is considered one of the healthiest dietary models, as it is nutritionally complete and easy to follow., Objective: To assess the adherence to MDP and its association with the practice of physical activity (PA) and PSC levels in the older adult Spanish population., Methods: A cross-sectional study was conducted on a representative sample of Spanish older adults (n = 342; older than 55 years old). Their PSC was assessed using a previously validated PSC questionnaire. Adherence to an MDP was assessed using a validated Mediterranean Diet Adherence Screener questionnaire. Their PA was measured using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Data on age, sex, hypertension, cholesterol or diabetes suffered in the last 12 months, as well as weight, height, and BMI, were collected., Results: At the lowest levels of PSC, the percentage of individuals who were non-active and non-adhering to the MDP was lower compared to the highest levels (75.0% vs. 19.6; p = 0.001; Cramer's V = 0.414, and 83.3% vs. 57.9%; p = 0.001; Cramer's V = 0.221, respectively). This sample showed an abandonment of the most classic habits of the MDP, such as the consumption of olive oil, vegetables, fruits, nuts and fish., Conclusions: Non-adherence to the MDP and low levels of PA are associated with low levels of PSC in older adults.

Aim: The main cause of childhood overweight/obesity is an imbalance between energy intake and energy expenditure. The objective was to determine whether the intake by Spanish schoolchildren of sugars from habitually consumed foods and drinks can be related to overweight/obesity., Methods: Subjects The study included 657 schoolchildren between 7-10 years from educational centers in Southern Spain. These children live under the influence of the Mediterranean diet. Design Participants completed an encoded questionnaire with three sections: a) data on sex, age, educational center, school year, and life/family habits, among others; b) semi-quantitative food frequency questionnaire related to the previous 12 months; and c) information on anthropometrics and physical activities., Results: Obesity was observed in 10.9% of the children. The daily activity questionnaire showed a mean energy expenditure of 8.73 (1.33) MJ/day. The study considered foods that supply carbohydrates in any form (total carbohydrates, starch, total sugars, added sugars, and free sugars). The likelihood of overweight/obesity was significantly greater with a higher intake/day of total sugars, starch, added sugars, and free sugars. The likelihood of normal weight was significantly greater with lower energy expenditure in sedentary activities (OR = 3.03), higher energy expenditure in sports activities (OR = 1.72), and higher total activity/day measured as METs (OR = 8.31)., Conclusions: In this population, overweight/obesity was influenced by the physical activity of the children and by their intake of energy, total sugars, starch, added sugars, and free sugars. Further studies are warranted to verify this observation and explore the implications for public health policies., Competing Interests: No authors have competing interests.

Objectives: To determine the outcome predictors of in-hospital mortality in acute total occlusion of the left main coronary artery (ATOLMA) patients referred to emergent angioplasty and to describe the clinical presentation and the long-term outcome of these patients., Background: ATOLMA is an uncommon angiographic finding that usually leads to a catastrophic presentation. Limited and inconsistent data have been previously reported regarding true ATOLMA, yet comprehensive knowledge remains scarce., Methods: This is a multicenter retrospective cohort that includes patients presenting with myocardial infarction due to a confirmed ATOLMA who underwent emergency percutaneous coronary intervention (PCI)., Results: In the period of the study, 7930 emergent PCI were performed in the five participating centers, and 46 of them had a true ATOLMA (0.58%). At admission, cardiogenic shock was present in 89% of patients, and cardiopulmonary resuscitation was required in 67.4%. All the patients had right dominance. Angiographic success was achieved in 80.4% of the procedures, 13 patients (28.2%) died during the catheterization, and the in-hospital mortality rate was 58.6% (27/46). At one-year and at the final follow-up, 18 patients (39%) were alive, including four cases successfully transplanted. Multivariate analysis showed that postprocedural TIMI flow was the only independent predictor of in-hospital mortality (OR 0.23, (95% CI 0.1-0.36), p < 0.001)., Conclusions: Our study confirms that the clinical presentation of ATOLMA is catastrophic, presenting a high in-hospital mortality rate; nevertheless, primary angioplasty in this setting is feasible. Postprocedural TIMI flow resulted as the only independent predictor of in-hospital mortality. In-hospital survivors presented an encouraging outcome. ATOLMA and left dominance could be incompatible with life., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2020 A. Gutiérrez-Barrios et al.)

Phytoestrogens are natural components of plants, including numerous foods that form part of the habitual diet of humans and animals. They have similar estrogenic effects to those of synthetic endocrine disrupters such as monomers of plastic materials, e.g., polycarbonates and epoxy resins. The most frequently used monomer is bisphenol A (BPA), which has been found to migrate from drink and food packaging, plastic baby bottles, and the coating of cans. Numerous studies have associated exposure to endocrine disrupters with obesity, classifying them as obesogens. The objectives of this study were to estimate the dietary exposure to phytoestrogens and BPA in a group of Spanish schoolchildren and to estimate their potential obesogenic effects. The diet of this population of healthy Spanish children was estimated to have a mean total estrogenic capacity of 5.10 -12  M eq.E2 (5 pmol/day). The effects of this additional estrogenic burden are highly controversial, and no definitive conclusion has been reached. Thus, some authors consider exposure to these substances with estrogenic activity to be positive at certain stages of life, whereas others regard it as posing a risk at any age. In the present population of children, the likelihood of normal weight versus obesity was significantly related to the total proliferative effect (OR = 0.51, p = 0.026) as well as to the energy expenditure on physical activity, with lesser activity implying a greater risk of obesity (OR = 13.54, p = 0.001). Further research is warranted on the obesogenic effects of exposure to endocrine disruptors present in foods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019. Published by Elsevier Ltd.)

To assess characteristics and outcomes of patients hospitalized with interstitial lung diseases (ILD) and to analyze patient's comorbidities, procedures, and in-hospital outcomes.We identified patients hospitalized with idiopathic pulmonary fibrosis and others ILD such as hypersensitivity pneumonitis, cryptogenic organizing pneumonia, lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, and sarcoidosis in Spain during 2014 and 2015.We identified 14,565 discharges among patients admitted for ILD in Spain during the study period: idiopathic pulmonary fibrosis (IPF) in 42.32% (n = 6164), sarcoidosis in 37.65% (n = 5484), hypersensitivity pneumonitis in 10.55% (n = 1538), cryptogenic organizing pneumonia in 7.06% (n = 1028), pulmonary Langerhans cell histiocytosis in 1.48% (n = 215), and lymphangioleiomyomatosis in 0.94% (n = 136). The most common associated comorbidities according to those included in the Charlson Comorbidity Index (CCI) were COPD, diabetes, and congestive heart disease. The presence of pulmonary hypertension increased the probability of dying in patients with idiopathic pulmonary fibrosis (OR 1.36; 95%CI 1.06-1.73). Patients with cryptogenic organizing pneumonia had the longest length of hospital stay and the highest percentage of hospital readmissions (23.64%). The highest IHM corresponded to the idiopathic pulmonary fibrosis (14.94%). Computed tomography of the chest was the procedure more used during admissions for ILD.IPF was responsible for larger percentage of hospital admission among ILD in our study. In addition, the IHM were higher in IPF patients in comparison with those with other ILD. The most common associated comorbidity in ILD according to those included in the CCI was COPD. Computed tomography of the chest was the procedure more frequently used.

The growth and survival of plants in semiarid Mediterranean forests can be improved through the benefits conferred by thinning, a forest management practice that removes trees and reduces the competition between the remaining ones. Here, we evaluate the impacts of induced drought (the exclusion of 25% of the natural rainfall for 5 years) and thinning, and their interaction, with the objective of determining whether the thinning of Holm oak (Quercus ilex L.) modulates the resistance of the soil microbial community to drought. Sequencing of 16S rRNA and ITS amplicons revealed that drought, thinning, and their interaction influenced the composition of the bacterial community, while the fungal community was exclusively affected by thinning. Thinning consisted of the removal of the aboveground parts of the Holm oak trees, which were thereafter left in forest stand. Thinning contributed to the C and N contents, with parallel increases in microbial biomass, particularly in summer. Drought increased the amounts of total organic C and total N, likely due to the reduced enzyme activities. Indeed, the composition of the bacterial community was modulated primarily by the indirect and long-term effects of drought - the accumulation of soil organic matter - rather than by the direct effect of the lower water content imposed by the drought treatments. Thinning under drought conditions did not increase soil organic C (SOC) content. However, the resistance of the soil microbial community to drought was fostered by thinning, particularly at the functional level, as indicated by the enzyme activities related to C, N and P cycles. These responses were associated to variations in the composition of the microbial communities in thinned, drought-exposed plots, in comparison to unthinned, drought-exposed plots. In conclusion, the interaction between forest management and drought influenced the soil microbial community of a Holm oak-dominated Mediterranean ecosystem., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction: Introduction: the dietary intake patterns of children should be monitored because of their influence on health in adulthood. It is now widely accepted that childhood nutrition is linked to specific diseases such as obesity and to risk factors for cardiovascular disease in adulthood. Therefore, knowledge of dietary intake during childhood may be useful to identify possible risk factors for disease in adulthood. The main focus of research into children's diets has been the contribution of macronutrients and micronutrients. Objective: several indices have been developed for assessing the diet quality of previously defined population groups. The aim of the present study was to compare the nutritional status of Andalusian children and adolescents and examine the relationship between their diet quality and socio-demographic or lifestyle factors. Results and conclusions: the food intake of the younger children in this study was closer to RDIs compared with the adolescents, who generally reported a lower energy supply in their diet than the recommended. The mean (SD) diet quality score was 12.1 (1.9) for the younger children (6-9 years) and 9.4 (3.2) for the older group (10-17 years), a statistically significant difference. A good correlation was found between energy intake (MJ/kg body weight) and estimated energy (MET MJ/kg body weight).

Purpose: The objectives of this study were to analyze the characteristics of male and female patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) during 2006-2014 according to the presence or absence of bronchiectasis and to study the factors associated with in-hospital mortality (IHM) in patients hospitalized with AE-COPD and concomitant bronchiectasis., Methods: We used the Spanish National Hospital Database to analyze patients admitted with AE-COPD as their primary diagnosis. Patients included in the study were stratified according to the presence or absence of bronchiectasis as their secondary diagnosis., Results: We identified 386,646 admissions for AE-COPD, of which 19,679 (5.09%) involved patients with concomitant bronchiectasis. When patients with and without bronchiectasis were compared, we observed that the incidence of infection by Pseudomonas aeruginosa was substantially higher in the former, as were the mean stay, cost, and percentage of readmissions, although IHM and comorbidity were lower. The course of patients with AE-COPD and bronchiectasis was characterized by a gradual increase in prevalence and mean age among men and no differences in prevalence or lower mean age in women. Mortality was 4.24% and 5.02% in patients with and without bronchiectasis, respectively, although significance was lost after a multivariate adjustment (OR 0.94; 95% CI, 0.88-1.01). The factors associated with IHM were older age, higher comorbidity, isolation of P. aeruginosa, mechanical ventilation and readmission., Conclusions: The prevalence of admission with AE-COPD and bronchiectasis increased in men but not in women during the study period. In patients hospitalized with AE-COPD, we did not find differences in mortality when comparing the presence and absence of bronchiectasis. The analysis of temporal trends revealed a significant reduction in mortality from 2006 to 2014 in male patients with COPD and concomitant bronchiectasis, but not among women. It is important to consider the factors associated with IHM such as age, comorbidity, isolation of P. aeruginosa, mechanical ventilation and readmission to better identify those patients who are at greater risk of dying during hospitalization., Competing Interests: The authors have declared that no competing interests exist.

Fruit, vegetables, cereals, and olive oil are common elements of the Mediterranean diet (MD), but each country in the Mediterranean basin has its own gastronomic customs influenced by socio-cultural, religious, and economic factors. This study compared the dietary habits of three Mediterranean populations with different cultures and lifestyles, a total of 600 adults (61.9% females) between 25 and 70 yrs from Spain, Morocco, and Palestine. All participants completed a self administered questionnaire, including sociodemographic and anthropometric items, a validated semi-quantitative food frequency questionnaire adapted to the foods consumed in each country, and three 24-h recalls. MD adherence was estimated with the MD Serving Score (MDSS). All populations showed a moderate adherence to the Mediterranean dietary pattern. In comparison to the Palestine population, MDSS-assessed adherence to the MD was 6.36-fold higher in the Spanish population and 3.88-fold higher in the Moroccan population. Besides the country of origin, age was another predictive factor of MD adherence, which was greater (higher MDSS) in participants aged over 50 yrs than in those aged 30 yrs or younger. This preliminary study contributes initial data on dietary differences between European and non-European countries in the Mediterranean basin. The Spanish diet was shown to be closer to MD recommendations than the diet of Morocco or Palestine. Given the impact of good dietary habits on the prevention of chronic non-transmittable diseases, health policies should focus on adherence to a healthy diet, supporting traditional dietary patterns in an era of intense commercial pressures for change., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Introduction: The influenza pandemic of 2009 had a great social impact. Many health resources were devoted to the care, prevention and surveillance of this disease. Epidemiological surveillance is based on the reporting of cases of influenza-like illness (ILI) and confirmed influenza cases. The objective was to estimate the true incidence of ILI during the influenza pandemic of 2009., Methods: The capture-recapture method was applied during the month of highest influenza incidence in Castellón. Two notification systems were used: (i)electronic reporting of Notifiable Diseases (ND), and (ii)laboratory-based (LAB) data collection. Estimates were made by stratifying by age group and week. Independence coefficients were calculated for those strata., Results: No dependence was found between stratification variables and the reporting system. A total of 7,181 ND cases and 524 LAB cases were identified, of which 211 were recorded in both systems. The estimated total of cases was 17,785 in a single month. In the study period, almost 4% of people in the area suffered flu symptoms (cumulative incidence), with 1% being affected each day (daily prevalence). The sensitivity of the ND system was 40%, i.e., the percentage of patients seeking primary care., Conclusions: To obtain an estimate of the actual incidence of influenza-like illness in the population during a pandemic period, the number of medical consultations should be multiplied by a factor of 2.5. This factor is lower than that estimated for periods without pandemic alert., (Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.)

Background: Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits., Material and Methods: A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant., Results: A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation., Conclusions: These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk.

Objective: To analyze the impact of the eSET followed by single-embryo cryotransfer versus double embryo transfer in older women (<38 years) without taking into account embryo quality., Study Design: This is a prospective randomised clinical trial performed on 194 couples attempting a first IVF cycle in a Public Hospital in Spain. The women in Group 1 received eSET plus a single-embryo cryotransfer, and those in Group 2 received a double embryo transfer (DET)., Results: In the intention-to-treat analysis, the cumulative live birth delivery rate in the eSET group was similar to the results obtained for the DET group (45.2% vs. 41.8%; p = 0.60). The rate of multiple gestation was significantly lower in the eSET group than in the DET group (0% vs. 26.4%; p < 0.05). The findings obtained in the per-protocol analysis were similar to those obtained in the intention-to-treat analysis. The per-protocol analysis revealed no significant differences in the rate of implantation (29.8% in eSET vs. 29.7% in DET; p = 0.98), in cumulative pregnancy rates per transfer (49.1% in eSET vs. 46.9% in DET; p = 0.80) or in the cumulative live birth delivery rate (38.6% in eSET vs. 42.2% in DET; p = 0.69). In the cycles with eSET, there were no twin pregnancies (0% in eSET vs. 27.6 in DET; p < 0.05)., Conclusions: For women aged under 38 years with good prognosis, without taking embryo quality as a criterion for inclusion, an eSET policy can be applied, achieving acceptable cumulative clinical pregnancy rates and birth rates., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

This study aimed to describe morphological characteristics of elite female volleyball players from the highest Spanish league, with special focus on differences by performance level and playing positions. Nearly all female players playing in the highest Spanish volleyball league during season 2003/2004 participated in this study (N=148 elite players, 92% of the total). Anthropometric, body composition and somatotype parameters according to performance and playing positions were analysed. The players' characteristics were as follows; body mass 72.3 ± 8.4 kg; stature 179.8 ± 7.1 cm; body fat 24.0 ± 3.1% and skeletal muscle mass 27.3 ± 2.9 kg. Mean somatotype was 3.1 ± 0.7; 3.4 ± 0.9; 3.1 ± 0.9 characterised as central with a tendency to balanced mesomorph. Top level players (whose teams were better classified in the team performance ranking) were taller, had higher skeletal muscle mass and ectomorphy, and had a lower level of adiposity markers, compared with lower level players. Players selected for their respective National teams (individual performance) were taller, heavier, had higher muscle mass and lower endomorphy than non-selected players. Differences according to playing positions were found. This study provides a complete set of reference data on anthropometry, body composition and somatotype of elite female volleyball players. Morphological differences have been identified according to performance level and playing position.

The objective of the study was to determine the mean polyphenol composition of different varieties of virgin olive oil (VOO) habitually consumed in the region of southern Spain and to estimate the dietary exposure to olive oil polyphenols in that population. There were statistically significant differences in total polyphenols among varieties, with the Picual variety containing the largest amount with a mean value of 591.8 mg kg(-1). The main phenolic compounds found in the VOOs under study were tyrosol and hydroxytyrosol. The highest amounts of both substances were found in Picual olive oils with concentrations of 2.3-6.6 mg kg(-1). The total intake of polyphenols from VOO ranged between 8.2 mg day(-1) (SD = 4.14) for the under 19 year olds and 21.3 mg day(-1) (SD = 3) for the over 50 year olds. Some polyphenols, including tyrosol and hydroxytyrosol, were consumed principally as olive oil. The intake of these compounds in the studied population was in the range of 88.5-237.4 μg day(-1). This has particular importance as recent studies have demonstrated that hydroxytyrosol helps to improve plasma lipids levels and repair oxidative damage related to cardiovascular disease. There was a greater dietary consumption of polyphenols in olive oil among the participants who more closely followed the Mediterranean diet pattern. A higher consumption of olive oil and therefore a greater exposure to polyphenols was observed in females versus males and in participants of normal weight versus those who were overweight. The total intake of polyphenols from VOO significantly increased with higher age, reflecting the greater intake of this oil by older people, who also show a closer adherence to the Mediterranean diet. The over 50-year-old age group showed the greatest consumption of this olive oil and therefore of phenolic compounds, which are healthy protectors in the human diet that contribute to the acknowledged benefits of the Mediterranean diet.

The aim of this study was to measure selected metal concentrations in Trachurus trachurus, Trachurus picturatus, and Trachurus mediterraneus, which are widely consumed in Spain. Principal component analysis suggested that the variable Cr was the main responsible variable for the identification of T. trachurus, the variables As and Sn for T. mediterraneus, and the rest of variables for T. picturatus. This well-defined discrimination between fish species provided by mineral element allows us to distinguish them on the basis of their metal content. Based on the samples collected, and recognizing the inferential limitation of the sample size of this study, the metal concentrations found are below the proposed limit values for human consumption. However, it should be taken into consideration that there are other dietary sources of these metals. In conclusion, metal contents in the fish species analyzed are acceptable for human consumption from a nutritional and toxicity point of view.

An adequate folic acid intake has been related to female fertility. The recommended intake of this vitamin was recently increased to 400μg/day, with an additional 200μg/day during pregnancy. The Mediterranean Diet includes sources of folate such as pulses, green-leaf vegetables, fruit, cereals, and dried fruits; other foods of interest are liver and blue fish. The objectives were to determine the foods that contribute most to folate intake and analyze the factors that influence their consumption by three generations in a female population (n=898; age, 10-75yrs) from Southern Spain: 230 adolescents (10-16yrs), 296 healthy pregnant women (19-45yrs), and 372 menopausal women (>45yrs). Participants completed a previously validated semi-quantitative food frequency questionnaire. Over 90% of their folate intake was supplied by cereals, fruit, natural juice, pulses, and cooked and raw vegetables. The mean (SD) daily intake of folate was 288.27(63.64) μg. A higher Mediterranean Diet Score (MDS) was significantly related to a greater folate intake. The daily folate intake was not significantly influenced by educational level, number of children, or place of residence (rural vs. urban). In logistic regression analysis, the factors related to an adequate folate intake (>2/3 of recommendations) were higher age, higher MDS, and lower BMI., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Several lines of evidence suggest a tight association between oxidative stress and the pathogenesis of osteoporosis in humans. The intake of antioxidants may influence Bone Mineral Density by acting as free radical scavengers, preventing oxidation-induced damage to bone cells., Objective: The aim of this study was to assess the association between the Dietary Antioxidant Quality Score and bone mineral density in a sample of healthy women., Methods: A total of 280 women were grouped into three major groups: women aged ≤ 35 years; women aged 36-45, and finally women aged >45 years. Calcaneous Bone Mineral Density (g/cm²) was measured by dual energy X-ray absorptiometry. Data on the eating habits of each participant were collected with a structured 24-hour diet recall questionnaire. A Dietary Antioxidant Quality Score was used to calculate antioxidant-nutrient intake., Results: A significant and positive association was observed among Bone Mineral Density and dietary intake of vitamin C and selenium. Zinc intake was significantly related to Bone Mineral Density in the youngest group. Low antioxidant consumers were considered individuals whose Dietary Antioxidant Quality Score was lower or equal than the median (3.5), and high antioxidant consumers were those whose Dietary Antioxidant Quality Score were higher than 3.5. Bone Mineral Density was higher in the participants defined as high antioxidant consumers in all aged groups., Conclusion: The study showed that there is an association between Bone Mineral Density and the Dietary Antioxidant Quality Score in all the women studied. Therefore, new therapies for osteoporosis based on higher dietary antioxidant intakes might be developed basing on the results obtained in this study.

Objective: The aim of the present study was to determine the nutritional behaviour of an elderly urban population in Southern Spain, estimating their degree of adherence to the Mediterranean. DIET DESIGN: A population-based cross-sectional nutritional survey, recruiting a representative sample of elderly inhabitants. The study sample comprised 260 people. The mean age was 73.60 yrs for the men and 72.25 yrs for the women. Around 70% lived with their family., Results: The questionnaires used were first validated by using the Bland-Altman plot and the Wilcoxon test for paired samples. The degree of adherence to the Mediterranean Diet was around 50%, similar to findings in other Mediterranean populations. We highlight the mean consumption of milk and milk products (300-317 g/day) and of fruit/vegetables (250 g/day), which are slightly below recommendations. Our study subjects were all autonomous in their movements and were physically independent: 80% reported that they performed some type of physical activity., Conclusion: In this study, both adherence to the Mediterranean Diet and physical activity were considered as components of a healthy life. In summary, a majority of this elderly population was slightly overweight, considered themselves to be in good health.

The number of people using online social networks in their everyday life is continuously growing at a pace never saw before. This new kind of communication has an enormous impact on opinions, cultural trends, information spreading and even in the commercial success of new products. More importantly, social online networks have revealed as a fundamental organizing mechanism in recent country-wide social movements. In this paper, we provide a quantitative analysis of the structural and dynamical patterns emerging from the activity of an online social network around the ongoing May 15th (15M) movement in Spain. Our network is made up by users that exchanged tweets in a time period of one month, which includes the birth and stabilization of the 15M movement. We characterize in depth the growth of such dynamical network and find that it is scale-free with communities at the mesoscale. We also find that its dynamics exhibits typical features of critical systems such as robustness and power-law distributions for several quantities. Remarkably, we report that the patterns characterizing the spreading dynamics are asymmetric, giving rise to a clear distinction between information sources and sinks. Our study represents a first step towards the use of data from online social media to comprehend modern societal dynamics.

We estimate the impact of the two previous influenza seasonal vaccines and the pandemic vaccine on risk of A (H1N1) 2009 laboratory confirmed hospitalizations during the autumn 2009 pandemic wave in Castellón, Spain. We conducted a test-negative, hospital-based, case-control study. Influenza A (H1N1) 2009 infection was detected in 147 (44%) of 334 patients hospitalized for a presumptive influenza related illness. No effect was observed for the 2008-2009 and 2009-2010 seasonal influenza vaccines. However, the pandemic vaccine was associated with an adjusted vaccine effectiveness of 90% (95% CI, 48-100%). Pandemic vaccines were effective in preventing pandemic influenza associated hospitalizations., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Exposure of pregnant women to organochlorine (OC) pesticides largely derives from contaminated food, but environmental, occupational, and domestic factors have also been implicated. We investigated the presence of nine OC residues in the umbilical cord blood of newborns in Southern Spain and analyzed the relationship of this exposure with maternal and pregnancy variables, including maternal adherence to the Mediterranean Diet (MD). OCs were detected in 95% of umbilical cord blood samples from the 318 mothers, who had a mean degree of adherence to the MD of 56.77 (SD: 16.35) (range, 0-100). The MD prioritizes consumption of vegetable and fruit over meat and dairy products, and OCs are generally lipophilic molecules that accumulate in foods of animal origin. Consumption of meat, fish, and dairy products was associated with dichlorodiphenyldichloroethylene (DDE) in umbilical cord serum, and dairy product intake with lindane. Vegetable consumption was also associated with lindane and fruit intake with endosulfan I. We found no significant association between MD adherence and the presence of OC residues in serum. However, closer adherence to the MD may offer greater protection against OC exposure because of its reduced content in meat and dairy products., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Objective: It has been considered a study of nutritional menus offered at noon School in Granada. Balanced diet in children and youth will enable the prevention of diseases in adulthood. Comparing the menus prepared on school and the services offered by catering., Material and Methods: The menus are aimed at 5,399 children from Granada, analyzed 354 school menus from 29 centres, public and private schools. Eleven colleges have their own kitchen, while 18 had hired a catering service. The amounts provided in each menu were estimated using standardized photographs of different sizes ration identified by those responsible for the dining room or by weighing Served directly from the ration. Nutritional assessment was determined by software, and the statistical treatment with the program SPSS v. 15.0., Results: There were statistically significant differences in the intakes of energy and nutrients from the menus developed in the centres and catering services. In the catering firms, the available energy and nutrition is similar, and in the menus prepared at the centres, there are significant differences in relation to some nutrients, depending on whether public school or private., Conclusions: The energy, protein and lipid is high and low input from carbohydrates. It is the frequency of excessive consumption of meat and derivatives. To balance the diet of school, it is necessary to complement the menu of midday meals with the rest of the day.

The Mediterranean diet is receiving increasing attention in cardiovascular epidemiology. The association of adherence to the Mediterranean diet with the incidence of hypertension was evaluated among 9,408 men and women enrolled in a dynamic Spanish prospective cohort study during 1999-2005. Dietary intake was assessed at baseline with a validated semiquantitative food frequency questionnaire, and a 9-point Mediterranean diet score was constructed. During a median follow-up period of 4.2 years (range, 1.9-7.9), 501 incident cases of hypertension were identified. After adjustment for major hypertension risk factors and nutritional covariates, adherence to the Mediterranean diet was not associated with hypertension (the hazard ratio was 1.10 (95% confidence interval (CI): 0.81, 1.41) for moderate adherence and 1.12 (95% CI: 0.79, 1.60) for high adherence). However, it was associated with reduced changes in mean levels of systolic blood pressure (moderate adherence, -2.4 mm Hg (95% CI: -4.0, -0.8); high adherence, -3.1 mm Hg (95% CI: -5.4, -0.8)) and diastolic blood pressure (moderate adherence, -1.3 mm Hg (95% CI: -2.5, -0.1); high adherence, -1.9 mm Hg (95% CI: -3.6, -0.1)) after 6 years of follow-up. These results suggest that adhering to a Mediterranean-type diet could contribute to the prevention of age-related changes in blood pressure.

This study was intended to help clarify the nature of dyslexia in Spanish. A sample of 30 children, 8 to 16 years old, participated in this study. Dyslexic children were compared to two control groups, a chronological age-matched control group and a reading level-matched control group. Measures included nonword and pseudohomophone reading (phonological procedure), homophone choice (orthographic procedure), and phonological awareness tasks (syllabic, intrasyllabic, and phonemic level). For each task, accuracy (error percentage) and performance time were measured. Results showed a deficit in the dyslexic group on all the tasks, which was more evident when time was considered. With the results consistent with studies in other transparent orthographies such as Italian and German, speed problems seem to be more evident and relevant than accuracy problems in Spanish dyslexic children.

Despite the prohibition of most persistent organochlorine (OC) pesticides in Spain, their presence has been widely documented in adult human tissues. However, scarce information is available on the exposure of children. The aim of the present study was to investigate the presence of 16 OC pesticide residues in 52 fat samples collected from boys with a mean age of 7yr (0-15yr) living in Southern Spain and to assess the association between OC pesticide levels and child characteristics. No pesticide was found in more than 50% of samples, except for p,p'-DDE (79% of samples; median, 710ng/g lipid). After this compound, the most frequent pesticides were o,p'-DDT (17%; median, 330ng/g lipid) and o,p'-DDD (15%; median, 1510ng/g lipid). No statistically significant association was found between p,p'-DDE or SigmaDDTs and the birth year, birth weight, gestational age, infant feeding history or the age, weight, height or Quetelet Index at the time of sampling. The lack of correlation between the presence of the main metabolite p,p'-DDE and that of the parent compounds, o,p'-DDT and p,p'-DDT, suggests that children were exposed mainly to the metabolite rather than to the commercial pesticide, which was banned 30yr ago. In contrast, among currently used OCs, endosulfan was positively correlated with the presence of its metabolites, suggesting exposure to the commercial products. Further research is warranted to investigate the health consequence in children resulting from exposure to chemicals suspected of endocrine-disrupting effects.

The aim of this study was to assess whether the recently developed Diet Quality Index-International (DQI-I) was useful to evaluate the diet quality of a young Mediterranean population. A cross-sectional nutritional survey was carried out in southern Spain (Granada-Andalucia) from 2002 to 2005. Dietary information (24 h recall and FFQ) and socio-demographic and lifestyle data were collected from a representative sample of the population (n 288, 44.1 % females and 55.9 % males) aged 6-18 years (mean 12.88 (sd 2.78) years). DQI-I was designed according to the method of Kim et al. modified by Tur et al. for Mediterranean populations. It focused on four main characteristics of a high-quality diet (variety, adequacy, moderation and overall balance). This young population from southern Spain obtained 56.31 % of the total DQI-I score, indicating a poor-quality diet. A higher score was associated with a longer breakfast and greater physical activity. The DQI-I may require further modification for application in Mediterranean populations, differentiating between olive oil and saturated fats, among other changes. Further research is needed to develop a new diet quality index adapted to the Mediterranean diet.

Background: Exposure to xenoestrogens during pregnancy may disturb the development and function of male sexual organs., Objective: In this study we aimed to determine whether the combined effect of environmental estrogens measured as total effective xenoestrogen burden (TEXB) is a risk factor for male urogenital malformations., Methods: In a case-control study, nested in a mother-child cohort (n = 702) established at Granada University Hospital, we compared 50 newborns with diagnosis of cryptorchidism and/or hypospadias with 114 boys without malformations matched by gestational age, date of birth, and parity. Controls did not differ from the total cohort in confounding variables. TEXB and levels of 16 organochlorine pesticides were measured in placenta tissues. Characteristics of parents, pregnancy, and birth were gathered by questionnaire. We used conditional and unconditional regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs)., Results: TEXB from organohalogenated compounds was detectable in 72% and 54% of case and control placentas, respectively. Compared with controls, cases had an OR for detectable versus non-detectable TEXB of 2.82 (95% CI, 1.10-7.24). More pesticides were detected in cases than in controls (9.34 +/- 3.19 vs. 6.97 +/- 3.93). ORs for cases with detectable levels of pesticides, after adjusting for potential confounders in the conditional regression analysis, were o,p'-DDT (OR = 2.25; 95% CI, 1.03-4.89), p,p'-DDT (OR = 2.63; 95% CI, 1.21-5.72), lindane (OR = 3.38; 95% CI, 1.36-8.38), mirex (OR = 2.85; 95% CI, 1.22-6.66), and endosulfan alpha (OR = 2.19; 95% CI, 0.99-4.82). Engagement of mothers in agriculture (OR = 3.47; 95% CI, 1.33-9.03), fathers' occupational exposure to xenoestrogens (OR = 2.98; 95% CI, 1.11-8.01), and history of previous stillbirths (OR = 4.20; 95% CI, 1.11-16.66) were also associated with risk of malformations., Conclusions: We found an increased risk for male urogenital malformations related to the combined effect of environmental estrogens in placenta.

We studied 44 cases of small cell bladder carcinoma (SCBC) and 2 cases of large cell neuroendocrine bladder carcinoma (LCNBC) to determine the immunohistochemical profile and biologic behavior. Thyroid transcription factor (TTF)-1, cytokeratin (CK)20, chromogranin A (CgA), synaptophysin, neuron-specific enolase (NSE), and Leu-7 studies were performed. TTF-1+ cases were stained for surfactant protein A (SP-A). The immunohistochemical profile for 44 SCBC cases was as follows: TTF-1+, 11 (25%); CK20+, 3 (7%); CgA+, 13 (30%); synaptophysin+, 22 (50%); NSE+, 35 (80%); and Leu-7+, 30 (68%), and for 2 LCNBC cases was as follows: TTF-1+, 2 (100%); CgA+, (50%); synaptophysin+, 1 (50%); NSE+, 2 (100%); and Leu- 7+, 2 (100%). All cases with TTF-1 expression were negative for SP-A, except 1 case. This case was a mixed SCBC with TTF-1 expression in the urothelial component, which also expressed SP-A. Immunohistochemical markers were not associated with survival. The prognosis of SCBC is relatively better than its pulmonary counterpart. LCNBC seems to be a rarely recognized entity. TTF-1 expression is not limited to small cell lung carcinoma.

The widespread presence of organochlorine (OC) pesticides in human samples may be explained by the environmental exposure of the population. Foods are considered a constant source of exposure, despite compliance with maximum permitted residue levels. This study aimed to examine the relationship between nutritional habits of women in Southeast Spain and their serum concentrations of OCs. A semi-quantitative questionnaire was used to estimate the frequency of consumption of foods by two age groups of women, pre-menopausal (Pre-M) and post-menopausal (Post-M), and their serum pesticide levels were measured by gas chromatography (GC) with electron capture detector and confirmed by GC and mass spectrometry. The Pre-M group showed significantly higher serum concentrations of all OCs studied with the exception of DDE. The groups significantly differed in consumption of all food groups with the exception of fruit. In the Pre-M group, the mean serum p,p-DDT concentration was significantly associated with milk/yoghurt (p<0.045) and red meat (p<0.023), serum o,p-DDT with red meat (p<0.049), serum aldrin with eggs (p<0.038) and poultry (p<0.024), and serum DDE with eggs (p<0.025). In the Post-M group, serum lindane was associated with fresh and cured cheese (p<0.001), red meat (p<0.001) and white and oily fish (p<0.001), and both serum DDE and dieldrin were associated with fresh cheese, cured cheese, red meat, and white and oily fish (p<0.001). These results confirm foods as a source of human exposure to persistent organic molecules. Consideration should be given to the reduction of permitted residue levels to minimize this threat to human and animal health.

During pregnancy, lipophilic xenobiotics stored in maternal adipose tissue can be mobilized and enter her blood circulation and reach the placenta. This study measured residues of oestrogen-mimicking organochlorine pesticides (OCs) in 150 placenta samples from women in Southern Spain. OCs were extracted from placenta by solid-liquid technique and purified by preparative liquid chromatography. Gas chromatography/electron-capture detection and mass spectrometry were used to identify and quantify p,p'-DDT and congeners/metabolites, endosulphan and congeners/metabolites, lindane, aldrin/dieldrin/endrin, hexachlorobenzene, methoxychlor and mirex. A mean of eight pesticides per placenta were detected (range, 3-15 pesticides). Endosulphan-ether, endosulphan-diol, endosulphan-I, p,p'-DDE, o,p'-DDD, p,p'-DDT, o,p'-DDT and lindane were detected in >or=50% of samples; p,p'-DDE was the most frequent (96.03%), followed by endosulphan-diol (76.86%) and lindane (74.17%). Presence of more pesticides was significantly associated with lower birth weight. Mean concentration of p,p'-DDE was 2.37+/-2.80 ng/g of placenta or 76.62+/-104.85 ng/g of lipid. Higher maternal body mass index was significantly associated with higher endosulphan concentrations in placenta, and greater maternal weight gain was significantly associated with higher p,p'-DDE concentrations. Prenatal exposure to OC xenoestrogens may be a causative factor in adverse reproductive health trends, and further studies are required to identify and describe pathways of this exposure to enhance preventive measures.