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Cytomegalovirus (CMV) viral load after liver transplantation (LT) is controlled by cell mediated immune responses (CMI). Quantification of CMV-specific T-cells may identify patients who control CMV spontaneously and avoid expensive and potentially toxic antiviral therapies. Prospective post-LT clinical, virological and immunological monitoring was carried out up to 1-year post-LT in a cohort of adult recipients. The CMV-specific T-cell response was characterized using flow cytometry intracellular cytokine staining in 49 LT recipients-R (79.6% R+, 20.4% R-). CMV infection occurred in 24 patients (18 D+/R+ and 6 D+/R-). Only patients with undetectable polyfunctional CMV-specific CD4+ T-cells developed CMV infection. Predictive models showed that polyfunctional CMV-specific CD4+ T-cells pre-existing before LT are protective for CMV reactivation posttransplantation. Quantitation of CD4+ T-cell responses to CMV may be a useful marker for spontaneous control of viral replication to tailor antiviral prophylaxis after LT.

Families with rare diseases (RDs) have unmet needs that are often overlooked by health professionals. Describing these needs and the impact of the disease could improve their medical care. A total of 163 surveys were obtained from patients visiting primary care centres in the Valencian Region (Spain), during 2015-2017, with a confirmed or suspected diagnosis of RD. Of the 84.7% with a confirmed diagnosis, 50.4% had a diagnostic delay exceeding one year, and it was more prevalent among adults (62.2%). Families with paediatric patients were in a worse economic situation, with lower incomes and higher monthly disease-related expenses (euro300 on average). These expenses were incurred by 66.5% of families and were mainly for medication (40.3%). Among them, 58.5% reported not being able to afford adjuvant therapies. The disease had an impact on 73.1% of families, especially on their routine and emotional state. Expenses, needs, and impacts were more frequent among families of patients with a history of hospitalisation or deterioration. Patients with delayed diagnosis had a higher consumption of drugs prior to diagnosis. People affected by RDs in the Valencian Region need therapies to improve their autonomy and emotional state. Health professionals should be aware of these needs.

IMPORTANCE: Being born small for gestational age (SGA), approximately 10% of all births, is associated with increased risk of cardiovascular mortality in adulthood, but mechanistic pathways are unclear. Cardiac remodeling and dysfunction occur in fetuses SGA and children born SGA, but it is uncertain whether and how these changes persist into adulthood. OBJECTIVE: To evaluate baseline cardiac function and structure and exercise capacity in young adults born SGA. DESIGN, SETTING, AND PARTICIPANTS: This cohort study conducted from January 2015 to January 2018 assessed a perinatal cohort born at a tertiary university hospital in Spain between 1975 and 1995. Participants included 158 randomly selected young adults aged 20 to 40 years born SGA (birth weight below the 10th centile) or with intrauterine growth within standard reference ranges (controls). Participants provided their medical history, filled out questionnaires regarding smoking and physical activity habits, and underwent incremental cardiopulmonary exercise stress testing, cardiac magnetic resonance imaging, and a physical examination, with blood pressure, glucose level, and lipid profile data collected. EXPOSURE: Being born SGA. MAIN OUTCOMES AND MEASURES: Cardiac structure and function assessed by cardiac magnetic resonance imaging, including biventricular end-diastolic shape analysis. Exercise capacity assessed by incremental exercise stress testing. RESULTS: This cohort study included 81 adults born SGA (median age at study, 34.4 years [IQR, 30.8-36.7 years]; 43 women [53%]) and 77 control participants (median age at study, 33.7 years [interquartile range (IQR), 31.0-37.1 years]; 33 women [43%]). All participants were of White race/ethnicity and underwent imaging, whereas 127 participants (80% of the cohort; 66 control participants and 61 adults born SGA) completed the exercise test. Cardiac shape analysis showed minor changes at rest in right ventricular geometry (DeLong test z, 2.2098; P = .02) with preserved cardiac function in individuals born SGA. However, compared with controls, adults born SGA had lower exercise capacity, with decreased maximal workload (mean [SD], 180 [62] W vs 214 [60] W; P = .006) and oxygen consumption (median, 26.0 mL/min/kg [IQR, 21.5-33.5 mL/min/kg vs 29.5 mL/min/kg [IQR, 24.0-36.0 mL/min/kg]; P = .02). Exercise capacity was significantly correlated with left ventricular mass (? = 0.7934; P < .001). CONCLUSIONS AND RELEVANCE: This cohort of young adults born SGA had markedly reduced exercise capacity. These results support further research to clarify the causes of impaired exercise capacity and the potential association with increased cardiovascular mortality among adults born SGA.

Exposure to emerging contaminants, such as phthalates, bisphenols and parabens in children has been associated with possible neurodevelopment and endocrine alterations. In the present study, the biomonitoring of biomarkers in children (5-12 years old) from the Valencia Region (Spain) have been implemented using urines from the BIOVAL program. More than 75% of the children studied (n = 562) were internally exposed (>LOQ) to bisphenols and parabens, and the whole population assessed (n = 557) were exposed to at least one phthalate. The geometric means (GM) of the concentrations of bisphenol A, methyl paraben and propyl paraben were 0.9, 1.4 and 0.39 ng/mL, respectively. Regarding phthalates, monoethyl phthalate GM was 55.0 ng/mL and diethyl hexyl phthalate (as the sum of five metabolites) GM was 60.6 ng/mL. Despite the studied population being widely exposed, the detection frequencies and concentrations were in general lower than in previous studies involving children in Spain and in other countries in recent years. Furthermore, the risk assessment study concluded that the internal exposure to phthalates, bisphenols and parabens is lower than the guidance values established, and, therefore, a health risk derived from the exposure to these compounds in the studied population is not expected.

The present study analyzed the exposure and risk assessment of 4 toxic (Hg, Cd, As, Tl) and 2 essential (Se, Mo) elements in 119 Spanish women of reproductive age. The focus was on the elements for which risk-based benchmark, biomonitoring equivalents, or health-related human biomonitoring values have already been established. All elements presented frequencies of detection of 100% (greater than the limit of detection), except for Cd (99%). The 95th percentile concentrations were, for the toxic metals, 358.37 mu g/L (total As), 1.10 mu g/L (Cd), 0.41 mu g/L (Tl), and 3.03 mu g/L (total Hg) and, for the essential elements, 68.95 mu g/L (total Se) and 154.67 (Mo). We examined sociodemographic factors and dietary habits of women as predictors of urinary metal concentrations. Arsenic was positively associated with fish, shellfish, and canned fish consumption, whereas Mo was found to be associated with the consumption of cereals and pastry products. Maternal urine levels of As were negatively correlated with gestational age. In a risk-assessment context, hazard quotients (HQs) using the 95th percentile ranged from 0.08 (Tl) to 15.1 (urinary speciated As), with Cd presenting an HQ of 1.1 (95th percentile). None of the essential metals presented concentrations higher than their upper intake level; however, 3% of the mothers showed lower levels of Se than the estimated average requirement (EAR) biomonitoring equivalent, and 20% of the mothers were found to have lower levels of Mo than the EAR biomonitoring equivalent, suggesting a nutritionally inadequate diet. Environ Toxicol Chem 2021;00:1-14. (c) 2021 SETAC

This study analyzed the exposure and risk assessment of four toxic (Hg, Cd, As, Tl) and two essential (Se, Mo) elements in 119 Spanish women of reproductive age. The focus here was on the elements for which risk-based benchmark, biomonitoring equivalents (BE), or health-related human biomonitoring (HBM) values have already been established. All elements presented frequencies of detection of 100% (% > limit of detection), except for Cd (99%). The 95 th percentile concentrations for the toxic metals were 358.37 µg/L (total As), 1.10 µg/L (Cd), 0.41 µg/L (Tl) and 3.03 µg/L (total Hg), and for the essential elements, they were 68.95 µg/L (total Se) and 154.67 (Mo). We examined socio-demographic factors and dietary habits of women as predictors of urinary metal concentrations. Arsenic was positively associated with fish, shellfish, and canned fish consumption, while Mo was found to be associated with the consumption of cereals and pastry products. Maternal urine levels of As were negatively correlated with gestational age. This article is protected by copyright. All rights reserved.

This case study investigates the exposure of 119 Spanish women of reproductive age to 5 essential (Co, Cu, Mn, V, Zn) and 10 toxic (Ba, Be, Cs, Ni, Pb, Pt, Sb, Th, Al, U) elements and assesses their risk. The essential elements (Co, Cu, Mn, V, and Zn) showed average concentrations (GM: geometric mean) of 0.8, 35, 0.5, 0.2, and 347 mu g/L, respectively. Five of the toxic elements (Ba, Cs, Ni, Al, U) exhibited detection frequencies of 100%. The GM concentrations of the novel toxic elements were 12 mu g/L (Al), 0.01 mu g/L (Pt), 0.02 mu g/L (U), 0.12 mu g/L (Th), 0.009 mu g/L (Be) and 4 mu g/L (Cs). The urine analysis was combined with a survey to assess any variations between subgroups and potential predictors of exposure to elements in the female population. Significant differences were obtained between the rural and urban areas studied for the toxic element Cs, with higher levels found in mothers living in urban areas. In relation to diet, statistically significantly higher levels of essential (Cu) and toxic (Ba) elements were detected in women with a high consumption of fish, while mothers who consumed a large quantity of legumes presented higher levels of the toxic element Ni (p = 0.0134). In a risk-assessment context, hazard quotients (HQs) greater than 1 were only observed for the essential elements Zn and Cu in P95. No deficiency was found regarding the only essential element for which a biomonitoring equivalent for nutritional deficit is available (Zn). For the less-studied toxic elements (Al, Pt, U, Th, Be, and Cs), HQs were lower than 1, and thus, the health risk due to exposure to these elements is expected to be low for the female population under study.

Se logra durabilidad inducida en la madera de apamate (Tabebuia rosea) utilizada en la industria del mueble en Venezuela, mediante la preservación de probetas con diferentes concentraciones de soluciones preservantes que contienen: ácido bórico – bórax (50:50 pp), Deltametrina (2,5 %) y cobre amoniacal cuaternario (13 % de cobre). Se ensayaron tres métodos de preservación: simple inmersión y posterior difusión, baño caliente – frio y a presión (Lowry modificado) logrando absorciones calificadas como altas según la clasificación de la Junta del Acuerdo de Cartagena y retenciones de menores a altas, según la concentración de los productos ensayados. Para evaluar la durabilidad natural e inducida de la madera de apamate se realizaron ensayos usando termitas de madera seca Cryptotermes brevis. La madera de apamate en su estado natural tiene resistencia moderada al ataque de termitas, pero se mejora su resistencia mediante la preservación, lo que permite conseguir mortalidad completa de las termitas y ningún indicio de erosión o desgaste ocasionado por las termitas. Induced durability is achieved in apamate wood (Tabebuia rosea) used in the furniture industry in Venezuela, by treating wood samples with different concentrations of preservative solutions containing: boric acid - borax (50:50 pp), Deltamethrin (2,5 %) and ammoniacal copper quats (13% copper). Three preservation methods were tested: simple immersion and subsequent diffusion, hot-cold and pressure treatment (Lowry modified) achieving high-rated absorptions according to the classification of the Cartagena Agreement Board and withholdings from minor to high, according to the concentration of the products tested. To evaluate the natural and induced durability of apamate wood, tests were carried out using dry wood termites Cryptotermes brevis. Apamate wood in its natural state has moderate resistance to termite attack, but its resistance is improved by preservation, which allows to achieve complete termite mortality and no evidence of erosion or wear caused by termites. 47–57 are@ula.ve oencinas@ula.ve Anual

Objectives/Interrogation: The advances of reconstructive microsurgery in orthopaedic surgery provided better functional and aesthetic results and prevented many indications of amputations. The indications of free flaps for the treatment of traumatized extremity is increasing, including, open wounds,[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

The main objective of the present research is to evaluate the exposure to pesticides in children (n = 568) from the Valencian Region (Spain). Six non-specific and 20 specific metabolites of organophosphate pesticides (OPs), herbicides (Herb), and pyrethroids (Pyr) were analyzed in urine samples. The biomarkers with the highest detection frequencies (>70%) were diethyl phosphate, p-nitrophenol, 3-phenoxybenzoic acid, and 3,5,6-trichloro-2-pyridinol, whose geometric mean concentrations (ng.ml-n1) were 1.53, 1.03, 1.51 and 1.19, respectively. Robust regression models showed that the province of residence and the recent consumption of vegetables, legumes and cereals were some of the most important predictors of pesticide exposure. Pesticide risk assessment is estimated using two different strategies: one based on the pesticides' mode of action (MoA); and the other based on cumulative assessment groups (CAGs), proposed by EFSA. The estimated daily intakes (EDIs) ranged from 0.08 (chlorpyrifos) to 1.62 mu g.kgbw(-1) (lambda-cyhalothrin). The MoA approach resulted in hazard quotients ranging from 0.01 (chlorpyrifos) to 0.65 (lambda-cyhalothrin), and a hazard index for OPs lower than 1. Similarly, the risk assessment based on CAGs led to total margins of exposure (MOETs) far from 100. In conclusion, both risk assessment strategies does not reveal any evidence of a potential health risk due to pesticide exposure in Spanish children. (C) 2020 Elsevier B.V. All rights reserved.

The main objective of the present research was to evaluate the levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (dl-PCBs) in the human milk of Spanish lactating women who participated in the t:RMILK project so that exposure and risk could be assessed for these mothers and their breastfed children. The total Sigma PCDD/Fs + dl-PCBs TEQ(2005) concentrations in the upper-bound (UB) ranged from 129 to 13.48 pg-TEQ(2005) g(-1) lipid.The estimated geometric mean level for the sum of PCDD/F and dl-PCBs was 4.10 and 4.42 pg-TEQ(2005) g(-1) lipid, lower-bound (LB) and UB respectively and were below the reference level reported by EFSA, which is associated with adverse effects in boys of 9 years and related to lactating mothers' exposure values of the tolerable weekly intake (TWI) of around 2 pg-TEQ(2005) kg(-1) bw per week. Nevertheless, it was exceeded when the 95th percentile (8.31 pg-TEQ(2005) g(-1) lipid, as UB) was considered. Results from a multiple regression analysis showed that age has a significant impact on milk Sigma PCDD/Fs + dl PCBs levels, with higher concentrations observed in the milk from older mothers. (C) 2020 Elsevier B.V. All rights reserved.

The aim of the present study was to assess the exposure to pesticides in urine from Spanish lactating mothers (n?=?116). Six nonspecific (dialkyl phosphates) and 20 specific metabolites of organophosphate pesticides (OPs), herbicides and pyrethroids were analyzed. The most frequently detected biomarkers were diethyl phosphate, p-nitrophenol, 3,5,6-trichloro-2-pyridinol and 3-phenoxybenzoic acid, whose geometric means were 1.9?ngmL -1 , 0.8?ngmL -1 , 1.5?ngmL -1 and 1.4?ngmL -1 , respectively. Herbicide metabolites were the least frequently detected biomarkers with detection frequencies between 0% (2,4,5-Trichlorophenoxyacetic acid) and 22% (2,4-Dichlorophenoxyacetic acid). Multiple regression analyses showed that the closeness to a farming activity, the place of residence and the presence of garden/plants at home were some of the most important contributors to urinary levels of pesticide metabolites. Estimated daily intake (EDI), hazard quotient (HQ) and hazard index (HI) were obtained in order to interpret urinary levels of the most frequently detected pesticide metabolites in a risk assessment context. The highest EDIs were obtained for chlorpyrifos (0.40-1.14?gkg?bw -1 day -1 ) and deltamethrin (0.34-4.73?gkg?bw - 1 day -1 ). The calculated HQ for chlorpyrifos, dimethoate, parathion and deltamethrin ranged from 0.01 to 0.47, and HI for OPs ranged from 0.09 to 0.33 showing that apparently there were low health risks due to the exposure to these pesticides in this group of Spanish breastfeeding women.

Dietary exposure to polybrominated diphenyl ethers (PBDEs) of the population in the Region of Valencia, Spain, was assessed. A group of 320 composite samples of different fatty foods was collected and analyzed, including the following: vegetable oils, and foods of animal origin such as (a) fish and seafood, (b) eggs, (c) milk and dairy products, and (d) meat and meat products. Two scenarios were assumed for left-censored results: lower-bound (LB) and upper-bound (UB). Vegetable oils, and fish and seafood presented the highest content of PBDEs [mean values of 503 and 464 pg g(-1) wet weight (ww) for total PBDEs, respectively, in the UB]. The dominating congeners were BDE47 in the food categories of fish and seafood, meat and meat products, and vegetable oils, and BDE99 in the categories of eggs, and milk and dairy products. The dietary exposure to PBDEs through consumption of the studied foods by the population in the Region of Valencia was estimated for adults (>15 years of age) and young people (6-15 years of age). Average intake levels (UB scenario) were 1.443 and 3.456 ng kg bw(-1) day(-1) for adults and young people, respectively. In a risk-assessment context, the margin of exposure (MOE) for congener BDE47, -99, -153, and -209 (ranged: 30-3E6) indicate that the current dietary exposure to these substances does not pose a risk to human health. (C) 2020 Elsevier Ltd. All rights reserved.

In the present study we used human biomonitoring to assess the internal exposure and the risk to four parabens and three bisphenols in 103 Spanish breastfeeding mothers participating in the BETTERMIILK project. Urinary methylparaben (MP), ethylparaben (EP), propylparaben (PP) and butylparaben (BP) presented detection frequencies ranging from 12% (BP) to 92% (MP), while bisphenol A (BPA), bisphenol F (BPF) and bisphenol S (BPS) were detected in 76% (BPA) and 20% (BPF, BPS) of the mothers. Average paraben concentrations (geometric mean) ranged from 0.021 ng mL(-1) (BP) to 17.7 ng mL(-1) (MP), whereas bisphenols had geometric means concentrations from 0.042 ng mL(-1) (BPF) to 0.927 ng mL(-1) (BPA). Except for BPA, the estimated daily intakes (EDI) were calculated in order to interpret urinary levels in a risk assessment context. The obtained EDIs ranged from 0.00042 mg/kg/day for PP to 0.0434 mg/kg/day for MP and EP. A hazard quotient (HQ) was calculated for BPA (0.0049) and parabens (0.001-0.004), showing no risk in the studied population. Sociodemographic characteristics, food consumption, and usage patterns of personal care products (PCPs) were investigated as possible determinants of exposure. Use of makeup and skincare products were associated with higher concentrations of MP and PP, respectively. Regarding dietary habits, MP was also associated with the consumption of packaged and bakery products.