Background: There are few studies in Spain on the use of activated charcoal (AC) in acute poisoning via the digestive tract, and more specifically on its protocol and adverse events following its administration. The aim of this article is to know the experience in the use of AC by doctors and nurses of the Spanish emergency services. Method: Survey developed using Google Docs to health professionals in emergency services. Results: Three hundred and sixty-four questionnaires were received, 52% of them from doctors. Catheterization prior to the use of AC in 74.5% of patients was performed, and did not use a catheter in 13%. The application of AC was considered correct in 37.4%, and overall it was used in 92.4% of cases. The lateral safety position was used in 46.2%, antiemetics in 86.5% and isolation of the airway in case of coma (GCS<8) in 60%. The most described adverse events were vomiting of AC (61%), epixtasis when the catheter was positioned (51.1%), and its incorrect positioning (36%). Inhaling vomit occurred in 11.8% and inhaling carbon in 4.7%. Seven point one percent stated that the adverse events had been life-threatening to patients. No relation was found between the protocol and serious or life-threatening adverse events, nor between these latter and clinical safety measures. Conclusions: The incidence of adverse events according to the information provided by professionals in this survey of clinical practice might be higher than the incidence found in the literature.

Fundamento: Existen pocos estudios en España sobre el uso de carbón activado (CA) en las intoxicaciones agudas por vía digestiva, y más concretamente sobre su protocolización y eventos adversos tras su administración. Este trabajo tiene como objetivo conocer la experiencia en el uso de CA, por los médicos y enfermeros de los servicios de urgencias y emergencias españoles. Método: Diseño de una encuesta a profesionales sanitarios de urgencias y emergencias, mediante la aplicación informática Google Docs. Resultados: Ser recibieron 364 encuestas, de ellas un 52% procedentes de facultativos. Contestaron realizar sondaje previo al uso de CA el 74,5%, y no utilizar sonda en el 13% de los pacientes. Se consideró correcta la aplicación de CA en un 37,4%, usándose globalmente en un 92,4% de los casos. La posición lateral de seguridad manifestaron usarla el 46,2%, antieméticos el 86,5% y aislaban la vía aérea en caso de coma (GCS<8) el 60%. Los eventos adversos más descritos fueron los vómitos de CA (61%), la epixtasis al colocar la sonda (51,1%) y la incorrecta colocación de la misma (36%). La broncoaspiración de vómitos les ocurrió al 11,8% y de carbón al 4,7%. Un 7,1% manifestó que los eventos adversos habían supuesto riesgo vital para los pacientes. No se halló relación entre protocolización de la asistencia y eventos adversos graves o riesgo vital, ni entre éstos y las medidas de seguridad clínica. Conclusiones: La incidencia de eventos adversos, en función de lo manifestado por los profesionales en esta encuesta sobre su práctica clínica, podría ser superior a las que se encuentran en la literatura.

Legal normatives for pesticides residues are becoming more restrictive. Frequently, significant reductions are applied to the Maximum Residue Levels (MRL), including in some cases, prohibition of their use. Modern phytosanitary strategies must consider insecticide residue levels as well as dissipation rates in fruits in order to overcome increasing pesticide restrictions and reducing both toxicological and commercial risks. Argentine legislation for chlorpyrifos, a widely used insecticide for controlling different citrus pests, establishes MRL of 0.3 mg/kg for whole fruits including a Pre-Harvest Interval (PHI) of 21 days. These values coincide with those established by the European Union (EU), except for mandarins, and also with those of the Russian Federation. In this paper, degradation rates and persistence of chlorpyrifos were studied on two orange and three mandarin varieties. Assays were performed using chlorpyrifos 48 (emulsifiable concentrate), suspending 120 cm³ in 100 L of water using an air blast sprayer and volumes of 2000 to 2500 l/ha. Pesticide degradation in fruit was studied for a 120-day period since insecticide application and fruit samples were taken a different time intervals. Experimental data were used to perform a mathematical model where degradation was considered as a function of time. In all cases, initial residue levels were found above MRL established for the national legislation, while dissipation followed a logarithmic model. Dissipation of chlorpyrifos followed a fast rate till PHI was reached, with 69 to 82% of insecticide residues being eliminated. Since then, dissipation rates were slower than initially, reaching at the end of the experiment levels of 0.03-0.01 mg/kg. Residue levels of chlorpyrifos were below the MRL of Argentina´s and export countries legislation at the moment PHI was reached. However, presence of residues at the end of the assay showed great persistence of chlorpyrifos in citrus fruit.

Las normativas legales sobre residuos de plaguicidas son cada vez más exigentes. Con frecuencia, hay una reducción significativa en el Límite Máximo de Residuos (LMR) y en casos severos una prohibición de su uso. La estrategia de control fitosanitario debe tener en cuenta los niveles de residuos que quedan en la fruta y la cinética de disipación que disminuye los riesgos toxicológicos y comerciales. El clorpirifós es un insecticida utilizado en cítricos para el control de diversas plagas. La legislación argentina establece un LMR de 0,3 mg/kg para fruta entera y un Período de Carencia (PC) de 21 días. Este valor coincide con el exigido por la Unión Europea (UE), excepto en mandarinas, y por la Federación de Rusia. En el presente trabajo se estudió la cinética de degradación y persistencia del clorpirifós en dos variedades de naranjas y tres de mandarinas. Los ensayos se realizaron con clorpirifós 48% (concentrado emulsionable) en la preparación de un caldo con 120 cm³ cada 100 L de agua. Se utilizó una pulverizadora de turbina y un volumen de 2000-2500 l/ha. La degradación de residuos en frutas se estudió durante 120 días con toma de muestras periódicas. Los datos experimentales se utilizaron para establecer un modelo matemático de degradación en función del tiempo. En todos los casos, los residuos iniciales superaron el LMR y la disipación siguió un modelo logarítmico. Hasta el PC la eliminación fue rápida, con una reducción del 69 al 82% de los residuos. Luego continuó una fase de eliminación más lenta con niveles al final del ensayo entre 0,03 mg/kg y 0,01 mg/kg. En el PC se cumple con el LMR fijado por la legislación nacional y de los países compradores. La aparición de residuos en el final del ensayo indica una gran persistencia del clorpirifós.

Introduction: The presence of binge eating disorder (BED) can influence the outcomes of laparoscopic gastric bypass (BPGL) in the treatment of morbid obesity. In English population, BED is assessed usually through the Eating Disorder Examination-Questionnaire (EDE-Q) and Questionnaire on Eating and Weight Patterns-Revised (QEWP-R). Objectives: To study validity and concordance of EDEQ and QEWP-R for diagnosis and psychopathologic assessment of BED in Spanish gastric bypass patients. Methods: In a cross sectional study 27 recent gastric bypass patients completed Spanish version of EDE-Q and QEWP-R. Then patients were classified in BED or no BED. We evaluated possible differences between these groups in the items with psychometric relevance and we measure concordance between the questionnaires. Results: The QEWP-R and EDE-Q identified respectively 25,9% and 18,5% patients with BED. These achieved higher scores in the items related to importance of weight or shape in self-assessment, interference in concentration because of thinking about food, shape or weight, and frequency of guilty feeling after eating. Diagnostic concordance was poor between questionnaires, but we found a strong relation between items with psychometric relevance. Conclusions: BED is frequent in gastric bypass patients and constitute a distinct subgroup of patients with more severe psychopathology. Spanish version of QEWP-R and EDE-Q are suitable questionnaires for assessment of BED.

Introducción: La presencia de trastorno por atracón (TA) podría influir en los resultados del bypass gástrico laparoscópico (BPGL) en el tratamiento de la obesidad mórbida. En población anglosajona, el TA suele valorarse mediante los cuestionarios Eating Disorder Examination-Questionnaire (EDE-Q) y Questionnaire on Eating and Weight Patterns-Revised (QEWP-R). Objetivos: Estudiar la validez y concordancia del EDEQ y QEWP-R para el diagnóstico y valoración psicopatológica del TA en población española con obesidad mórbida intervenida mediante BPGL. Métodos: En un estudio transversal se le ha solicitado a 27 obesos mórbidos recién intervenidos mediante BPGL que cumplimentaran el EDE-Q y QEWP-R traducidos al español. Según las respuestas se han identificado los pacientes con y sin TA, evaluando posibles diferencias entre estos grupos en los ítems con interés psicométrico y midiendo la concordancia entre ambos cuestionarios. Resultados: El QEWP-R permitió diagnosticar un 25,9% de TA y el EDE-Q un 18,5%. Los pacientes con TA tuvieron mayores puntuaciones en los ítems sobre la importancia del peso o figura en la autovaloración, la interferencia en la capacidad de concentración por pensar en la comida, silueta o peso y la frecuencia del sentimiento de culpa después de comer. Entre ambos cuestionarios la concordancia diagnóstica fue escasa, pero se encontró una asociación fuerte entre los ítems con interés psicométrico. Conclusiones: El TA es frecuente en obesos mórbidos intervenidos mediante BPGL y forma un subgrupo de pacientes con más alteraciones psicopatológicas. El QEWP-R y el EDE-Q en español son cuestionarios adecuados para su valoración.

Antibacterial activity of organic and aqueous extracts of Acacia aroma was evaluated against methicillin-resistant Staphylococcus aureus (MRSA), methicillin sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus epidermidis. Inhibition of bacterial growth was determined using agar diffusion and bioautographic methods. Among all assayed organic extracts only ethanolic and ethyl acetate extracts presented highest activities against all tested Staphylococcus strains with minimal inhibitory concentration (MIC) values ranging from 2.5 to 10 mg/ml and from 2.5 to 5 mg/ml respectively. The aqueous extracts show little antibacterial activity against Staphylococcus strains. The bioautography assay demonstrated well-defined growth inhibition zones against S. aureus in correspondence with flavonoids and saponins. A. aroma would be an interesting topic for further study and possibly for an alternative treatment for skin infections.

The stress state in ADI internal gears mounted with interference in aluminum casings is numerically simulated, considering working load as well as circularity distortion (ovalization) and residual stresses resulting from heat treatment. Ovalization exerts the greatest influence on interference and residual stresses, leading to a significantly high compressive stress which does not affect the gear structural integrity due to the high compression strength of ADI. This grants this alloy a competitive edge over steels of similar tensile strength. Still, ovalization has to be minimized considering its unfavorable effect on performance and working load capacity.

ABSTRACT. Since some Anesthesiologists have reported side effects with the use of lidocaine in our country, we have made a pharmacological evaluation to define the anesthetic activity of lidocaine. The pharmacological evaluation was made in guinea pigs, by the method of Bülbring and Wajda(7). For the statistical analysis of the different treatments, Analysis of Variance was used, as well as, the Theorem of Fieller for the potency of lidocaine. The AC50 of commercial 2% lidocaine alkalinizated with 10% sodium hydroxyde was higher than that alkalinizated with 5% sodium bicarbonate and the standard USP (p <= 0,05). We have also evaluated the potency for commercial 2% lidocaine alkalinizated with 10% sodium hydroxyde below 60%. pH of the studied solutions and the adjusted-pH agent were determined, and we concluded that adjusted-pH agent was a determining factor in the anesthetic potency of lidocaine.

Objective: A rise in plasma levels of the amino acid homocysteine (HCY) is a possible risk factor in cardiovascular disease. The mechanisms proposed to explain how HCY can increase the risk of vascular disease include its direct effect on the vascular endothelium and its role in increasing the risk of thrombosis. The present work has been designed to determine HCY levels in patients with coronary artery disease (CAD) residents in the Canary Islands and to establish whether hyperhomocysteinemia can be considered as an risk factor. Methods: The sample studied consisted of 132 patients with, angiographically demonstrated, CAD and 18 controls with normal coronary arteries. Biochemical parameters determined included: HCY, vitamin B12, vitamin B6, folic acid, creatinine, cholesterol and its fractions, triglycerides, glucose and fibrinogen. Results: Mean levels of HCY were not significantly different between the cases and controls (p= 0.37). In the distribution of HCY levels into quintiles there was no significant association between the quintiles and the occurrence of CAD (p= 0.57). Multiple logistic regression analysis in which the risk factors were compared with quintiles 2,3,4 and 5 of HCY did not reveal a significant relation between HCY levels and risk of CAD. Conclusions: This study questions the previously accepted consideration that hyperhomocysteinemia is a risk factor of CAD. Controlled intervention trials are, therefore, necessary to clarify the possible association between total HCY levels and cardiovascular disease.

Objetivo: El aumento de las concentraciones séricas del aminoácido homocisteína (HCY) es un posible factor de riesgo de enfermedades cardiovasculares. Los mecanismos propuestos para explicar porqué la HCY puede hacer aumentar el riesgo de enfermedades vasculares son un efecto directo sobre el endotelio vascular y su intervención en el aumento del riesgo de trombosis. El presente estudio ha sido diseñado para conocer la homocisteinemia de pacientes residentes en las Islas Canarias con enfermedad arterial coronaria (EAC), y comprobar si la hiperhomocisteinemia es un factor de riesgo. Métodos: Se incluyeron 132 pacientes afectos de EAC demostrada angiográficamente y 18 controles con arterias coronarias normales. Se determinaron los valores de HCY, vitamina B12, vitamina B6 , ácido fólico, creatinina, colesterol con sus diferentes fracciones, triglicéridos, glucosa y fibrinógeno. Resultados: Las concentraciones medias de HCY no difirieron significativamente (p= 0,37) entre los casos y los sujetos de control. La distribución de los niveles de HCY por quintiles no parece estar asociada sobre la producción de EAC (p= 0,57). El análisis de regresión logística múltiple de los factores de riesgos comparado con los quintiles 2, 3, 4 y 5 de HCY no demostró evidencia significativa entre la concentración de HCY y el riesgo de EAC. Conclusiones: Este estudio añade incertidumbre de que la hiperhomocisteinemia sea factor de riesgo para EAC. Es necesario realizar estudios controlados de intervención clínica, algunos de los cuales están en marcha, para intentar aclarar las interrelaciones entre la HCY total y las enfermedades cardiovasculares.