Silicon as an attenuator of the toxic effects of aluminum in Schinus terebinthifolius plants.

Aluminum (Al) is highly toxic to plants, since it causes stress and inhibits plant growth. Silicon (Si) is known to mitigate the stress caused by Al in several plant species. Thus, the current study aims to investigate the soothing effects of Si on morphophysiological and photosynthetic variables, and the attributes associated with oxidative stress in Schinus terebinthifolius plants exposed to Al. Treatments have followed a completely randomized design, with three repetitions based on the following Al/Si combinations (in mM): Treatment 1: 0 Al + 0 Si; Treatment 2: 0 Al + 2.5 Si; Treatment 3: 1.85 Al + 0 Si; Treatment 4: 1.85 Al + 2.5 Si; Treatment 5: 3.71 Al + 0 Si; Treatment 6: 3.71 Al + 2.5 Si. Each sampling unit consisted of a tray with 15 plants, totaling forty-five per treatment. Shoot and root morphological variables, photosynthetic variables, photosynthetic pigments, hydrogen peroxide concentration, lipid peroxidation (MDA), guaiacol peroxidase (POD) and superoxide dismutase (SOD) enzymes, and non-enzymatic antioxidant such as Ascorbic acid (AsA) and non-protein thiol (NPSH) concentration were assessed. Root growth inhibition followed by changes in root morphological variables have negatively affected root and shoot biomass production in plants only subjected to Al. However, adding 2.5 mM Si to the treatment has mitigated the toxic effects caused by 1.85 mM of aluminum on S. terebinthifolius plants.

Intraocular pressure fluctuations in patients implanted with an implantable collamer lens (ICL V4c). Three-month follow-up. / Fluctuaciones de presión intraocular en pacientes operados con implante de implantable collamer lens (ICL V4c). Seguimiento a 3 meses.

INTRODUCTION: Fluctuating elevated intraocular pressure (IOP) is one of the complications of an implantable collamer lens (ICL), and its alteration is a predictive factor for the development of glaucoma. MATERIAL AND METHODS: A prospective, cross-sectional analytic study was conducted on patients suitable for ICL implantation. Complete clinical and biometric work-ups were performed, as well as night-time IOP curve, in supine position, with 4 determinations, in order to assess fluctuation, considering abnormal with a value higher than 5 mmHg. Patients underwent surgery with conventional technique and three months after the work-ups were repeated, including a night-time IOP curve to assess any changes in IOP fluctuations. RESULTS: A total of 31 eyes of 16 patients were studied. Mean IOP fluctuation in the preoperative assessment was 3.35 ± 2 mmHg, whereas the postoperative mean was 3.0 ± 2.2 mmHg, with the difference not being statistically significant. Visual acuity and capacity, as well as spheric equivalent did show a statistically significant improvement. There were 6 cases of complications, which were related to a higher vault and a greater ICL size. There was no relationship between these findings and the angle grade, pigment, and the level of training of the surgeon. CONCLUSIONS: The effect of an ICL on IOP fluctuations, has been studied for the first time, which was found to be not statistically significant. As in previous publications, the procedure was safe and reproducible, adding the fact that the level of training of the surgeon is not a determining factor in these findings.

A pilot study on usability analysis of emergency department information system by nurses.

OBJECTIVES: Employing new health information technologies while concurrently providing quality patient care and reducing risk is a major challenge in all health care sectors. In this study, we investigated the usability gaps in the Emergency Department Information System (EDIS) as ten nurses differentiated by two experience levels, namely six expert nurses and four novice nurses, completed two lists of nine scenario-based tasks. METHODS: Standard usability tests using video analysis, including four sets of performance measures, a task completion survey, the system usability scale (SUS), and sub-task analysis were conducted in order to analyze usability gaps between the two nurse groups. RESULTS: A varying degree of usability gaps were observed between the expert and novice nurse groups, as novice nurses completed the tasks both less efficiently, and expressed less satisfaction with the EDIS. The most interesting finding in this study was the result of 'percent task success rate,' the clearest performance measure, with no substantial difference observed between the two nurse groups. Geometric mean values between expert and novice nurse groups for this measure were 60% vs. 62% in scenario 1 and 66% vs. 55% in scenario 2 respectively, while there were some marginal to substantial gaps observed in other performance measures. In addition to performance measures and the SUS, sub-task analysis highlighted navigation pattern differences between users, regardless of experience level. CONCLUSION: This study will serve as a baseline study for a future comparative usability evaluation of EDIS in other institutions with similar clinical settings.

Plasma mineral content in type-2 diabetic patients and their association with the metabolic syndrome.

BACKGROUND: Metabolic syndrome is a clinical disorder that is becoming more prevalent in Spain. The syndrome encompasses a set of metabolic disorders such as type-2 diabetes mellitus, hypertension, dyslipidemia, and obesity, which may be associated with variations in serum levels and poor delivery of certain mineral elements. METHODS: This study attempted to ascertain whether metabolic syndrome might be linked to alterations in serum levels of the mineral elements magnesium, copper, zinc, chromium, and nickel in a population of 92 diabetic subjects, some suffering from certain conditions associated with the metabolic syndrome, and 72 control subjects (Hospital Príncipe de Asturias, Alcalá de Henares, Spain). RESULTS: The results indicated that as a group the alterations implicated in metabolic syndrome were indeed associated with variations in blood levels of the mineral elements considered, though statistically significant differences were recorded only in the case of copper. Still, trends in mineral levels for each of the separate components contributing to the syndrome tended to increase. CONCLUSION: Metabolic complications appear to be associated with alterations in the levels of some minerals, especially copper.

[Repercussions of chromium picolinate in the protein metabolism based on the age]. / Repercusiones del picolinato de cromo en el metabolismo proteico en función de la edad.

ANTECEDENTS: Commercialized like dietetic supplement, chromium picolinate has been promoted to favour the increase of muscle mass and the loss of weight, due to its' effect on the action of insulin. OBJECTIVE: To evaluate the effect of supplementation of the diet with chromium (500 microg/kg) in the form of chromium picolinate (CrPic) (12 days) on growth and protein turnover in rats at different growth stages (infantile and puberal). RESULTS AND DISCUSSION: No significant effect of CrPic on bodyweight gain, feed intake and feed conversion rate was observed at any of the stages of development studied. CrPic seems to increase the muscle mass, either by stimulating protein anabolism due to the involution of the insulin by chromium, or by reducing protein catabolism. CONCLUSIONS: Since the use of chromium picolinate could jeopardize the correct renal function and its' beneficial effects are not evident, it should always be consumed with caution.

[Infliximab in rheumatoid arthritis-use in a third level hospital]. / Infliximab en artritis reumatoide. Utilización en un hospital de tercer nivel.

OBJECTIVES: To study the conditions of infliximab use in rheumatoid arthritis, as well as the effectiveness and adverse effects of this therapy, and to perform an economic assessment of infliximab therapy in a third-level hospital. MATERIAL AND METHODS: A retrospective study was performed including patients treated with infliximab from January 2001 to March 2003. RESULTS: Twenty-five percent of patients received doses greater than 3 mg/kg, and 12% of them at intervals shorter than 8 weeks; 78% also received methotrexate concurrently. Adverse effects reported were similar in type to those described in the pro-duct's data sheet. Regarding therapy effectiveness, objective para-meters were seen to improve, less so the remaining parameters. Therapy cost was 5.6% of day hospital costs. CONCLUSIONS: Anti-TNF drugs are a relevant alternative in the treatment of rheumatoid arthritis because of their effectiveness-safety profile, but understanding their frame of use and following recommendations issued by scientific societies are important considerations.

[Pharmacotherapy and costs of DRD 88. Chronic obstructive pulmonary disease in hospital]. / Tratamiento farmacológico y costes hospitalarios del GRD 88. Enfermedad pulmonar obstructiva crónica.

BACKGROUND: Diagnosis-Related Group (DRG) 88 -chronic obstructive pulmonary disease is one of the most frequent groups of patients in hospital case-mix and accounts for substantial health-care costs. Our purpose was to determine drug utilization pattern and related costs for this DRG and to analyse their relationship with several factors. METHODS: 288 patients treated at a tertiary referral hospital between january and december 1997 were studied. We analysed demographic, clinical, and administrative data, as well as drugs prescription and cost for every patient. RESULTS: Most patients received antibiotics (n=267) which, in addition, represented 46% of total pharmacy cost of this DRG. Cephalosporines were the most frequently prescribed. 67% of patients were treated with inhaled B-agonists and theophillyne, whereas the combination of B-agonists and Ipratropium Bromide was less frequent (n=152). Oral or parenteral corticosteroids were used in 233 patients. This treatment regime presented differences according to main diagnosis and to department responsible for patient discharge. Cost per episode was 116,6 +/- 110,5 euros. Cost per hospital stay was 13,1+/- 15,5 euros. Correlation of pharmacy costs with length of stay was moderate. CONCLUSION: Pharmacy costs are mainly determined by the use of antibiotics. Treatment pattern shows a certain variability that can be attributed to patients clinical features as well as to physician prescribing habits.

Cerebrospinal fluid levels of selenium in patients with Alzheimer's disease.

We compared CSF and serum selenium levels, measured by atomic absorption spectrophotometry, in 27 patients with Alzheimer's disease (AD) (13 females, 14 males, mean +/- SD age 73.6 +/- 7.4 years) without major clinical signs of undernutrition, and 34 matched controls (18 females, 16 males, mean +/- SD age 70.7 +/- 7.8 years). CSF and serum selenium levels did not differ significantly between AD-patient (11.4 +/- 7.8 ng/ml and 28.5 +/- 13.0 ng/ml, respectively) and control groups (13.3 +/- 7.0 ng/ml and 22.5 +/- 17.5 ng/ml). These values were not correlated with age, age at onset, duration of the disease, and scores of the MiniMental State Examination in the AD group. Weight and body mass index were significantly lower in AD patients than in controls. These results suggest that CSF selenium concentrations are apparently unrelated with the reported oxidative stress processes in patients with AD.

Effect of diabetes on the tissular Zn/Cu ratio.

One of the parameters related to the development of coronary disease in diabetic patients is the tissular Zn/Cu ratio. We evaluated the levels of Zn and Cu, and the Zn/Cu ratio in insulin target tissues in diabetic and normoglucemic growing Wistar rats in order to determine the influence of diabetes and the disease evolution period. Diabetes was induced chemically by administration of streptozotocin. In order to determine the influence of the duration of diabetes on the Zn/Cu ratio, three time periods were studied: 7, 21 and 60 days. The animals were subsequently sacrificed and the target tissues (liver, adipose tissue, and skeletal muscle) were removed. Zn and Cu levels were measured by AAS after wet mineralization. STZ-induced diabetes modified the tissular Zn and Cu content. There was a significant decrease (p < 0.01) in liver and adipose tissue, but not in skeletal muscle. The in adipose tissue and skeletal muscle, but not in liver, effects were dependent on the duration of diabetes. The Cu content was higher in the liver of diabetic rats (p < 0.1) and lower in adipose tissue (p < 0.1) and skeletal muscle (NS). Tissular Cu levels also were affected significantly by the duration of diabetes. The Zn/Cu ratio showed a generalized decrease, except in skeletal muscle. This decrease was dependent on the presence of diabetes mellitus and the duration of the disease (p < 0.01).

Cerebrospinal fluid levels of transition metals in patients with Alzheimer's disease.

We compared CSF and serum levels of iron, copper, manganese, and zinc, measured by atomic absorption spectrophotometry, in 26 patients patients with Alzheimer's disease (AD) without major clinical signs of undernutrition, and 28 matched controls. CSF zinc levels were significantly decreased in AD patients as compared with controls (p < 0.05). The serum levels of zinc, and the CSF and serum levels of iron, copper, and manganese, did not differ significantly between AD-patient and control groups. These values were not correlated with age, age at onset, duration of the disease, and scores of the MiniMental State Examination in the AD group. Weight and body mass index were significantly lower in AD patients than in controls. Because serum zinc levels were normal, the possibility that low CSF zinc levels were due to a deficiency of dietary intake seems unlikely. However, it is possible that they might be related to the interaction of beta-amyloid and/or amyloid precursor protein with zinc, that could result in a depletion of zinc levels.

Cerebrospinal fluid levels of transition metals in patients with Parkinson's disease.

We compared CSF and serum levels of iron, copper, manganese, and zinc, measured by atomic absorption spectrophotometry, in 37 patients with Parkinson's disease (PD) and 37 matched controls. The CSF levels of zinc were significantly decreased in PD patients as compared with controls (p < 0.05). The serum levels of zinc, and the CSF and serum levels of iron, copper, and manganese, did not differ significantly between PD-patient and control groups. There was no influence of antiparkinsonian therapy on CSF levels of none of these transition metals. These values were not correlated with age, age at onset, duration of the disease, scores of the Unified Parkinson Disease Rating Scale of the Hoehn and Yahr staging in the PD group, with the exception of CSF copper levels with the duration of the disease (r = 0.38, p < 0.05). These results suggest that low CSF zinc concentrations might be related with the risk for PD, although they could be related with oxidative stress processes.

Cerebrospinal fluid selenium and chromium levels in patients with Parkinson's disease.

We compared CSF and serum levels of selenium and chromium, measured by atomic absorption spectrophotometry, in 28 patients with Parkinson's disease (PD) and 43 matched controls. The CSF and serum levels of these trace metals did not differ significantly between PD patients and controls. CSF selenium and chromium levels were not correlated with age, age at onset, duration of the disease, scores of the Unified Parkinson Disease Rating Scale of the Hoehn and Yahr staging in the PD group. Although antiparkinsonian therapy did not influence significantly the CSF levels of selenium, PD patients not treated with levodopa had significantly higher CSF selenium levels than controls (p < 0.01). It is possible that increased CSF selenium levels could indicate an attempt of protection against oxidative stress. The normality of CSF and serum chromium levels suggest that these values are not related with the risk for PD.

Effects of arsenic (V)-chromium (III) interaction on plasma glucose and cholesterol levels in growing rats.

Recent studies have demonstrated interaction between arsenic (As) and chromium (Cr) affecting absorption and/or protein catabolism. In the present study the possible effects of As(V)/Cr(III) interaction on growth rate, organ weight, and the two main organic functions of Cr, i.e., regulation of plasma glucose levels and total plasma cholesterol levels, was examined in weaned male Wistar rats. The diet of 20 rats was supplemented with 5 micrograms of As(V) and/or Cr(III) per gram of food for 10 weeks. As/Cr interaction did not significantly affect growth rates on organ weight:body weight ratios but did decrease total plasma cholesterol levels, though the decrease was not as pronounced as in the group supplemented with Cr alone (p < 0.1). Since supplementation with As(V) produced the opposite effect (96.83 vs. 47.27) (p < 0.01), the combined use of As and Cr may prove beneficial in cases of chronic As(V) intoxication. Supplementation treatment with As(V) and Cr(III) combined had no significant effect on glucose levels, because though As(V) affects Cr tissue levels and thus alters the effect of Cr on plasma cholesterol levels, individual effects of As(V) and Cr(III) are similar, and hence basal glucose levels are unaffected.

Mechanisms of absorption of As2O5 from rat small intestine: the effect of different parameters.

The main purpose of this research was to study the effects of water movement on arsenic absorption. In order to appreciate and measure the interaction between these two variables we investigated the perfusion of isotonic and hypotonic buffers (containing 3.2 microgram/ml As2 O5 into rat small intestines. The As (V) depended on osmolarity sensitive. This implied the presence of a saturable uptake kinetic mechanism and suggested the participation of some kind of carrier-mediated transport system. An increase in arsenate absorption and its accumulation in organs was detected in the presence of an Na+ gradient. The same technique, combining isotonic buffers with different pH values and buffers containing valinomycin, was used in order to study the effects of intraluminal pH on membrane potential. A significant decrease in arsenic levels and As(V) absorption in organs was detected as a result of an increase in the pH. This influence of pH on the As(V) absorption mechanism indicated dependence on a proton (H+) gradient. An inside negative potassium potential induced by valinomycin increased significantly the uptake of arsenate, suggesting an electrogenic transport of arsenate. In conclusion, the As(V) might be absorbed from the small intestine through a carrier-mediated mechanism, which would depend on the Na+(-) and H+(-)gradients and the membrane potential differential from both sides of the intestinal epithelial cells.

Plasma levels of inorganic sulfates in patients with Parkinson's disease.

Some investigators reported pharmacogenetic differences in the metabolism of sulfur-containing drugs and lower plasma sulfate levels in patients with Parkinson's disease (PD) compared with controls. However, other group did not confirm these findings. We studied the plasma levels of sulfate by indirect atomic absorption spectrophotometry in 55 PD patients and 57 age and sex-matched controls. The plasma sulfate levels did not differ significantly between PD patients and control groups (mean +/- SEM 73 +/- 8 and 75 +/- 7 mg/l, respectively). They were not influenced by antiparkinsonian drugs and they did not correlate with age at onset, duration, Hoehn & Yahr staging or activities of daily living subscale of the Unified Parkinson's disease rating scale. There was a low but significant correlation of plasma sulfate levels with motor examination (r = -0.39, p < 0.05) and total score (r = -0.33, p < 0.05) of this scale in the PD group. These data suggest that plasma sulfate levels are apparently unrelated with the risk for PD.

[The effect of chromium picolinate on the liver levels of trace elements]. / Efecto del picolinato de cromo en los niveles hepáticos de algunos elementos traza.

Chromium picolinate has been implicated as a lipid and carbohydrate reducing agent, and therefore it may be a valuable adjunct to the treatment and prevention of diabetes and heart disease. This compound is inexpensive and apparently nontoxic. In this work, we have determined the influence of its administration (100, 200, 500 micrograms Cr/ml, for 7 and 21 days) on hepatic content of Zn, Mn, Cu and Fe of male Wistar rats. The results show a variation of the levels of these elements after the administration of chromium picolinate, although the differences are only significantly (p < 0.01) in the case of Mn. This influence is dose-dependent, occurring a decrease of 72% in the group treated with 500 micrograms/ml (Pic-500) respect to the content of control group.

Inorganic pentavalent arsenic methylation by rats: effect of concentration and dichromate.

The effect of the administered arsenic (As) dose and the dichromate ion (Cr) on the methylation process of arsenic was studied in rats exposed to arsenate to elucidate the biotransformation of As. After oral administration of different As (V) and Cr (VI) concentrations, the different As metabolites (inorganic, methylarsonic acid [MMA] and dimethylarsinic acid [DMA] were separated by cation-exchange chromatography and measured by atomic absorption spectrophotometry. Administration of high doses of As produced enzymatic saturation and non-enzymatic depletion, with decreases in DMA levels. The presence of the dichromate ion supported arsenate methylation as it favored reduction of As (V) to As (III), but Cr (VI) produced a significant decrease in the total As excreted.

[Factors relating to the cost and quality of drug prescriptions in primary care]. / Factores relacionados con el gasto y la calidad de la prescripción farmacéutica en atención primaria.

OBJECTIVES: To analyse, quantitatively and qualitatively, the pharmaceuticals prescribed by doctors within two models of Primary Care: the reformed (RM) and non-reformed (NRM). To study which variables of the doctor, work-centre or community attended explain prescription variations. DESIGN: An observational crossover study. SETTING: Primary Health Care centres in the province of Málaga. PARTICIPANTS: The prescriptions of 454 doctors were studied: 259 RM and 195 NRM. A univariant analysis was performed on the indicators of prescription of both health-care models, with afterwards a multiple linear regression analysis to study the effect of the rest of the variables. RESULTS: There were differences in two of the quantitative indicators studied, with more prescriptions and expense per insured person per day in the NRM, as well as higher prescription for several therapeutic groups, mainly of drugs against flu, and also of drugs against infections, tonics, restoratives and capillary protectors. The variables which best explained prescriptions in the multivariant analysis were: consultations per insured person per day and the percentage of pensioners on the doctor's list. CONCLUSIONS: We thought that the differences between the two health-care models in the quantitative analysis were of very little relevance. They were greater in the qualitative one and suggested higher quality of prescription in the RM. Pressure of numbers was identified as, among the studied variables, that which best explains prescription, over and above others like the health-care model or medical training. As for the percentage of pensioners on the doctor's list, it should be borne in mind at the hour of evaluating his/her prescriptions.

Serum and urinary manganese levels in patients with Parkinson's disease.

To elucidate the possible role of manganese in the risk of developing Parkinson's disease (PD), we compared serum levels of manganese, and 24-h manganese excretion by urine in 29 PD patients and in 27 matched controls. We also measured chromium and cobalt in the same samples. All these values did not differ significantly between the groups, they were not influenced by antiparkinsonian drugs, and they did not correlate with age, age at onset and duration of the PD, scores of the Unified PD Rating Scale or the Hoehn & Yahr staging in the PD group. These results might suggest that serum levels and urinary excretion of manganese are apparently unrelated to the risk of developing PD.

Gastrointestinal absorption of inorganic arsenic (V): The effect of concentration and interactions with phosphate and dichromate.

The absorption of inorganic pentavalent arsenic (As) by the rat small intestine was investigated using 2 different procedures: In vivo determination of overall extent of gastrointestinal absorption; and an intestinal perfusion technique. The aim was to determine the effect of concentration and the interaction with phosphate and dichromate anions on gastrointestinal absorption of As to understand the mechanism of As absorption at intestinal level. The results indicate there is a direct relationship, although not proportional, between the received dose and the absorbed amount of As. Intestinal absorption of As appears carried out by a saturable transport process. The phosphate produces a pronounced decrease in the intestinal absorption of As due to the fact that phosphate and As can share the same transport mechanism which is an active secondary carrier-mediated system depending on Na+ and H+ gradient. Addition of dichromate to perfusion buffers significantly (p > 0.05) increased As absorption. Several hypothesis may explain this fact: Dichromate produces pH modifications at the intracellular level, providing an adequate H(+)-gradient for As absorption; dichromate exerts a caustic effect, which damages the intestinal wall at the microvilli level. This allows free diffusion of As through the resulting openings.