Evaluation of Essential, Toxic and Potentially Toxic Elements in Leafy Vegetables Grown in the Canary Islands.

Forty-seven elements in leafy green vegetables were studied to estimate the daily intakes from this food category in different scenarios (average and high consumers) and age groups of the Canary Islands population. The contribution of the consumption of each type of vegetable to the reference intakes of essential, toxic and potentially toxic elements was assessed and the risk-benefit ratio was evaluated. The leafy vegetables that provide the highest levels of elements are spinach, arugula, watercress and chard. While spinach, chard, arugula, lettuce sprouts and watercress were the leafy vegetables with the highest concentrations of essential elements (38,743 ng/g of Fe in spinach, 3733 ng/g of Zn in watercress), the high levels of Mn in chard, spinach and watercress are noteworthy. Among the toxic elements, Cd is the element with the highest concentration, followed by As and Pb. The vegetable with the highest concentration of potentially toxic elements (Al, Ag, Be, Cr, Ni, Sr and V) is spinach. In average adult consumers, while the greatest contribution of essential elements comes from arugula, spinach and watercress, insignificant dietary intakes of potentially toxic metals are observed. Toxic metal intakes from the consumption of leafy vegetables in the Canary Islands do not show significant values, so the consumption of these foods does not pose a health risk. In conclusion, the consumption of leafy vegetables provides significant levels of some essential elements (Fe, Mn, Mo, Co and Se), but also of some potentially toxic elements (Al, Cr and Tl). A high consumer of leafy vegetables would see their daily nutritional needs regarding Fe, Mn, Mo, and Co covered, although they are also exposed to moderately worrying levels of Tl. To monitor the safety of dietary exposure to these metals, total diet studies on those elements with dietary exposures above the reference values derived from the consumption of this food category, mainly Tl, are recommended.

The Role of Veterinarians in Managing Community Cats: A Contextualized, Comprehensive Approach for Biodiversity, Public Health, and Animal Welfare.

Homeless cats are a major problem in Europe, with hundreds of thousands abandoned every year. While many die, others can adapt to a lifestyle of roaming freely and establish community cat populations that tend to cluster together in groups. These groups of cats are typically found in urban areas that offer food and shelter to the cats. Animal welfare organizations often care for these cats, providing them with food, shelter, and medical attention. Despite this, conflicts can arise due to the presence of free-roaming cats, with some individuals advocating for drastic measures such as trapping and killing the cats to reduce their populations. However, it is essential to note that such methods are frequently illegal, inhumane, and ultimately ineffective in most situations. A thorough assessment of the impact of cats on a particular natural area requires a comprehensive cat census, a detailed study of the species being preyed upon, and an investigation into the prevalence of zoonotic or epizootic diseases. Moreover, veterinary experts assert that the public health risks associated with cats are often overstated. This article aims to provide a nuanced perspective on the impact of cats on biodiversity in natural areas, while also discussing their role in transmitting the main zoonotic diseases identified in European countries in recent years, with a particular focus on Spain. Effective cat control programs should focus on non-lethal methods such as trap-neuter-return (TNR) and adoption. TNR has proven to be the most effective and humane method of controlling the free-roaming cat population, but its effectiveness is influenced by several factors, including adoption programs and public education on responsible pet ownership. According to Spanish veterinarians, sustainable and science-based solutions such as TNR programs are the best way to achieve population control of free-roaming cats. The veterinary profession should raise awareness regarding sterilization, vaccination, and identification of cats and the consequences of abandonment. They oppose lethal control and removal of cats from the environment, which are ineffective and unethical methods. To promote animal welfare, veterinary professionals must collaborate with public administrations to implement long-term, sustainable solutions to the problem of cat overpopulation. Greater social awareness regarding the importance of sterilization and identification to prevent abandonment and reduce the number of free-roaming cats is also needed. Despite the challenges presented by homeless cat populations in Spain and the rest of Europe, there are many reasons for optimism. Animal welfare organizations and veterinary professionals are actively collaborating to develop humane and effective solutions to manage community cats, including programs such as TNR and adoption. Furthermore, these initiatives are gaining momentum and support from emerging laws and regulations, such as the recent Spanish animal welfare law. Through these efforts, we can reduce the number of free-roaming cats and improve their quality of life.

Utilidad clínica de la mamografía con contraste (CEM): una revisión de la literatura / Clinical utility of contrast-enhanced mammography: A literature review

La mamografía con contraste (CEM) es una nueva y prometedora técnica de imagen basada en la neovascularización de los tumores de manera similar a la resonancia magnética de la mama. Los resultados de los estudios clínicos muestran que su rendimiento diagnóstico es significativamente mejor que el de la mamografía digital convencional, y que sus valores de sensibilidad y especificidad la hacen comparable con la resonancia magnética. Sus usos actuales y los propuestos incluyen la evaluación adicional de pacientes sintomáticos o pacientes con exámenes previos anormales, la evaluación de la extensión local de los cánceres de mama recién diagnosticados, el seguimiento de la quimioterapia neoadyuvante y la detección del cáncer de mama en pacientes de alto riesgo. Aunque la técnica se aprobó para uso clínico en 2010, todavía es poco conocida. En esta revisión, presentamos la técnica CEM y sus resultados de rendimiento de diagnóstico comparados con la mamografía convencional y la resonancia magnética de la mama. También presentamos los diferentes escenarios en los que se puede utilizar con éxito, tanto en el diagnóstico de la enfermedad de mama, como en la estadificación local del cáncer de mama, así como su papel potencial en los programas de detección del cáncer de mama. (AU)

Contrast-enhanced mammography (CEM) is a promising new imaging technique based on neovascularisation of the tumour, similar to magnetic resonance imaging of the breast. The results of clinical studies show that its diagnostic performance is significantly better than that of conventional digital mammography, and that its sensitivity and specificity are comparable to those of magnetic resonance imaging. Its current and proposed uses include further evaluation of symptomatic patients or patients with abnormal results on previous examinations, assessment of the local extension of newly diagnosed breast tumours, follow-up of neoadjuvant chemotherapy and detection of breast cancer in high-risk patients. Although the technique was approved for clinical use in 2010, it is still little known. In this review, we present the technique of CEM and its results in terms of diagnostic performance compared with conventional mammography and breast MRI. We also discuss the various scenarios in which it can be used successfully, both in the diagnosis of breast disease and in the local staging of breast cancer, as well as its potential role in breast cancer screening programmes. (AU)

Impact of chemical elements released by the volcanic eruption of La Palma (Canary Islands, Spain) on banana agriculture and European consumers.

The recent volcanic eruption on the island of La Palma has aroused the concern of banana producers and consumers, given that in its area of influence there are thousands of hectares of banana plantations with an annual production of about 100 million kilos for export. Since volcanoes are one of the main natural sources of heavy metal contamination, we sampled bananas from the affected area and determined the concentrations of 50 elements (Ag, Al, As, Au, Ba, Be, Bi, Cd, Ce, Co, Cr, Cu, Cu, Dy, Er, Eu, Fe, Ga, Gd, Hg, Ho, In, La, Lu, Mn, Mo, Nb, Nd, Ni, Os, Pb, Pd, Pm, Pr, Pt, Sb, Sc, Se, Sm, Sn, Sr, Ta, Tb, Th, Ti, Tl, Tm, U, Y, Yb and Zn). The levels of 36 elements were elevated but the washing implemented after the eruption can remove a good part. After the washout, bananas have elevated levels of Fe, Al, Ti, V, Ba, Pb, most of the rare earth elements, Mo, and Co. In all cases, except Mo, the elevation is much higher in the peel than in the flesh. In the case of Mo, the elevation in banana flesh would translate into a higher nutritional intake of this trace element, which could represent up to 35% of the daily nutritional requirements. Exposure to toxic or potentially toxic elements, does not represent a health risk, since would not exceed 5% of the tolerable daily intake, even in the worst-case scenario.

A Method Scope Extension for the Simultaneous Analysis of POPs, Current-Use and Banned Pesticides, Rodenticides, and Pharmaceuticals in Liver. Application to Food Safety and Biomonitoring.

The screening of hundreds of substances belonging to multiple chemical classes in liver is required in areas such as food safety or biomonitoring. We adapted a previous QuEChERS-based method in blood to the liver matrix and applied to these fields of study. The validation of the method allowed the inclusion of 351 contaminants, 80% with a LOQ < 2 ng/g. In the analysis of 42 consumer liver samples, we detected trace levels of 29 different contaminants. The most frequent and concentrated was 4,4'-DDE. POPs accounted for 66% of the compounds detected. In no case was the MRL reached for any of the contaminants detected. We also applied the method to 151 livers of wild birds to perform a biomonitoring pilot study in the Canary Islands. We detected 52 contaminants in 15 bird species. These were also mostly POPs, although high frequencies and concentrations of anticoagulant rodenticides (AR) and some other agricultural pesticides also stand out. POPs and AR contamination levels were significantly higher in terrestrial birds, raptors and particularly in nocturnal birds. Pesticide contamination levels were also higher in terrestrial birds, as well as in non-raptors and diurnal birds. The validated method is simple, robust, and sensitive and performs well in a variety of practical scenarios, where it can be carried out relatively quickly and inexpensively.

Epidemiology of Animal Poisonings in the Canary Islands (Spain) during the Period 2014-2021.

Animal poisoning is one of the greatest conservation threats facing wildlife. In a preliminary study in the oceanic archipelago of the Canary Islands, we showed that the degree of threat from this circumstance was very high-even higher than that reported in other regions of continental Europe. Consequently, a legal framework for the effective prosecution of the crime of wildlife poisoning came into force in 2014 in this region. We present the results of the investigation of 961 animals and 84 baits sent to our laboratory for the diagnosis of animal poisonings during the period 2014-2021. We were able to identify poison as the cause of death in 251 animals and 61 baits. Carbofuran stands out as the main agent used in this archipelago. We have also detected an increasing tendency to use mixtures of several pesticides in the preparation of baits. The entry into operation of two canine patrols has led to the detection of more dead animals in the wild and a greater number of poisoned animals. The percentage of poison positives is significantly higher in areas with lower population density, corresponding to rural environments, as well as in areas with greater agricultural and livestock activity.

Adjuvant radiotherapy for low-risk early breast cancer in elderly women: evidence from randomized trials.

Breast cancer is the most common cancer pathology in women in the Western world. The median age at diagnosis is 60 years and in the coming decades it is estimated that the number of elderly women affected reaches an important percentage. This aging of the cancer population, associated with its inherent comorbidities and aggravated by the lack of consensus about the most appropriate treatment, make it difficult to administer an effective postoperative treatment in elderly women with a low-risk profile. An exhaustive geriatric evaluation is a sine qua non condition to opt for a specific type of treatment. To date, several options are available such as endocrine therapy (ET) alone, moderate/high hypofractionation and various accelerated partial breast irradiation (APBI) techniques. In this article, we provide information about each of them.

Diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM): a retrospective study involving 644 breast lesions.

OBJECTIVE: To evaluate the diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM) in comparison with that of full-field digital mammography (FFDM), either alone or accompanied with breast ultrasound (BUS) in a large series of patients/breast lesions (n = 644). PATIENTS AND METHODS: In this retrospective study, five radiologists evaluated the lesions by three imaging modalities: FFDM, FFDM + BUS, and CESM and compared the imaging to the gold standard (histopathology or clinical follow-up). Diagnostic performance parameters and receiver operating characteristic (ROC) curves of CESM were calculated and compared to those of FFDM or FFDM + BUS (McNemar's test). Additionally, the reliability of tumor size measurement by CESM was compared with the histopathological measurement. RESULTS: The study included 218 benign and 426 malignant lesions. 85% of benign and 93% of malignant lesions were adequately identified using CESM. With respect to FFDM and FFDM + BUS, CESM significantly increased sensitivity to 93.2% (+ 10.7% and + 3.4%, respectively); specificity to 84.4% (+ 15.8% and + 1.7%, respectively); PPV to 92.3% (+ 26.8% and + 3.6%, respectively); NPV to 86.0% (+ 1.6% and + 1.8%, respectively); and accuracy to 90.2% (+ 15.8% and + 3.2%, respectively). In the ROC curves analyses, the comparison among the three AUC values was also statistically significant (p < 0.001). Good agreement between tumor diameters measured using CESM and histopathology was observed (Spearman's rank correlation, r = 0.891, p < 0.0001), although this technique tended to produce an overestimation of the size (+ 7 mm). CONCLUSIONS: CESM has high diagnostic accuracy and can be considered as a useful technique for the assessment of breast lesions.

Adult-onset Alexander disease with a heterozygous D128N GFAP mutation: a pathological study.

The various forms of Alexander disease (AD) have been linked to heterozygous point mutations in the coding region of the human Glial Fibrillary Acidic Protein (GFAP) gene. The aim of this study was to confirm and characterise an adult variant of AD based on the presence of Rosenthal fibres, which were identified at brain autopsy. We performed histological and immunohistochemical studies and mutation screening by cycle sequencing of exons 1, 4, 6, and 8. A heterozygous D128N GFAP mutation, previously described in three other cases of adult-onset AD (AOAD), was genetically confirmed. The mutation was seemingly sporadic. Symptoms of the female, 65-year-old patient started with occasionally asymmetric motor impairment and concluded, 23 months later, with a lack of spontaneous movement in all four limbs, reduced consciousness, an acute respiratory problem, and eventually lethal exitus. The most striking characteristics were a cerebellar syndrome with subsequent clinical signs due to brainstem and spinal cord involvement. The final diagnosis was based on a complete autopsy, detection of Rosenthal fibres, GFAP, vimentin, alpha B-crystallin, ubiquitin, hsp27, neurofilament, and synaptophysin, and the identification of the corresponding GFAP gene mutation. Blood analyses were positive for ANA and rheumatoid factor. In conclusion, this work describes sporadic, rapidly advancing AOAD in a female patient and links it with other published cases with the same mutation. Reflections are provided on the influence of vasculitis and ANA in AD as well as the presence of Rosenthal fibres in the neurohypophysis.

A Case of a Concurrent and Co-Located Invasive Carcinoma and a Fibroadenoma to Illustrate the Potential of Dual-Energy, Contrast-Enhanced Digital Mammography on the Diagnosis of Complex Breast Lesions.

Up to 19% of breast malignancies may be missed by conventional imaging techniques, especially when they are concurrent or co-located with other benign lesions. However, more sensitive techniques, such as magnetic resonance imaging (MRI), are often too expensive for routine use in developing countries. Contrast-enhanced, dual-energy digital mammography (CESM) is a recently introduced imaging modality whose performance has been reported to be similar to that of MRI. Being much cheaper, CESM may constitute a good alternative for improving diagnostic sensitivity in these countries. In this paper, we present a challenging case of the concurrent and co-located presentation of a fibroadenoma and a triple negative invasive carcinoma of no special type (TNBC-NST). The malignancy was indistinguishable from the fibroadenoma by mammography. By ultrasound, a suspicious area was observed and biopsied, but the histopathology did not confirm a cancer diagnosis. As the suspicion was not confirmed, a second stage of the imaging diagnosis using CESM was recommended. This technique allowed clear visualization of the malignancy, which was finally excised by breast-conserving surgery. This case reveals the potential of CESM as an easy, rapid and inexpensive new technique for the diagnosis of malignancies that might easily remain occult to mammography plus breast ultrasound (BUS).

Is contrast-enhanced spectral mammography (CESM) helpful in differentiating diabetic mastopathy from breast carcinoma?

Diabetic mastopathy (DM) is a rare benign inflammatory disease of the breast, which nevertheless gives suspicious image of malignancy by breast ultrasound and mammography. MRI studies of this disease have indicated both nonspecific enhancement and non-enhancement of the lesion, depending on its degree of lymphocytic infiltration. This is the first case report discussing the appearances of DM on CESM, a novel mammographic technique.

Continued implication of the banned pesticides carbofuran and aldicarb in the poisoning of domestic and wild animals of the Canary Islands (Spain).

Although nowadays the intentional poisoning of domestic and wild animals is a crime in EU, in the past the poison was used in rural areas of a number of European countries to kill animals that were considered harmful for human activities. In Spain evidences indicate that intentional poisonings continue to occur throughout the entire country nowadays. This situation seems to be of particular concern in the Canary Islands (Spain), where this study was performed. Our results confirmed that 225 animals were poisoned by pesticides over the study period (32 months; 2010-2013). The intentionality of the poisoning was confirmed in 117 cases. It has to be highlighted that the other 108 animals also died by pesticide poisoning, although the intentionality was only suspected. This incidence is currently the highest reported in any region from European Union. The pesticides carbofuran, bromadiolone, brodifacoum and aldicarb were the most frequently detected involved. Among the affected species, it has to be highlighted that endangered species are frequently affected in poisoning incidents. Notably, chemicals banned in the EU (carbofuran and aldicarb) were identified in approximately 75% of cases, and in almost 100% of baits, which suggests that these pesticides are still available to the population. Several circumstances may explain these results. Firstly, little control over the sale and possession of pesticide products, and the potential existence of an illegal market of pesticides banned in the European Union in the neighbouring African continent. In addition, the limited awareness of the population about the dangerousness of these compounds, for the environment, animals, or even people, make the situation very worrying in these islands. Stronger regulations, control of legal and illegal pesticide use, development of educational programs and legal action in poisoning incidents are needed to decrease the impact of pesticide misuse on wildlife and domestic animals.