[Prognosis in elderly patients with falls treated in emergency departments: The EDEN-3 study]. / Pronóstico en pacientes ancianos con caídas atendidos en servicios de urgencias: estudio EDEN-3.

OBJECTIVE: To investigate whether falls in people ≥65 years old are a prognostic factor for adverse events compared to the rest of older patients who consult emergency departments, and identify factors related to a worse long-term evolution. METHOD: EDEN cohort that included patients ≥65 years old. Those patients who consulted for fall and the rest were distinguished. Twelve variables were collected. For comparison: two groups matched by fall propensity score. We compared mortality at one year and combined adverse event post-discharge at one year. In patients with falls, variables independently related to evolution were identified. RESULTS: Two thousand seven hundred and forty-five patients treated for falls and 22,920 for other reasons. Mortality at one year was 14.4% (9.5% vs. 15.0%, respectively, P<.001) and the combined post-discharge adverse event at one year was 60.6% (52.2% vs. 61.7%, respectively, P<.001). In 4748 patients matched by fall propensity score (2372 in each group), the inverse association between consultation for fall and mortality (HR: 0.705, 95% CI: 0.5880.846) and post-discharge combined adverse event (0.758, 0.701-0.820) remained significant. Factors associated with mortality in patients with falls were ≥80 years (2.097, 1.521-2.891) and comorbidity (2.393, 1.574-3.636) while being female was a protective factor (0.758, 0.584-0.985). Between the factors associated with post-discharge combined adverse hospitalization in the index event was a protective factor (0.804, 0.685-0.943). CONCLUSIONS: Patients over 65 years of age treated in the emergency room for falls have a better prognosis. Hospitalization was a protective factor of combined postdischarge adverse event.

Head-space gas chromatography coupled to mass spectrometry for the assessment of the contamination of mayonnaise by yeasts.

Head-space (HS) gas chromatography (GC) coupled to mass spectrometry (MS) is proposed for the assessment of the contamination of mayonnaise as an alternative to plate counting, which is the technique commonly used for evaluating microbial contamination. More specifically, this method was applied in the detection of Candida metapsilosis and Zygosaccharomyces bailii, both of great importance in term of food spoilage since they are resistant to many of the common methods of food preservation. Different chemometric models were investigated using the data obtained by GC-MS (m/z profile, area of the chromatographic peaks and entire chromatographic profile), in order to obtain the highest classification success. The best results were obtained using the chromatographic profile (success rate of 92%). Contaminated samples could also be classified according to the concentration of yeast, obtaining a success rate of 87.5%. Finally, a chemometric model was constructed in an attempt to differentiate between strains.

A GIS model-based assessment of the environmental distribution of gamma-hexachlorocyclohexane in European soils and waters.

The MAPPE GIS based multimedia model is used to produce a quantitative description of the behaviour of gamma-hexachlorocyclohexane (gamma-HCH) in Europe, with emphasis on continental surface waters. The model is found to reasonably reproduce gamma-HCH distributions and variations along the years in atmosphere and soil; for continental surface waters, concentrations were reasonably well predicted for year 1995, when lindane was still used in agriculture, while for 2005, assuming severe restrictions in use, yields to substantial underestimation. Much better results were yielded when same mode of release as in 1995 was considered, supporting the conjecture that for gamma-HCH, emission data rather that model structure and parameterization can be responsible for wrong estimation of concentrations. Future research should be directed to improve the quality of emission data. Joint interpretation of monitoring and modelling results, highlights that lindane emissions in Europe, despite the marked decreasing trend, persist beyond the provisions of existing legislation.

Spatially explicit multimedia fate models for pollutants in Europe: state of the art and perspectives.

A review by Hollander et al. (in preparation), discusses the relative potentials, advantages and shortcomings of spatial and non spatial models of chemical fate, highlighting that spatially explicit models may be needed for specific purposes. The present paper reviews the state of the art in spatially explicit chemical fate and transport modeling in Europe. We summarize the three main approaches currently adopted in spatially explicit modeling, namely (1) multiple box models, (2) numerical solutions of simultaneous advection-dispersion equations (ADE) in air, soil and water, and (3) the development of meta-models. As all three approaches experience limitations, we describe in further detail geographic information system (GIS)-based modeling as an alternative approach allowing a simple, yet spatially explicit description of chemical fate. We review the input data needed, and the options available for their retrieval at the European scale. We also discuss the importance of, and limitations in model evaluation. We observe that the high uncertainty in chemical emissions and physico-chemical behavior in the environment make realistic simulations difficult to obtain. Therefore we envisage a shift in model use from process simulation to hypothesis testing, in which explaining the discrepancies between observed and computed chemical concentrations in the environment takes importance over prediction per se. This shift may take advantage of using simple models in GIS with residual uses of complex models for detailed studies. It also calls for tighter joint interpretation of models and spatially distributed monitoring datasets, and more refined spatial representation of environmental drivers such as landscape and climate variables, and better emission estimates. In summary, we conclude that the problem is not "how to compute" (i.e. emphasis on numerical methods, spatial/temporal discretization, quantitative uncertainty and sensitivity analysis...) but "what to compute" (i.e. emphasis on spatial distribution of emissions, and the depiction of appropriate spatial patterns of environmental drivers).

A GIS model-based screening of potential contamination of soil and water by pyrethroids in Europe.

The paper presents a geographic information system (GIS) model-based approach for analysis of potential contamination of soil and water by pyrethroids for the European continent. Pyrethroids are widely used pesticides and their chemical and toxicological characteristics suggest there may be concerns about human health and ecosystems, although so far there is no strong evidence indicating actual risk. However, little monitoring has been conducted and limited experimental information is available. We perform an assessment exercise that demonstrates how accessible information and GIS-based modeling allow to estimate the spatial distribution of chemical concentrations and fluxes at a screening level. The assessment highlights potential hot spots and the main environmental transport pathways, in a quick and simple way. By combining information on pesticide use, crop distribution and landscape and climate parameters we identify potential problem areas to help focusing monitoring campaigns. The approach presented here is simple and fast, and can be applied to virtually all pesticide classes used over a large domain, and is therefore suitable for the screening of large quantities of chemicals, of which the majority has not undergone any systematic environmental monitoring program. The method has been tested through benchmarking with other well-established models. However, further research is needed to evaluate it against experimental observations.