High serum nitrates levels in non-survivor COVID-19 patients.

OBJECTIVE: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. DESIGN: A prospective observation study was carried out. SETTING: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). PATIENTS: COVID-19 patients admitted to the ICU. INTERVENTIONS: Determination of serum nitrate levels at ICU admission. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006-1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006-1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73-92%; p<0.001), APACHE II (AUC=85%; 95%CI=75-96%; p<0.001) and SOFA (AUC=78%; 95%CI=63-92%; p=0.005) based on the DeLong method. The Kaplan-Meier analysis found patients with serum nitrates levels>68.4µmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3-863.9; p<0.001). CONCLUSIONS: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

Food nitrates and nitrites as possible causes of cancer: A review / Nitratos y nitratos alimentarios como posibles causas de cáncer: una revisión / Nitratos e nitratos dietéticos como possíveis causas de câncer: uma revisão

SUMMARY Introduction: Nitrates and nitrites can be found in meat and dairy products, vegetables, and fruits. The consumption of these preservatives has been associated with the emergence of gastric, colorectal cancer and non-Hodgkin's lymphoma, although studies are still inconclusive. Methodology: It is a review of literature of the narrative type, in which there was a recovery of articles published in English and Portuguese, in the databases SciELO, Lilacs, Science Direct and Capes journals. Articles related to nitrates and nitrites in foods were included, as well as articles that correlated the consumption of these preservatives with the appearance of cancers, regardless of the year of publication, although articles published between the years 2009 to 2019 were prioritized. Results: Nitrates and nitrites are generally associated with industrialized food products; therefore, it is possible to observe the presence of these salts in a wide variety of foods. The excessive consumption of nitrates and nitrites, whether through water or food, has been associated with a great diversity of diseases, stimulating the development of several studies investigating, including, the correlation between the consumption of these preservatives and the appearance of cancers. Conclusion: It is observed that nitrates and nitrites form compounds with a carcinogenic potential, making them interesting to avoid excessive consumption of these preservatives.

RESUMEN Introducción: Los nitratos y nitritos pueden ser encontrados en carnes y productos lácteos, verduras y frutas. El consumo de estos conservantes ha sido asociado con la aparición de cáncer gástrico, colorrectal y linfoma no Hodgkin, aunque los estudios aún no son concluyentes. Metodología: Se hizo una revisión de tipo narrativo de la literatura, en la que se recuperaron artículos publicados en inglés y portugués, en las bases de datos SciELO, Lilacs, Science Direct y revistas Capes. Se incluyeron artículos relacionados con nitratos y nitritos en alimentos, así como artículos que correlacionaban el consumo de estos conservantes con la aparición de cánceres, independientemente del año de publicación, aunque se priorizaron artículos publicados entre los años 2009 a 2019. Resultados: Los nitratos y nitritos se asocian generalmente con productos alimenticios industrializados; por tanto, es posible observar la presencia de estas sales en una amplia variedad de alimentos. El consumo excesivo de nitratos y nitritos, ya sea a través del agua o de los alimentos, se ha asociado a una gran diversidad de enfermedades, estimulando el desarrollo de varios estudios que investigan, entre ellos, la correlación entre el consumo de estos conservantes y la aparición de cánceres. Conclusión: Así, se observa que los nitratos y nitritos, forman compuestos con potencial carcinogénico, por lo que resulta interesante evitar el consumo excesivo de estos conservantes.

RESUMO Introdução: Nitratos e nitritos podem ser encontrados em carnes e laticínios, vegetais e frutas. O consumo desses conservantes tem sido associado ao desenvolvimento de câncer gástrico e colorretal e linfoma não Hodgkin, embora os estudos ainda não sejam conclusivos. Metodologia: Trata-se de uma revisão de literatura do tipo narrativa, na qual houve a recuperação de artigos publicados em inglês e português, nas bases de dados SciELO, Lilacs, Science Direct e Periódicos Capes. Foram incluídos artigos relacionados a nitratos e nitritos em alimentos, bem como artigos que correlacionassem o consumo desses conservantes com o aparecimento de cânceres, independentemente do ano de publicação, embora tenham sido priorizados os artigos publicados entre os anos de 2009 a 2019. Resultados: Nitratos e nitritos são geralmente associados a produtos alimentícios industrializados; portanto, é possível observar a presença desses sais em uma grande variedade de alimentos. O consumo excessivo de nitratos e nitritos, seja pela água ou pelos alimentos, tem sido associado a uma grande diversidade de doenças, estimulando o desenvolvimento de diversos estudos que investiguem, inclusive, a correlação entre o consumo desses conservantes e o aparecimento de cânceres. Conclusão: Assim, observa-se que nitratos e nitritos formam compostos com potencial carcinogê-nico, por isso é interessante evitar o consumo excessivo desses conservantes.

High serum nitrates levels in non-survivor COVID-19 patients.

OBJECTIVE: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. DESIGN: A prospective observation study was carried out. SETTING: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). PATIENTS: COVID-19 patients admitted to the ICU. INTERVENTIONS: Determination of serum nitrate levels at ICU admission. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006-1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006-1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73-92%; p<0.001), APACHE II (AUC=85%; 95%CI=75-96%; p<0.001) and SOFA (AUC=78%; 95%CI=63-92%; p=0.005) based on the DeLong method. The Kaplan-Meier analysis found patients with serum nitrates levels>68.4µmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3-863.9; p<0.001). CONCLUSIONS: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

Vigilancia de nitritos y nitratos presentes en salchichas expendidas en los mercados: Rodríguez y Villa Fátima de la ciudad de La Paz / Surveillance of nitrites and nitrates present in sausages expended in the markets: Rodríguez y Villa Fátima de La Paz city

INTRODUCCIÓN: los Nitritos y Nitratos son aditivos alimentarios utilizados como con-servadores de productos cárnicos, los nitritos proporcionan un color característico rojizo en salchichas, pero también son reconocidos como un agente cancerígeno. Esta es la razón por la que el límite máximo de aceptación de Nitritos es de 125 mg NaNO2/Kg muestra. OBJETIVO: realizar una vigilancia de nitritos y nitratos presentes en las salchichas expendidas en los mercados Rodríguez y Villa Fátima de la ciudad de La Paz. MÉTODO: para la determinación de nitritos se usó el método de Espectrofotometría UV/Vis según los requisitos exigidos Norma Boliviana. RESULTADOS: en el estudio realizado de vigilancia se pudo observar que un 12% de las muestras no cumplen con el parámetro establecido de máximo 125 mg NaNO2/Kg muestra según Norma Boliviana y el Código Alimentario Argentino (C.A.A.) sin embargo el 88% de las muestras analizadas si cumplen con este pará-metro. El porcentaje promedio de humedad en las muestras fue de 60,34% y el promedio de pH fue de 5,92 aplicando la metodología de Norma Boliviana para productos cárnicos. CONCLUSIONES: en la determinación de Humedad y pH, la totalidad de las muestras cumplieron con los requisitos de aceptación para ambos parámetros. Sin embargo en el caso de la determinación de Nitritos, se encontraron muestras que contienen valores por encima de los valores de referencia por lo que es importante que los entes oficiales de control realicen vigilancias rutinarias a salchichas que son expendidas en ambos mercados, con el fin de que el aditivo Nitrito de sodio o Nitrito de potasio sean utilizados de acuerdo a lo establecido evitando de esta manera problemas de salud a los consumidores.

Introduction: nitrites and nitrates are food additives used as preservatives in meat pro-ducts, nitrites provide a characteristic reddish color in sausages, but they are also recognized as a carcinogenic agent. This is the reason why the maximum acceptance limit for nitrites is 125 mg NaNO2 / Kg sample. Objective: to carry out a surveillance of nitrites and nitrates present in the sausages sold in the Rodríguez and Villa Fatima markets of the city of La Paz. METHOD: for the determination of nitrites, the UV / Vis spectrophotometry method was used according to the requirements of the Bolivian Standard Results: In the surveillance study carried out it was observed that 12% of the samples do not comply with the established parameter of maximum 125 mg NaNO2 / Kg sample according to the Bolivian Norm and the Argentine Food Code (CAA), however 88% of the samples analyzed if they meet this parameter. The average percentage of moisture in the samples was 60.34% and the average pH was 5.92 applying the Bolivian Standard methodology for meat products. RESULTS: in the surveillance study carried out it was observed that 12% of the samples do not comply with the established parameter of maximum 125 mg NaNO2 / Kg sample according to the Bolivian Norm and the Argentine Food Code (CAA), however 88% of the samples analyzed if they meet this parameter. The average percentage of moisture in the samples was 60.34% and the average pH was 5.92 applying the Bolivian Standard methodology for meat products. CONCLUSIONS: in the determination of humidity and pH, all of the samples met the acceptance requirements for both parameters. However, in the case of Nitrite determination, samples were found that contain values above the reference values, so it is important that the official control entities carry out routine surveillance of sausages that are sold in both markets, in order to that the additive Sodium Nitrite or Potassium Nitrite are used according to what is established, thus avoiding health problems for consumers.

Marcadores de estrés oxidativo en pacientes con esclerosis múltiple durante un brote y su remisión / Oxidative stress markers in patients with multiple sclerosis during an outbreak and its remission / Marcadores de estresse oxidativo em pacientes com esclerose múltipla durante um surto e sua remissão

La esclerosis múltiple remitente-recurrente (EM-RR) es una enfermedad desmielinizante del sistema nervioso central. A fin de entender la asociación del estrés oxidativo a nivel periférico con la recaída de la enfermedad se determinaron los niveles de marcadores de estrés oxidativo en plasma de pacientes en la recaída o brote y una semana después de la misma. Se analizaron muestras de 60 personas (20 pacientes con recaída, 20 pacientes sin recaída y 20 controles sanos). Se cuantificaron mediante métodos espectrofotométricos las actividades enzimáticas de óxido nítrico sintasa (ONS), glutatión peroxidasa (GPx), los niveles de lipoperóxidos y nitritos-nitratos y la fluidez de membrana. En el brote de la enfermedad aumentan significativamente los niveles de las actividades enzimáticas de ONS y GPx y los niveles de nitritos-nitratos y lipoperóxidos (p<0,01 en todos los casos), al ser comparados con los de individuos sanos. Dichos parámetros disminuyeron significativamente una semana después de iniciado el brote. Además, los parámetros evaluados se mantuvieron elevados en pacientes que no experimentaron un brote de la enfermedad cuando se los comparó con individuos sanos. La fluidez de membrana en los pacientes con y sin brote fue similar a la de los controles. En conclusión, el estrés oxidativo es un componente importante en los pacientes con esclerosis múltiple.

Recurrent-remitting multiple sclerosis (RR-MS) is a demyelinating disease of the central nervous system. In order to understand the association of oxidative stress at the peripheral level with the relapse of the disease, the levels of oxidative stress markers in plasma of patients in the relapse or outbreak and one week after relapse were determined. Samples of 60 subjects were analyzed (20 patients in relapse, 20 patients without relapse, and 20 healthy controls). The enzymatic activities of nitric oxide synthase (NOS), glutathione peroxidase (GPx), lipoperoxides and nitrite-nitrate levels and membrane fluidity were quantified by spectrophotometric methods. In relapse, the levels of enzymatic activities of NOS and GPx, and the levels of lipoperoxides and nitrites-nitrates were significantly increased (p<0.01, in all cases), compared with healthy individuals. These parameters decreased significantly 1 week after the start of the outbreak. In addition, the parameters evaluated remained high in patients who did not experience an outbreak of the disease compared to healthy subjects. The membrane fluidity in the patients with and without outbreak was similar to that of the controls. In conclusion, oxidative stress is an important component in patients with multiple sclerosis.

A esclerose múltipla recorrente-remitente (EM-RR) é uma doença desmielinizante do sistema nervoso central. Para compreender a associação do estresse oxidativo a nível periférico com a recaída da doença foram determinados os níveis de marcadores de estresse oxidativo em plasma de doentes na recaída ou surto e uma semana após a recaída. Foram analisadas a amostras de 60 pessoas (20 pacientes com recaída, 20 pacientes sem recaída e 20 controles saudáveis). As atividades enzimáticas de óxido nítrico sintase (ONS), glutationa peroxidase (GPX), os níveis de lipoperóxidos e nitritos-nitratos e a fluidez de membrana foram quantificadas por métodos espectrofotométricos. No surto da doença aumentam em forma significativa os níveis da atividade enzimática de ONS e GPX, e os níveis de nitritos-nitratos e lipoperóxidos (p<0,01 em todos os casos), em comparação com os indivíduos saudáveis. Esses parâmetros diminuíram significativamente uma semana após o início do surto. Além disso, os parâmetros avaliados permaneceram elevados em pacientes que não experimentaram um surto da doença quando comparados com indivíduos saudáveis. A fluência de membrana nos pacientes com e sem surto foi semelhante à dos controles. Em conclusão, o estresse oxidativo é um componente importante nos pacientes com esclerose múltipla.

Efectos de nitratos y sacarosa en la propagación in vitro de tres variedades de papa nativa / Effect of nitrates and sucrose on the in vitro propagation of three cultivars of venezuelan potatos

RESUMEN En Venezuela es prioridad rescatar las papas nativas por representar un gran alimento y un valioso recurso genético. Pero, desafortunadamente estas papas fueron desplazadas por variedades comerciales introducidas y las pocas semillas existentes están degeneradas y reutilizadas en continuos ciclos de siembra, No obstante, estandarizar las condiciones del cultivo aséptico es garantía de "semillas" rehabilitadas con mejor calidad fitosanitaria. Se planteó, entonces investigar el efecto de distintas concentraciones de nitratos y sacarosa en la propagación in vitro de variedades venezolanas ̀̀Cucubaʹ ̀̀Arbolona Negraʹ y ̀̀Rosadaʹ. Segmentos uninodales fueron cultivados e incubados en fotoperíodo de16 horas de luz (76 μmol m-2 s-1) y temperatura 19º C ± 1. Fue implementado el diseño estadístico factorial, estableciendo tres tratamientos partiendo del medio básico Murashige & Skoog (MS), sólido. Hubo un efecto significativo entre los tratamiento, al menos una de las medias es diferente a las otras, para las tres variedades la mayor inducción de crecimiento ocurrió, al modificar MS aumentando sus concentraciones de nitrato de amonio a 1,98 g L-1, nitrato de potasio 2,28 g L-1y bajando sacarosa a 20 g L-1, los vástagos desarrollaron 5,82 cm. de longitud promedio y las raíces 3 cm. Mientras, el MS (tratamiento control), presentó vástagos de 2,94cm. longitud promedio y sin enraizar. Entre las variedades ̀̀Cucuba´ obtuvo el mayor crecimiento. Posteriormente, las vitroplántulas resultantes, tratadas en MS líquido, con sacarosa al 8 % fueron inducidas a producir microtubérculos a los 90 días. Obteniendo así resultados prometedores para la propagación in vitro de las papas nativas.

ABSTRACT The recovery of native potato varieties is a current priority in Venezuela, given their value as a genetic resource of high nutritional quality. Unfortunately, native potato varieties were progressively replaced by exotic commercial, varieties. To date, the limited existing germplasm of native potato varieties is impoverished and of low quality, due to its continual reutilization in crop cycles. Nevertheless, efforts can be made to recover and standardize the production of quality propagules under adequate sanitary conditions. The aim of this study was to assay the effect of varying concentrations of nitrates and saccharose in tissue culture media of three Venezuelan varieties "Cucuba", "Arbolona Negra" and "Rosada". Unimodal segments were planted and incubated using a photoperiod of 16 h light (76 μmol photon m-2 s-1) at 19 ± 1 ºC. The experiment was designed following a standard factor analysis, consisting of three treatments, parting from the basic Murashige & Skoog (MS) medium and data were submitted to an multifactor ANOVA. Our findings indicate significant statistical differences amongst all of the treatments assayed, confirming that all of the varieties reached maximum physiological response under increasing concentrations of nitrates. Such was the case with 1.98 g L-1 ammonium nitrate and 2.28 g L-1 potassium nitrate using a concentration of saccharose 20g L-1. Mean shoot and root lengths under optimal concentrations were 5.82 cm and 3.0 cm, respectively. In contrast, MS basic culture media represented the treatment of least growth induction; yielding un rooted shoots of a mean length of 2.94 cm. Of these three native varieties, "Cucuba" proved to have the highest growth rates. All of the Vitroplantlets were then transferred to liquid MS media, with a saccharose concentration of 8 %, originating microtubers after 90 days. We conclude that these findings may be of use for massive in vitro production of native potato varieties.

Metahemoglobinemia relacionada con ingesta de puré de acelgas / Methemoglobinemia due to ingestion of chard puree

La metahemoglobinemia es un síndrome clínico dado por la presencia de una forma aberrante de hemoglobina, ocasionada por diversos agentes oxidantes. Se describe un caso clínico de metahemoglobinemia severa asociada a la ingesta de puré de acelgas con alto contenido en nitratos y nitritos. Paciente de un año, con antecedentes de comunicación interauricular (CIA), que presentó un cambio en coloración de la piel 7 h antes, en forma progresiva, acompañado de vómitos. Ingresó al Departamento de Emergencia con cianosis generalizada que no mejoró con oxigenoterapia, taquicardia y tendencia a hipotensión arterial. En cuidados intensivos se realizó ecocardiograma que evidenció CIA sin repercusión hemodinámica. Metahemoglobinemia 37%. Se realizó dosis de azul de metileno al 1% por vía intravenosa, con franca mejoría clínica a la hora de la administración del antídoto y descenso de niveles de metahemoglobina. Alta médica a las 36 horas del ingreso. Existía una relación cronológica entre la exposición a nitratos por ingesta de un puré de acelgas y la aparición del cuadro. Los niveles de nitratos hallados en dicho alimento fueron muy elevados considerando estándares internacionales, lo que sumado a una inadecuada conservación del alimento cocido los días previos, permitió confirmar el planteo etiológico realizado. Resulta importante sospechar esta entidad patológica poco frecuente frente a cianosis que no mejora con oxígeno, y prevenir cuadros similares al descrito mediante una adecuada manipulación y conservación de las verduras con alto contenido en nitratos.

Methemoglobinemia is a clinical syndrome due to the presence of an aberrant form of hemoglobin, caused by various oxidizing agents. The study reports a case of severe methemoglobinemia associated with the ingestion of chard puree with high levels of nitrates and nitrites. A 1-year-old patient with a history of atrial septal defect (ASD), who progressively showed change of skin color 7 hours earlier, accompanied by vomiting. She was admitted to the Emergency Department with generalized cyanosis not improving with oxygen therapy, tachycardia and tendency to hypotension. In the intensive care unit, an echocardiogram showed ASD without hemodynamic complications. Methemoglobinemia 37%. A 1% methylene blue dose was administered intravenously, with clinical improvement one hour after antidote administration and decrease in methemoglobin levels. Medical discharge at 36 hours of admission. There was a chronological relationship between nitrates exposure by ingestion of chard puree and the clinical onset of methemoglobinemia. The toxic cause was confirmed after high nitrates levels were found in this vegetable considering international standards, and an inadequate preservation of the cooked chard on previous days. It is important to suspect this rare pathological entity when cyanosis fails to improve with oxygen, and to prevent poisonings similar to those described by an adequate manipulation and preservation of vegetables with high nitrate levels.

Effects of Nitrate Intake on Myocardial Ischemia-Reperfusion Injury in Diabetic Rats / Efeitos do Consumo de Nitrato na Lesão de Isquemia-Reperfusão Miocárdica em Ratos Diabéticos

Abstract Background: Coronary artery disease is 2-3 times more common in diabetic individuals. Dietary nitrate/nitrite has beneficial effects in both diabetes and cardiovascular disease. It also has protective effects against myocardial ischemia-reperfusion (IR) injury in healthy animals. However, the effects of nitrate on myocardial IR injury in diabetic rats have not yet been investigated. Objective: We examined the effects of dietary nitrate on myocardial IR injury in streptozotocin-nicotinamide-induced diabetic rats. Method: Rats were divided into four groups (n=7 in each group): control, control+nitrate, diabetes, and diabetes+nitrate. Type 2 diabetes was induced by injection of streptozotocin and nicotinamide. Nitrate (sodium nitrate) was added to drinking water (100 mg/L) for 2 months. The hearts were perfused in a Langendorff apparatus at 2 months and assessed before (baseline) and after myocardial IR for the following parameters: left ventricular developed pressure (LVDP), minimum and maximum rates of pressure change in the left ventricle (±dP/dt), endothelial nitric oxide (NO) synthase (eNOS) and inducible NO synthase (iNOS) mRNA expression, and levels of malondialdehyde (MDA) and NO metabolites (NOx). Results: Recovery of LVDP and ±dP/dt was lower in diabetic rats versus controls, but almost normalized after nitrate intake. Diabetic rats had lower eNOS and higher iNOS expression both at baseline and after IR, and dietary nitrate restored these parameters to normal values after IR. Compared with controls, heart NOx level was lower in diabetic rats at baseline but was higher after IR. Diabetic rats had higher MDA levels both at baseline and after IR, which along with heart NOx levels decreased following nitrate intake. Conclusion: Dietary nitrate in diabetic rats provides cardioprotection against IR injury by regulating eNOS and iNOS expression and inhibiting lipid peroxidation in the heart.

Resumo Fundamentos: A doença arterial coronariana é duas a três vezes mais comum em indivíduos diabéticos. O nitrato/nitrito dietético tem efeitos benéficos tanto para o diabetes quanto para a doença cardiovascular, assim como efeitos protetores contra a lesão de isquemia-reperfusão (IR) miocárdica em animais saudáveis. Porém, os efeitos do nitrato na lesão de IR miocárdica em ratos diabéticos ainda não foram investigados. Objetivos: Foram examinados os efeitos sobre a lesão de IR miocárdica da adição de nitrato à dieta de ratos com diabetes mellitus tipo 2 induzido por estreptozotocina-nicotinamida. Métodos: Os ratos foram divididos em quatro grupos (n = 7 em cada grupo): controle, controle+nitrato, diabetes e diabetes+nitrato. O diabetes foi induzido nos animais por injeção de estreptozotocina e nicotinamida. Nitrato (nitrato de sódio) foi adicionado à água de beber (100 mg/L) por 2 meses. Os corações foram perfundidos em sistema de Langendorff aos 2 meses e avaliados antes (basal) e após IR miocárdica em relação aos seguintes parâmetros: pressão desenvolvida no ventrículo esquerdo (PDVE), taxas máximas de variação positiva e negativa da pressão ventricular esquerda (±dP/dt), expressão do RNAm da óxido nítrico (NO) sintase (NOS) endotelial (eNOS) e da NOS induzível (iNOS), além de níveis de malondialdeído (MDA) e metabólitos do óxido nítrico (NOx). Resultados: A recuperação da PDVE e ±dP/dt foi inferior nos ratos diabéticos versus controles, mas quase normalizou após ingestão de nitrato. Ratos diabéticos apresentaram expressão diminuída de eNOS e aumentada de iNOS tanto no estado basal quanto após IR, e o consumo dietético de nitrato restaurou estes valores para o estado normal após a IR. O nível de NOx cardíaco foi menor nos ratos diabéticos em comparação aos controles no momento basal, mas foi superior após a IR. Ratos diabéticos apresentaram níveis mais elevados de MDA tanto no estado basal quanto após IR que, juntamente com os níveis cardíacos de NOx, reduziram após consumo dietético do nitrato. Conclusões: O consumo dietético de nitrato por ratos diabéticos ofereceu cardioproteção contra a lesão de IR através da regulação da expressão de eNOS e iNOS e inibição da peroxidação lipídica no coração.

Concentración de nitritos y nitratos en embutidos elaborados en Misiones y su relación con el crecimiento de Anaerobios reductores de sulfito / Concentration of nitrites and nitrates in sausages made in Misiones and its relationship with the growth of sulfite-reducing anaerobes

Los nitritos y nitratos son conservantes alimentarios utilizados para evitar la proliferación de micoorganismos anaerobios, incluido Clostridium botulinum, que produce la toxina causante del botulismo, enfermedad transmitida por alimentos con alta letalidad. Asimismo estos conservantes pueden tener efectos tóxicos agudos, causando en el consumidor metahemoglobinemia como en el caso de los nitratos, y efectos crónicos, mediante formación de nitrosaminas en el caso de los nitritos, consideradas potentes carcinógenos, por lo que deben usarse bajo límites establecidos en la legislación. El objetivo de esta investigación fue determinar la concentración de nitratos y nitritos en embutidos elaborados en la provincia de Misiones, Argentina, y su relación con el crecimiento de anaerobios reductores de sulfito. El estudio fue descriptivo de corte transversal. Tras determinación de tamaño muestral y selección aleatoria de participantes, previo consentimiento de los elaboradores, se tomaron muestras de embutidos elaborados en la provincia de Misiones con posterior determinación de nitratos y nitritos y recuento de anaerobios reductores de sulfito en el Laboratorio, mediante metodología oficial. De 58 muestras estudiadas, solo una (1,7%) excedió el límite establecido para la concentración de Nitritos y ninguna para las concentraciones de Nitratos. En cuanto a la relación entre el crecimiento de bacterias anaerobias reductoras de sulfito y la concentración de nitrito, se observó que hay una relación inversamente proporcional entre las mismas demostrado estadísticamente (χ2 = 31.48 y p < 0.05). Estos resultados contribuyeron al conocimiento sobre los parámetros antes descritos, al desarrollo de estrategias tanto de vigilancia como de asesoramiento hacia los elaboradores, con la finalidad de lograr un mejoramiento de las buenas prácticas de manufactura y de la elaboración de los embutidos en la provincia

Influence of Intravenous Nitrate Treatment on Early Mortality Among Patients With Acute Heart Failure. NITRO-EAHFE Study.

INTRODUCTION AND OBJECTIVES: There is little evidence on the prognostic influence of intravenous nitrates in patients with acute heart failure. Our purpose was to determine the influence of this treatment on early mortality and new visits. METHODS: Prospective, multicenter cohort study of patients with acute heart failure in an emergency room during 2 periods (May 2009 and November-December 2011). Patients with systolic blood pressure > 110mmHg were included, grouped according to whether they received intravenous nitroglycerin or not. Endpoints were mortality at 3, 7, 14, and 30 days and new visits at 30 days. The propensity score was estimated by logistic regression to determine the prognostic influence of the treatment. RESULTS: We included 3178 of 4897 individuals. A total of 308 (9.7%) had died within 30 days and 465 (17%) attended new visits. The mean (standard deviation) age was 79.5 (10.0) years, and 796 (25%) patients received intravenous nitrates. After matching, there were 685 individuals in each group. The hazard ratio for 30-day mortality with nitrates was 1.21 (95% confidence interval, 0.87-1.70) and was 0.93 for new visits (95% confidence interval, 0.71-1.22). The results were similar for mortality at 3, 7, and 14 days (hazard ratio = 1.05 [95% confidence interval, 0.56-1.96], hazard ratio = 1.20 [95% confidence interval, 0.74-1.94], and hazard ratio = 1.23 [95% confidence interval, 0.82-1.84], respectively). In the presence of hypertensive pulmonary edema, the nitrates group showed a hazard ratio of 0.88 (95% confidence interval, 0.47-1.63) for 30-day mortality. CONCLUSIONS: Intravenous nitrates do not influence early mortality or new visits in patients with acute heart failure.

Asociación entre niveles de proteína C-reactiva y óxido nítrico con el pronóstico de pacientes con infarto cerebral agudo / Association of C-reactive protein and nitric oxide levels with the prognosis of acute ischemic stroke

Introducción: La inflamación y alteraciones en la biodisponibilidad del óxido nítrico (NO) han sido involucradas en la fisiopatología de la enfermedad cerebrovascular. Objetivo: El objetivo del estudio fue determinar el valor pronóstico de la medición de metabolitos del NO y marcadores inflamatorios en pacientes con infarto cerebral agudo. Materiales y métodos: Se incluyeron 158 pacientes con diagnóstico de infarto cerebral agudo en un estudio observacional de cohorte. Entre 48 y 72 horas del inicio de los síntomas se tomó una muestra de sangre para determinación del perfil bioquímico, marcadores inflamatorios (PCR, IL1-β, IL6, TNF-α) y nitritos/nitratos plasmáticos. Se realizó seguimiento durante 2 años para determinar la aparición de un nuevo evento (infarto cerebral, infarto de miocardio, falla cardiaca) o muerte de origen vascular. Un análisis de regresión multivariada de Cox permitió determinar los factores asociados independientemente con el desenlace. Resultados: La edad promedio fue 70,5 ± 12,8 años. El 39,2% de los sujetos incluidos presentó el desenlace durante los primeros 24 meses de seguimiento. Los niveles de PCR > 12 mg/L (HR 2,22, IC 95% 1,07-4,59) y el puntaje > 13 en la escala NIHSS al ingreso (HR 2,81 IC 95% 1,46-5,41) se encontraron significativamente asociados con mayor riesgo de presentar un nuevo evento. La combinación de niveles de PCR < 12 mg/L y nitritos/nitratos < 35,5 µmol/L se identificó como un factor protector (HR 0,21, IC 95% 0,06-0,71). Conclusión: Este estudio sugiere que la determinación de nitritos/nitratos en conjunto con los niveles de PCR puede ser de utilidad para estratificar el riesgo de nuevos eventos en pacientes con infarto cerebral agudo.

Introduction: Inflammation and alterations in the bioavailability of nitric oxide (NO) have been involved in the pathophysiology of cerebrovascular disease. Objective: The aim of the study was to determine the prognostic value of measuring NO metabolites and inflammatory markers in patients with acute ischemic stroke. Materials and methods: A total of 158 patients with acute ischemic stroke were included in an observational cohort study. Between 48 and 72 hours post admission, a fasting blood sample was taken to determine the biochemical profile, inflammatory markers (CRP, IL1-β, IL6, TNF-α) and nitrites/nitrates plasma levels. The cohort's follow-up was conducted for two years to determine the occurrence of a new event (stroke, myocardial infarction, heart failure) or death of vascular origin. Comparisons between groups were made using the log-rank test. A Cox multivariate regression analysis permitted to determine factors independently associated with the outcome. Result: The mean age was 70.5 ± 12.8 years. 39.2% of the subjects presented the outcome during the first 24 months of follow-up. CRP levels > 12 mg/L (HR 2.22, 95% CI 1.07-4.59) and a score > 13 on the NIHSS scale at admission (HR 2.81 95% CI 1.46-5.41) were significantly associated with an increased risk of a new event. The combination of CRP levels < 12 mg/L and nitrites/nitrates levels < 35.5 mmol/L was identified as a protective factor (HR 0.21, 95% CI 0.06-0.71). Conclusion: This study demonstrates that the determination of CRP and NOx levels could be beneficial in clinical practice to stratify the risk of future events or death of vascular origin in acute ischemic stroke patients.

[Nitrate concentrations in tap water in Spain]. / Contenido en nitratos de aguas de consumo público españolas.

OBJECTIVE: To determine nitrate concentrations in drinking water in a sample of Spanish cities. MATERIAL AND METHODS: We used ion chromatography to analyze the nitrate concentrations of public drinking water in 108 Spanish municipalities with more than 50,000 inhabitants (supplying 21,290,707 potential individuals). The samples were collected between January and April 2012. The total number of samples tested was 324. RESULTS: The median nitrate concentration was 3.47 mg/L (range: 0.38-66.76; interquartile range: 4.51). The water from 94% of the municipalities contained less than 15 mg/L. The concentration was higher than 25mg/L in only 3 municipalities and was greater than 50mg/L in one. CONCLUSIONS: Nitrate levels in most public drinking water supplies in municipalities inhabited by almost half of the Spanish population are below 15 mg/L.

Combinaciones de bases nutritivas empleadas en el desarrollo del medio caldo nitrato / Nutritional bases combinations used in the development of nitrate broth medium

INTRODUCCIÓN: el medio caldo Nitrato es utilizado en los laboratorios de microbiología clínica como prueba bioquímica para la identificación de enterobacterias por la capacidad que tienen estos microorganismos para reducir los nitratos a nitrito. OBJETIVO: evaluar diferentes combinaciones de bases nutritivas destinadas al desarrollo del medio de cultivo. MÉTODOS: se seleccionó como material biológico un conjunto de cepas certificadas y aisladas pertenecientes a especies representativas de varios géneros de la familia de Enterobacteriaeceae. Se diseñaron cinco variantes y se utilizó como bases nutritivas la peptona de gelatina y el extracto de carne, en diferentes combinaciones y concentraciones, para determinar el incremento de absorbancia en el tiempo como indicador de la densidad microbiana y se calculó la velocidad de crecimiento. Se evaluó la capacidad funcional del medio de cultivo por la habilidad de las especies de reducir o no el nitrato a nitrito. RESULTADOS: la mejor combinación de bases nutritivas correspondió a la de mayor concentración de peptona de gelatina (10 g/L) y extracto de carne (3 g/L). La evaluación organoléptica y fisicoquímica del medio de cultivo mostró características satisfactorias para este tipo de producto. Se comprobó la reducción satisfactoria del nitrato a nitrito, por los microorganismos empleados como control positivo. CONCLUSIONES: el medio de cultivo caldo nitrato desarrollado, cumple con los requisitos de calidad y su funcionalidad microbiológica y permite la caracterización de especies bacterianas que poseen la capacidad de reducir los nitratos a nitritos.

INTRODUCTION: the nitrate broth culture medium is used in clinical microbiology laboratories as a biochemical test for the identification of Enterobacteriaceae by the ability of these microorganisms to reduce nitrate to nitrite. OBJECTIVE: to evaluate different combinations of nutritive bases for the development of the culture medium. METHODS: certificed strains were selected as biological test material. The strains belong to different generu of the Enterobactericiae family. Five variants were designed with gelatin peptone and meat extract as nutrient bases at different concentrations and combinations, the growth rate was calculated by measuring the increase in absorbance over time as an indicator of microbial density. The functionality of the culture medium was evaluated by the ability of tested bacteria or reduce nitrate to nitrite RESULTS: the best combination of nutritive bases contained the highest concentration of gelatin peptone (10 g/L) and beef extract (3 g/L). Physicochemical and sensory evaluation of the culture medium showed results characteristic for this type of product. Reductions of nitrate to nitrite were observed for all tested microorganisms choosed as the positive control. CONCLUSIONS: the nitrate broth culture medium developed complies the quality requiment and its microbiological functionality allows the characterization of bacterial species by the ir ability to reduce nitrate to nitrite

Combinaciones de bases nutritivas empleadas en el desarrollo del medio caldo nitrato / Nutritional bases combinations used in the development of nitrate broth medium

Introducción: el medio caldo nitrato es utilizado en los laboratorios de microbiología clínica como prueba bioquímica para la identificación de enterobacterias por la capacidad que tienen para reducir los nitratos a nitrito. Objetivo: evaluar diferentes combinaciones de bases nutritivas destinadas al desarrollo del medio de cultivo. Métodos: se seleccionó como material biológico un conjunto de cepas certificadas y aisladas pertenecientes a especies representativas de varios géneros de la familia de Enterobacteriaeceae. Se diseñaron cinco variantes y se utilizó como bases nutritivas la peptona de gelatina y el extracto de carne, en diferentes combinaciones y concentraciones, para determinar el incremento de absorbancia en el tiempo como indicador de la densidad microbiana y se calculó la velocidad de crecimiento. Se evaluó la capacidad funcional del medio de cultivo por la habilidad de las especies de reducir o no el nitrato a nitrito. Resultados: la mejor combinación de bases nutritivas correspondió a la de mayor concentración de peptona de gelatina (10 g/L) y extracto de carne (3 g/L). La evaluación organoléptica y fisicoquímica del medio de cultivo mostró características satisfactorias para este tipo de producto. Se comprobó la reducción satisfactoria del nitrato a nitrito, por los microorganismos empleados como control positivo. Conclusiones: el medio de cultivo caldo nitrato desarrollado, cumple con los requisitos de calidad y su funcionalidad microbiológica y permite la caracterización de especies bacterianas que poseen la capacidad de reducir los nitratos a nitritos(AU)

Introduction: the nitrate broth culture medium is used in clinical microbiology laboratories as a biochemical test for the identification of Enterobacteriaceae by the ability of these microorganisms to reduce nitrate to nitrite. Objective: to evaluate different combinations of nutritive bases for the development of the culture medium. Methods: certificed strains were selected as biological test material. The strains belong to different generu of the Enterobactericiae family. Five variants were designed with gelatin peptone and meat extract as nutrient bases at different concentrations and combinations, the growth rate was calculated by measuring the increase in absorbance over time as an indicator of microbial density. The functionality of the culture medium was evaluated by the ability of tested bacteria or reduce nitrate to nitrite Results: the best combination of nutritive bases contained the highest concentration of gelatin peptone (10 g/L) and beef extract (3 g/L). Physicochemical and sensory evaluation of the culture medium showed results characteristic for this type of product. Reductions of nitrate to nitrite were observed for all tested microorganisms choosed as the positive control. Conclusions: the nitrate broth culture medium developed complies the quality requiment and its microbiological functionality allows the characterization of bacterial species by the ir ability to reduce nitrate to nitrite(AU)

Levels of nitrates in a urea fertilized Kikuyu (Cenchrus clandestinus (Hochst. ex Chiov.) Morrone) pasture on the high plains of Antioquia, Colombia / Niveles de nitrato en pasto Kikuyo (Cenchrus clandestinus (Hochst. ex Chiov.) Morrone) fertilizado con urea en el antiplano de Antioquia, Colombia / Niveles de nitrato en pasto Kikuyo (Cenchrus clandestinus (Hochst. ex Chiov.) Morrone) fertilizado con urea en el antiplano de Antioquia, Colombia

Abstract Fertilization is one of the factors that can contribute to build-up of nitrates in kikuyu (Cenchrus clandestinus) pastures of the tropics. Field studies to evaluate the influence of nitrogen fertilization on yield and nitrate concentrations were conducted between December 2012 and June 2013 at the Agricultural Station of the National University at Santa Elena (Antioquia). The experimental design was a 4 x 4 block design with four replications in a monoculture paddock of kikuyu grass. Treatments were four levels of nitrogen applied as topdressing urea granules (0, 50, 100 and 200 kg/ha per plot). Whole grass samples (blades and stems) were collected at 42 days post-fertilization to mimic cattle grazing exposure. Biomass was estimated as dry matter yield per hectare and nitrates were measured by ion chromatography and expressed as parts per million (ppm) on dry matter content. No significant difference in biomass was observed between urea application rates; however, all treated plots produced more biomass than non-treated plots (mean 2.14 vs 1.12 Tons/ha, p<0,05). Mean ± SEM concentrations of NO3 for all time intervals combined increased from 369 ± 216 ppm with no fertilization, to 878 ± 881 ppm at the highest application rate. In spite of the large variation within each group, the highest NO3 level attained was 5600 ppm NO3, which are considered safe for cattle consumption. It can be concluded that nitrate levels in kikuyu pastures fertilized with 4 times the usual rate of nitrogen did not accumulate to pose a health risk in cattle; however, other factors that could also influence nitrate accumulation were not determined in this study.

Resumen La fertilización es uno de los factores que contribuye a la acumulación de nitratos en el pasto kikuyo (Cenchrus clandestinus) en el trópico. Este estudio, realizado entre diciembre de 2012 y junio de 2013 en la Hacienda Paysandú de la Universidad Nacional, ubicada en Santa Elena-Medellín (Antioquia), evaluó la influencia de la fertilización con nitrógeno sobre la producción y las concentraciones de nitratos. El diseño experimental fue en bloques de 4 x 4 con cuatro repeticiones de parcelas monocultivo de pasto kikuyo. Los tratamientos fueron cuatro niveles de nitrógeno aplicado como gránulos de urea sobre la superficie (0, 50, 100 y 200 kg/ha por corte). Las muestras de pasto completo (hojas y tallos) se colectaron a los 42 días posfertilización, con el fin de simular la exposición al pastoreo con ganado. La biomasa se midió como la producción de materia seca por hectárea; los nitratos se midieron por cromatografía iónica, expresada en partes por millón (ppm) sobre el contenido de materia seca. No hubo diferencia significativa en la producción de biomasa entre las diferentes tasas de aplicación de urea; sin embargo todas las parcelas tratadas produjeron más biomasa comparadas con las parcelas no tratadas (promedio 2.14 vs 1.12 ton/ha, p<0,05). Las concentraciones promedio ± SEM de NO3 para todos los tiempos de muestreo combinados, se incrementaron de 369 ± 216 ppm sin fertilización a 878 ± 881 ppm con la más alta tasa de fertilización aplicada. A pesar de la gran variación dentro de cada grupo, los niveles más altos de NO3 obtenidos fueron de 5600 ppm NO3, los cuales se consideran seguros para el consumo en ganado. Se puede concluir que los niveles de nitrato en el pasto kikuyu fertilizado con cuatro veces la tasa normal de nitrógeno, no se acumulan como para plantear un riesgo para la salud en el ganado. Sin embargo, es importante señalar que otros factores que pueden influir en la acumulación de nitratos no se evaluaron en este estudio.

Resumo A adubação é um dos fatores que contribuem na acumulação de nitratos da pastagem kikuyo (Cenchrus clandestinus) do trópico. Este estudo foi realizado entre dezembro de 2012 e junho de 2013 na fazenda Paysandu da Universidade Nacional da Colômbia, localizada no corregimento Santa Elena da cidade de Medellín, Antioquia. Avaliou-se a influência da adubação com nitrogênio sobre a produção e as concentrações de nitratos. O desenho experimental foi de blocos de 4 x 4 com quatro repetições nas parcelas da monocultura de pastagem kikuyo. Os tratamentos foram quatro níveis de nitrogênio aplicado como grânulos de uréia sobre a superfície (0, 50, 100 e 200 kg/ha por safra). As amostras da pastagem completa (folhas e talhos) coletaram-se aos 42 dias após adubação, com o intuito de simular a exposição ao pastoreio com gado. A biomassa mediou-se com a produção de matéria seca por hectare; os nitratos mediram-se por cromatografia iônica, expressada em partes por milhão (ppm) sobre o conteúdo de matéria seca. Não houve diferença significativa na produção de biomassa entre as diferentes taxas de aplicação de uréia; embora, todas as parcelas experimentais produziram maior biomassa comparada com as parcelas não tratadas (media 2.14 vs 1.12 ton/ha, p<0,05). As concentrações medias ± SEM de NO3 para todos os tempos de amostragem combinadas, se incrementaram de 369 ± 216 ppm sem adubação até 878 ± 881 ppm com a maior adubação aplicada. Ainda que houve grande variação dentro de cada grupo, os níveis maiores de NO3 obtidos foram de 5600 ppm NO3, os quais se consideram seguros para o consumo do gado. Pode-se concluir que os níveis de nitrato na pastagem kikuyo adubado com quatro vezes a taxa normal de nitrogênio, não apresentam acumulação como para ter um risco de saúde quando é consumido pelo gado. Embora, outros fatores são importantes para ter em conta, pois eles podem influir na acumulação de nitratos que não foram avaliados neste estudo.

Concentrações do nitrogênio amoniacal, nitritoe nitrato em áreas de engorda de ostras nomunicípio de Cananeia-SP / Concentrations of ammoniac nitrogen, nitrite and nitrate inareas of oyster culture in Cananeia-SP, Brazil

O nitrogênio possui um papel-chave em sistemas aquáticos, especialmente nos ambientes de transição entre águas marinhase doces como os estuários. Assim sendo, muitos organismos, como as ostras, podem ser afetados pelo aumentoda concentração em determinadas épocas, limitando assim seu cultivo. O objetivo deste estudo foi avaliar aspectos daqualidade da água das áreas utilizadas para o cultivo da ostra do mangue Crassostrea spp. em Cananeia (SP, Brasil) e desua adequabilidade para o cultivo dos moluscos com relação às concentrações de nitrogênio amoniacal, nitrito e nitrato.O nitrogênio amoniacal variou de 0,8 a 3,2 μmol/L, o nitrito, de 0,1 a 3,2 μmol/L, e o nitrato, de 0,1 a 1,9 μmol/L. Ao analisaresses dados em todas as estações, verificou-se que o nitrogênio amoniacal, o nitrito e o nitrato foram estatisticamentediferentes entre as marés de quadratura e alta de sizígia. Como não houve diferença entre as estações que fazem a engordadas ostras e a estação Agrossolar (controle), concluiu-se que a atividade no estuário de Cananeia não causa incrementosignificativo nas concentrações de amônia, nitrito e nitrato. As concentrações registradas em Cananeia são similares àsobservadas para outras regiões tropicais e subtropicais estuarinas do mundo.

Nitrogen plays a key role in aquatic systems, especially in environments which are influenced both by marine and freshwater,such as estuaries. The aim of this study was to evaluate aspects of water quality of Crassostrea spp. aquaculture sites inCananeia (SP, Brazil) and adequacy thereof for the cultivation of mollusks in relation to concentrations of total ammoniacalnitrogen, nitrite and nitrate. Variations in concentrations of total ammoniacal nitrogen were 0.8 to 3.2 μmol/L, nitrite 0.1to 3.2 μmol/L, and nitrate from 0.1 to 1.9 μmol/L. Analyzing these data in all seasons together, we found that average totalammoniacal nitrogen and nitrite levels were significantly different for the tides and neap tide. These concentrations recordedat Cananeia are similar to those observed for other estuarine tropical and subtropical regions of the world.

Emisiones antrooogénicas de amoniaco, nitratos óxido nitroso: compuestos nitrrogenados que afectan el medio ambiente en el sector agropecuario Colmbbiano / Anthrpogenic emiissions of ammonia, nitrates and nitrous oxide: nitrogen compounds that affect the environment in the Colombian agricultural sector

El cambio climático es un fenómeno global actual que posee diversas causas, tales como el incremento antropogénico en las emisiones de gases de efecto invernadero y su influencia en el planeta. El óxido nitroso (N2O) es un gas con un potencial de calentamiento 298 veces mayor que el CO2; es emitido por diversos sectores económicos, entre ellos la agricultura y la ganadería por el empleo de fertilizantes nitrogenados. Este uso no incrementa únicamente las emisiones de N2O, sino que afecta todos los eslabones del ciclo del nitrógeno, siendo importante reconocer las interacciones entre sus reacciones (amonificación, nitrificación, denitrificación, etc.) para comprender los efectos sobre la lixiviación de nitratos, volatilización de amoniaco y emisiones de N2O, tres compuestos naturales que afectan el medio ambiente. En Colombia, el IDEAM reportó que en 2004 el sector agropecuario nacional produjo 94,91 gigagramos (Gg) de N2O, pues los sistemas de producción agrícolas y bovinos utilizan altas cantidades de fertilizantes nitrogenados con bajos índices de asimilación. Por ello adquiere importancia implementar buenas prácticas que midan y mitiguen estas emisiones en campo, buscando mayor eficiencia en la transformación de componentes nitrogenados dentro del sistema. En este artículo se enfatiza un manejo adecuado del suelo y la utilización de inhibidores de nitrificación naturales (presentes en algunas plantas tropicales) o químicos, como la nitrapyrina, DCD y NBPT (este último como inhibidor de la amonificación), observando su forma de acción y medición, su efecto mitigador y los incrementos productivos. La presente es una revisión bibliográfica que aborda la problemática ambiental de la ganadería bovina.

Climate change is a global effect currently present with several causes, such as the increased of anthropogenic emissions of greenhouse gases and its influence on the planet. Nitrous oxide (N2O) is a gas with a global warming potential 298 times greater than CO, which comes of many sectors, one of them is the agriculture and livestock through the use of nitrogen fertilizers. This use not only increases N2O emissions, its affects all stages of the nitrogen cycle, being important to observe the interactions between their reactions (ammonification, nitrification, denitrification etc.) to understand the effects over nitrate leaching, ammonia volatilization and N2O emissions, three natural chemicals that affect the environment. In Colombia, IDEAM reports that for 2004, the national agricultural sector produced 94.91 Gg of N2O, knowing the agricultural and livestock productions use high quantities of nitrogen fertilizers, with low assimila2tion rates. Therefore, some adaptable practices and methodologies become important to measure and mitigate these emissions in the field, seeking greater efficiency in the transformation of nitrogen components in the system, being reviewed on this paper the appropriate land management or implementation of natural nitrification inhibitors (present in some tropical plants) or chemical inhibitors, such as nitrapyrina, DCD and NBPT (as an ammonification inhibitor). This is a literature review that approaches the environmental problems of livestock.

Metodología de análisis del riesgo por contaminación de agroquímicos: cuenca del Río San Blas, Costa Rica / Risk analysis methodology for agrochemical contamination: San Blasriver basin, Costa Rica

Establecer parámetros edafológicos e hidrogeológicos de la cuenca; y físico-químicos de fertilizantes y plaguicidas, que pudieran servir para el análisis del riesgo de su infiltración. Materiales y métodos: se realizó una investigación exploratoria de campo y gabinete para caracterizar hidrogeológicamente la cuenca. Se analizaron las concentraciones de plaguicidas y nitratos en aguas subterráneas y superficiales. Se consideraron algunas características de vulnerabilidad intrínsecas del acuífero, y otras relacionadas con la retención de contaminantes en suelos. Se determinó el coeficiente de distribución suelo/agua y el factor de retardo para seis sustancias de alto uso y se estimó su riesgo relativo hacia aguas subterráneas. Resultados: Las aguas subterráneas en zonas agrícolas muestran concentraciones de nitrato de dos a tres veces las concentraciones halladas en aguas para consumo humano. Se detectó glifosato en canales de irrigación agrícola. Los parámetros químicos del suelo más fuertemente correlacionados con la concentración de nitratos en aguas subterráneas fueron: a) capacidad de intercambio catiónico, b) relación aluminio: sílice, c) por ciento de retención de nitratos y d) pH del suelo en agua destilada. La concentración de nitratos en aguas subterráneas se relacionó directamente con el porcentaje de materiales finos (por ciento arcillas + por ciento limos) en los suelos. Discusión: Se proponen par metros para la evaluación del riesgo en acuíferos aluviales en la costa Pacífica de Costa Rica donde predomina el uso agrícola. Se considera que la terbutilazina, ametrina, carbendazim, diuron y nitratos representan amenaza importante al acuífero...

Acalásia idiopática com resposta duradoura ao tratamento farmacológico: relato de caso / Idiopathic acalasia with term response to medical treatment: case report

A acalásia é caracterizada pela aperistalse do corpo esofágico e pelo relaxamento incompleto ou ausente do esfíncter esofagiano inferior. De acordo com sua etiologia, pode ser classificada em chagásica ou idiopática. O tratamento pode ser farmacológico, endoscópico ou cirúrgico. O tratamento farmacológico é considerado pouco eficaz, pois seus efeitos não são permanentes, além de causar efeitos colaterais pronunciados em muitos casos, como cefaleia e hipotensão. As medicações de escolha são os bloqueadores dos canais de cálcio e os nitratos. Os autores relatam o caso de uma paciente com diagnóstico de acalásia idiopática cujo tratamento farmacológico tem sido eficaz ao longo de cinco anos. Tal modalidade foi instituída considerando a cronicidade da doença, a idade avançada da paciente e a presença de comorbidades.

Achalasia is characterized by esophageal body aperistalsis and incomplete or absent relaxation of the lower esophageal sphincter. According to its ethiology, it is classified in chagasic or idiopathic. The treatment options are pharmacological, endoscopical or surgery. Pharmacological treatment has low effectiveness, because clinical results are not permanent and can cause pronounced side effects, such as headache and hypotension. The drugs of choice are calcium channel blockers and nitrates. The authors report a case of a patient diagnosed with idiopathic achalasia whose pharmacological treatment has been effective for five years long. Such choice was made considering the chronic aspects of the disease, patients advanced age and comorbidities presented.