PP179—Identification of Drug–Drug Interactions Through a Digital Health Service

e74 Volume 35 Number 8S accounting for 21.2% and 16.2% of total AED consumption (DDD 163.7 and 125.2, respectively). In the same year, oxcarbazepine and lamotrigine were the most used new AEDs (10.91% and 10.79% of total; DDD 84.1 and 83.2, respectively), while gabapentin and pregabalin exhibited the higher incidence of use. The main indication of use was epileptic disorders for older AEDs and neuropathic pain for newer AEDs. A high number of patients treated with older AEDs, in particular carbamazepine, phenobarbital, and valproic acid, received coprescription at clinically relevant interaction risk. Among newer AEDs, lamotrigine showed a high annual rate of possible interaction. Conclusion: Significant differences were shown in the prescribing pattern of newer and older medications: older AEDs were mainly used in the treatment of epileptic disorders, while newer compounds were also preferred for conditions other than epilepsy, in particular neuropathic pain. The fall in the use of newer AEDs during 2007 agreed with revised reimbursement criteria for gabapentin and pregabalin. The coprescription should be evaluated with caution and avoided if possible. Drugs at risk of interactions should be replaced with others having same indication of use. Disclosure of Interest: None declared

Cortical Oxygenation during a Motor Task to Evaluate Recovery in Subacute Stroke Patients: A Study with Near-Infrared Spectroscopy

In subacute stroke patients we studied cortical oxygenation changes by near-infrared spectroscopy (NIRS) during a motor task performed with the hemiparetic arm (15 s of reaching and grasping, 45 s of rest, repeated 6 times). Twenty-three subjects were included at baseline, compared with six healthy subjects, and restudied after 6 weeks of rehabilitation. Motor/premotor cortical changes in oxyhemoglobin detected by NIRS were quantified as the area under the curve (AUC) for the total cortex (TOT-AUC) and for both affected (AFF-AUC) and unaffected hemispheres (UN-AUC). The ratio between AUC and the number of task repetitions performed identified the cortical metabolic cost (CMC) or the oxygenation increase for a single movement. Fugl–Meyer assessment of the upper extremity (FMA-UE) was also performed. At baseline, both total and hemispheric CMC were significantly higher in stroke patients than in healthy subjects and inversely correlated with FMA-UE. After rehabilitation, changes in total-CMC and unaffected-CMC, but not Affected-CMC, were inversely correlated with variations in the FMA-UE score. A value > 5000 a.u. for the ratio baseline TOT-CMC /days since stroke was associated with not reaching the clinically important difference for FMA-UE after rehabilitation. In subacute stroke the CMC, a biomarker assessed by NIRS during a motor task with the hemiparetic arm, may describe cortical time/treatment reorganization and favor patient selection for rehabilitation

2021 Tajogaite eruption records infiltration of crustal fluids within the upper mantle beneath La Palma, Canary Islands

The 2021 Tajogaite eruption at La Palma has represented a unique opportunity to investigate the characteristics of the mantle source feeding modern volcanism in the Canary Islands. With the aim of track the fingerprint of carbon in the local oceanic lithosphere-asthenosphere system, we report the isotopic composition of CO2 (δ13C values versus Vienna Pee Dee Belemnite) in olivine- and clinopyroxene-hosted fluid inclusions (FI) from the 2021 Tajogaite lavas and from lavas/ultramafic xenoliths (olivine-clinopyroxenites, clinopyroxenites, dunites and harzburgites) from the nearby 1677 San Antonio eruption cone/lavas, in an attempt to characterize the origin and evolution of carbon within the local mantle source. Our results indicate that the 2021 and 1677 lavas exhibit δ13C values ranging from −4.94‰ to −2.71‰ and CO2/3He ratios from 3.37 to 6.14 × 109. Ultramafic xenoliths fall in a comparable range of values despite showing higher CO2 concentrations. Our δ13C values fall within the range of carbon isotope results previously reported for the Dos Aguas cold spring located in the Taburiente Caldera (northern La Palma), suggesting an apparent carbon isotope homogeneity at the scale of the entire island. The (relatively narrow) δ13C vs. CO2/3He ratio range of La Palma samples is interpreted to reflect either i) variable extents of open-system degassing of a common mantle endmember having δ13C of ∼1.7‰, or ii) mixing between depleted mantle-like carbon (−6‰ < δ13C < −4‰) and crustal carbon (δ13C = 0‰) endmembers. Both models testify a crustal carbon component recycled in the local mantle. This component, also detected in mantle xenoliths from the neighboring island of El Hierro and the easternmost Lanzarote, indicates a regional characteristic of the mantle beneath the Canary Islands, interpreted as a result of infiltration of carbon-rich melts during past metasomatic events in the local mantle

The noble gas signature of the 2021 Tajogaite eruption (La Palma, Canary Islands)

Here, we characterize the temporal evolution of volatiles during the Tajogaite eruption by analyzing the elemental (He-Ar-CO2-N2) and isotopic (He-Ar-Ne) composition of fluid inclusions (FI) in phenocrysts (olivine+pyroxene) identified in erupted lavas. Our 2021 lava samples identify substantial temporal variations in volatile composition. We show that, during the 2021 Tajogaite eruption, the He-CO2-N2 concentrations in FI increased since October 15th; this increase was accompanied by increasing 40Ar/36Ar ratios (from ~300 to >500), and paralleled a major shift in bulk lava chemistry, with increasing Mg contents (Mg#, from 47 to 52 to 55–59), CaO/Al2O3 (from 0.65 to 0.74 to 0.75–0.90), Ni and Cr, and decreasing TiO2, P2O5 and incompatible elements. The olivine core composition also became more forsteritic (from Mg# = 80–81 to Mg# = 84–86). Mineral thermobarometry and FI barometry results indicate that the eruption was sustained by magmas previously stored in at least two magma accumulation zones, at respectively ~6–12 km and 15–30 km, corroborating previous seismic and FI evidence. We therefore propose that the compositional changes seen throughout the eruption can be explained by an increased contribution - since early/mid-October - of more primitive, lessdegassed magma from the deeper (mantle) reservoir. Conversely, Rc/Ra values (3He/4He ratios corrected for atmospheric contamination) remained constant throughout the whole eruption at MORB-like values (7.38 ± 0.22 Ra, 1σ), suggesting an isotopically homogeneous magma feeding source. The Tajogaite He isotope signature is within the range of values observed for the 1677 San Antonio lavas (7.37 ± 0.17Ra, 1σ), but is more radiogenic than the 3He/4He values (>9 Rc/Ra) observed in the Caldera de Taburiente to the north. The 3He/4He ratios (6.75 ± 0.20 Ra, 1σ) measured in mantle xenoliths from the San Antonio volcano indicate a relatively radiogenic nature of the mantle beneath the Cumbre Vieja ridge. Based on these results and mixing modeling calculations, we propose that the homogeneous He isotopic signatures observed in volatiles from the Tajogaite/San Antonio lavas reflect three component mixing between a MORB-like source, a radiogenic component and small additions (6–15%) of a high 3He/4He reservoir-derived (>9Ra) fluid components. The simultaneous occurrence of high 3 He/4 He (>9Ra)- and MORB-like He signatures in northern and southern La Palma is interpreted to reflect smallscale heterogeneities in the local mantle, arising from spatially variable proportions of MORB, radiogenic, and high 3He/4He component

Intake of fruits and vegetables and polymorphisms in DNA repair genes in bladder cancer

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Serum steroid profiling by isotopic dilution-liquid chromatography-mass spectrometry: comparison with current immunoassays and reference intervals in healthy adults.

BACKGROUND: The simultaneous, rapid and reliable measurement of a wide steroid panel is a powerful tool to unravel physiological and pathological hormone status. Clinical laboratories are currently dominated by high-throughput immunoassays, but these methods lack specificity due to cross-reactivity and matrix interferences. We developed and validated an isotopic dilution-liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) method for the simultaneous measurement of cortisol, corticosterone, 11deoxycortisol, androstenedione, deoxycorticosterone (DOC), testosterone, 17OHprogesterone, dehydroepiandrosterone (DHEA) and progesterone in serum, and compared it to routine immunoassays employed in our laboratory. We also established adult reference intervals in 416 healthy subjects. METHODS: 0.9 ml of serum were spiked with labelled internal standards (IS) and extracted on C18 cartridges. Eluate was injected into a two-dimensional LC-system, purified in a perfusion column and separated on a C8 column during a 21 min gradient run. Analytes were revealed by atmospheric pressure chemical ionization (APCI) followed by multiple reaction monitoring (MRM) analysis. RESULTS: Of the four immunoassays compared with the ID-LC-MS/MS method, only the results of ElecsysE170 for cortisol, testosterone in males and progesterone>1 ng/ml were in agreement with ID-LC-MS/MS. ElecsysE170 for testosterone in females and progesterone<1 ng/ml, Immulite2000 for androstenedione, DSL-9000 for DHEA and 17OHP Bridge for 17OHprogesterone, respectively, showed poor agreement. Reference intervals and steroid age and fertility related fluctuations were established. CONCLUSION: Our ID-LC-MS/MS method proved to be reliable and sensitive in revealing steroid circulating concentrations in adults and in highlighting the limits of routine immunoassays at low concentrations

The Variscan subduction inheritance in the Southern Alps Sub-Continental Lithospheric Mantle: clues from the Middle Triassic shoshonitic magmatism of the Dolomites (NE Italy)

Although often speculated, the link between the Middle Triassic shoshonitic magmatism at the NE margin of the Adria plate and the subduction-related metasomatism of the Southern Alps Sub-Continental Lithospheric Mantle (SCLM) has never been constrained. In this paper, a detailed geochemical and petrological characterization of the lavas, dykes and ultramafic cumulates belonging to the shoshonitic magmatic event that shaped the Dolomites (Southern Alps) was used to model the composition and evolution of the underlying SCLM in the time comprised between the Variscan subduction and the opening of the Alpine Tethys. Geochemical models and numerical simulations enabled us to define that 5–7% partial melting of an amphibole + phlogopite-bearing spinel lherzolite, similar to the Finero phlogopite peridotite, can account for the composition of the primitive Mid-Triassic SiO2-saturated to -undersaturated melts with shoshonitic affinity (87Sr/86Sri = 0.7032–0.7058; 143Nd/144Ndi = 0.51219–0.51235; Mg # ~ 70; ~1.1 wt% H2O). By taking into account the H2O content documented in mineral phases from the Finero phlogopite peridotite, it is suggested that the Mid-Triassic SCLM source was able to preserve a significant enrichment and volatile content (600–800 ppm H2O) for more than 50 Ma, i.e. since the slab-related metasomatism connected to the Variscan subduction. The partial melting of a Finero-like SCLM represents the exhaustion of the subduction-related signature in the Southern Alps lithosphere that predated the Late Triassic-Early Jurassic asthenospheric upwelling related to the opening of the Alpine Tethys

Active vitamin D (1,25-dihydroxyvitamin D) and bone health in middle-aged and elderly men: the European male aging study (EMAS)

&lt;p&gt;Context: There is little information on the potential impact of serum 1,25-dihydroxyvitamin D [1,25(OH)2D] on bone health including turnover.&lt;/p&gt; &lt;p&gt;Objective: The objective of the study was to determine the influence of 1,25(OH)2D and 25-hydroxyvitamin D [25(OH)D] on bone health in middle-aged and older European men.&lt;/p&gt; &lt;p&gt;Design, Setting, and Participants: Men aged 40–79 years were recruited from population registers in 8 European centers. Subjects completed questionnaires that included questions concerning lifestyle and were invited to attend for quantitative ultrasound (QUS) of the heel, assessment of height and weight, and a fasting blood sample from which 1,25(OH)2D, 25(OH)D, and PTH were measured. 1,25(OH)2D was measured using liquid chromatography tandem mass spectrometry. Bone markers serum N-terminal propeptide of type 1 procollagen (P1NP) and crosslinks (β-cTX) were also measured. Dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine was performed in 2 centers.&lt;/p&gt; &lt;p&gt;Main Outcome Measure(s): QUS of the heel, bone markers P1NP and β-cTX, and DXA of the hip and lumbar spine were measured.&lt;/p&gt; &lt;p&gt;Results: A total of 2783 men, mean age 60.0 years (SD 11.0) were included in the analysis. After adjustment for age and center, 1,25(OH)2D was positively associated with 25(OH)D but not with PTH. 25(OH)D was negatively associated with PTH. After adjustment for age, center, height, weight, lifestyle factors, and season, 1,25(OH)2D was associated negatively with QUS and DXA parameters and associated positively with β-cTX. 1,25(OH)2D was not correlated with P1NP. 25(OH)D was positively associated with the QUS and DXA parameters but not related to either bone turnover marker. Subjects with both high 1,25(OH)2D (upper tertile) and low 25(OH)D (lower tertile) had the lowest QUS and DXA parameters and the highest β-cTX levels.&lt;/p&gt; &lt;p&gt;Conclusions: Serum 1,25(OH)2D is associated with higher bone turnover and poorer bone health despite being positively related to 25(OH)D. A combination of high 1,25(OH)2D and low 25(OH)D is associated with the poorest bone health.&lt;/p&gt

Active vitamin D (1,25-dihydroxyvitamin D) and bone health in middle-aged and elderly men: the European male aging study (EMAS)

&lt;p&gt;Context: There is little information on the potential impact of serum 1,25-dihydroxyvitamin D [1,25(OH)2D] on bone health including turnover.&lt;/p&gt; &lt;p&gt;Objective: The objective of the study was to determine the influence of 1,25(OH)2D and 25-hydroxyvitamin D [25(OH)D] on bone health in middle-aged and older European men.&lt;/p&gt; &lt;p&gt;Design, Setting, and Participants: Men aged 40–79 years were recruited from population registers in 8 European centers. Subjects completed questionnaires that included questions concerning lifestyle and were invited to attend for quantitative ultrasound (QUS) of the heel, assessment of height and weight, and a fasting blood sample from which 1,25(OH)2D, 25(OH)D, and PTH were measured. 1,25(OH)2D was measured using liquid chromatography tandem mass spectrometry. Bone markers serum N-terminal propeptide of type 1 procollagen (P1NP) and crosslinks (β-cTX) were also measured. Dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine was performed in 2 centers.&lt;/p&gt; &lt;p&gt;Main Outcome Measure(s): QUS of the heel, bone markers P1NP and β-cTX, and DXA of the hip and lumbar spine were measured.&lt;/p&gt; &lt;p&gt;Results: A total of 2783 men, mean age 60.0 years (SD 11.0) were included in the analysis. After adjustment for age and center, 1,25(OH)2D was positively associated with 25(OH)D but not with PTH. 25(OH)D was negatively associated with PTH. After adjustment for age, center, height, weight, lifestyle factors, and season, 1,25(OH)2D was associated negatively with QUS and DXA parameters and associated positively with β-cTX. 1,25(OH)2D was not correlated with P1NP. 25(OH)D was positively associated with the QUS and DXA parameters but not related to either bone turnover marker. Subjects with both high 1,25(OH)2D (upper tertile) and low 25(OH)D (lower tertile) had the lowest QUS and DXA parameters and the highest β-cTX levels.&lt;/p&gt; &lt;p&gt;Conclusions: Serum 1,25(OH)2D is associated with higher bone turnover and poorer bone health despite being positively related to 25(OH)D. A combination of high 1,25(OH)2D and low 25(OH)D is associated with the poorest bone health.&lt;/p&gt