Fast methodology for the reliable determination of nonylphenol in water samples by minimal labeling isotope dilution mass spectrometry

In this work we have developed and validated an accurate and fast methodology for the determination of 4-nonylphenol (technical mixture) in complex matrix water samples by UHPLC–ESI-MS/MS. The procedure is based on isotope dilution mass spectrometry (IDMS) in combination with isotope pattern deconvolution (IPD), which provides the concentration of the analyte directly from the spiked sample without requiring any methodological calibration graph. To avoid any possible isotopic effect during the analytical procedure the in-house synthesized 13C1-4-(3,6-dimethyl-3-heptyl)phenol was used as labeled compound. This proposed surrogate was able to compensate the matrix effect even from wastewater samples. A SPE pre-concentration step together with exhaustive efforts to avoid contamination were included to reach the signal-to-noise ratio necessary to detect the endogenous concentrations present in environmental samples. Calculations were performed acquiring only three transitions, achieving limits of detection lower than 100 ng/g for all water matrix assayed. Recoveries within 83–108% and coefficients of variation ranging from 1.5% to 9% were obtained. On the contrary a considerable overestimation was obtained with the most usual classical calibration procedure using 4-n-nonylphenol as internal standard, demonstrating the suitability of the minimal labeling approach

Nephroprotection by Hypoglycemic Agents: Do We Have Supporting Data?

Current therapy directed at delaying the progression of diabetic nephropathy includes intensive glycemic and optimal blood pressure control, renin angiotensin-aldosterone system blockade and multifactorial intervention. However, the renal protection provided by these therapeutic modalities is incomplete. There is a scarcity of studies analysing the nephroprotective effect of antihyperglycaemic drugs beyond their glucose lowering effect and improved glycaemic control on the prevention and progression of diabetic nephropathy. This article analyzes the exisiting data about older and newer drugs as well as the mechanisms associated with hypoglycemic drugs, apart from their well known blood glucose lowering effect, in the prevention and progression of diabetic nephropathy. Most of them have been tested in humans, but with varying degrees of success. Although experimental data about most of antihyperglycemic drugs has shown a beneficial effect in kidney parameters, there is a lack of clinical trials that clearly prove these beneficial effects. The key question, however, is whether antihyperglycemic drugs are able to improve renal end-points beyond their antihyperglycemic effect. Existing experimental data are post hoc studies from clinical trials, and supportive of the potential renal-protective role of some of them, especially in the cases of dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors. Dedicated and adequately powered renal trials with renal outcomes are neccessary to assess the nephrotection of antihyperglycaemic drugs beyond the control of hyperglycaemia

Electronic Patient-Reported Outcomes in Nephrology: Focus on Hemodialysis

Hemodialysis; ePRO; PROMs; PREMsHemodiàlisi; ePRO; PROMs; PREMsHemodiálisis; ePRO; PROMs; PREMsThe success of hemodialysis (HD) treatments has been evaluated using objective measures of analytical parameters, or machine-measured parameters, despite having available validated instruments that assess patient perspective. There is an emerging interest regarding the use and relevance of patient-related outcomes (PROs). Electronic PROs (ePROs) involve the use of electronic technology, provide rapid access to this information, and are becoming more widely used in clinical trials and studies to evaluate efficacy and safety. Despite the scarce literature, this review suggests that ePROs are useful in providing a more customized and multidimensional approach to patient management and in making better clinical decisions in relevant aspects such as vascular access, duration and frequency of dialysis sessions, treatment of anemia, mental health, fatigue, and quality of life. The purpose of this review is to raise interest in the systematic use of ePROs in HD and to promote the development of studies in this field, which can respond to the gaps in knowledge and contribute to the implementation of the use of ePROs through new technologies, helping to improve the quality of health care

Modelización de temperaturas del aire a 850 Mb en el caso de la onda cálida de julio del 2006 en el noroeste de México

Ponencia presentada en: IX Congreso de la Asociación Española de Climatología celebrado en Almería entre el 28 y el 30 de octubre de 2014.[ES]El estudio de las ondas de calor se enfrenta al reto de conocer los elementos clave que intervienen en su formación y desarrollo y la manera en que afectan a la salud de la población, lo que en un futuro permitiría su modelación predictiva. Se analiza el caso de una onda cálida que afectó a la ciudad de Mexicali, Baja California, México, en los días del 16 al 26 de julio de 2006 que causó graves estragos en la población. Se identifican las principales variables que causan el desarrollo de una onda cálida, y se propone la modelación de la temperatura del aire a 850 mb (Taire850) mediante un modelo de regresión múltiple (MRM) y regresión con redes neuronales (RRN). Se encuentra que el MRM explica a la Taire850 un 67%, siendo la altura geopotencial a 500mb y la presión atmosférica al nivel del mar las variables que más contribuyen a esta explicación. En cuanto a la RRN muestra un desempeño más aceptable i.e. coeficientes de regresión de 0.89; el p-value obtenido fue de 0.0019, por lo que se puede afirmar que un modelo no lineal como la Red Neuronal tiene un mejor desempeño en la predicción de valores independientes que un modelo lineal.[EN]The study of heat waves is challenged to know the key elements involved in their formation and development, and how they affect the health of the population, which in the future would allow its predictive modeling. The case of a heat wave that affected the city of Mexicali, Baja California, Mexico, on days 16 to July 26, 2006 causing serious damage on the population is analyzed. Major variables that cause the development of a heat wave are identified, and the modeling of air temperature at 850 mb (Taire850) is proposed by a multiple regression model (MRM) and regression neural network (RNN). It was found that the MRM explained to Taire850 a 67%, with a 500mb geopotential height and atmospheric pressure at sea level the atmospheric variables that more contribute to this explanation. Insomuch as RNN show a performance more, i.e. regression coefficients of 0.89; the p-value obtained was 0.0019, so we can say that a nonlinear model such as neural network has a better performance in predicting independent values that a linear model

Optimizing the timing of nephrology referral for patients with diabetic kidney disease

Diabetis mellitus; Malaltia renal diabètica; Atenció multidisciplinàriaDiabetes mellitus; Diabetic kidney disease; Multidisciplinary careDiabetes mellitus; Enfermedad renal diabética; Atención multidisciplinariaAge-standardized rates of diabetes mellitus (DM)-related complications, such as acute myocardial infarction, stroke or amputations, have decreased in recent years, but this was not associated with a clear reduction of the incidence of advanced chronic kidney disease (CKD) requiring renal replacement therapy. The early detection of diabetic kidney disease (DKD) is a key to reduce complications, morbidity and mortality. Consensus documents and clinical practice guidelines recommend referral of DM patients to nephrology when the estimated glomerular filtration rate falls below 30 mL/min/1.73 m2 or when albuminuria exceeds 300 mg/g urinary creatinine. Conceptually, it strikes as odd that patients with CKD are referred to the specialist caring for the prevention and treatment of CKD only when >70% of the functioning kidney mass has been lost. The increasing global health burden of CKD, driven in large part by DKD, the suboptimal impact of routine care on DKD outcomes as compared with other DM complications, the realization that successful therapy of CKD requires early diagnosis and intervention, the advances in earlier diagnosis of kidney injury and the recent availability of antidiabetic drugs with a renal mechanism of action and lack of hypoglycaemia risk, which additionally are cardio- and nephroprotective, all point towards a paradigm shift in the care for DM patients in which they should be referred earlier to nephrology as part of a coordinated and integrated care approach.Sources of support: FIS/Fondos FEDER PI18/01386, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009), Sociedad Española de Nefrología, FRIAT, Comunidad de Madrid en Biomedicina B2017/BMD-3686 CIFRA2-CM

Air temperature measurements using autonomous self-recording dataloggers in mountainous and snow covered areas

High mountain areas are poorly represented by official weather observatories. It implies that new instruments must be evaluated over snow-covered and strongly insolated environments (i.e. mid-latitude mountain areas). We analyzed uncertainty sources over snow covered areas including: 1) temperature logger accuracy and bias of two widely used temperature sensors (Tinytag and iButton); 2) radiation shield performance under various radiation, snow, and wind conditions; 3) appropriate measurement height over snow covered ground; and 4) differences in air temperature measured among nearby devices over a horizontal band. The major results showed the following. 1) Tinytag performance device (mean absolute error: MAE≈ 0.1–0.2°C in relation to the reference thermistor) was superior to the iButton (MAE≈ 0.7°C), which was subject to operating errors. 2) Multi-plate radiation shield showed the best performance under all conditions (> 90% samples has bias between ±0.5°C). The tube shield required wind (> 2.5ms⁠−1) for adequate performance, while the funnel shield required limited radiation (< 400Wm⁠−2). Snow cover causes certain overheating. 3) Air temperatures were found to stabilize at 75–100cm above the snow surface. Air temperature profile was more constant at night, showing a considerable cooling on near surface at midday. 4) Horizontal air temperature differences were larger at midday (0.5°C). These findings indicate that to minimize errors air temperature measurements over snow surfaces should be carried out using multi-plate radiation shields with high-end thermistors such as Tinytags, and be made at a minimum height above the snow covered ground.This study was funded by the research projects “El papel de la nieve en la hidrología de la peninsula ibérica y su respuesta a procesos de cambio global-HIDROIBERNIEVE-CGL2017-82216-R” and CLIMPY “Characterization of the evolution of climate and provision of information for adaptation in the Pyrenees” (FEDER-POCTEFA)

GLP-1 Receptor Agonists and Diabetic Kidney Disease: A Call of Attention to Nephrologists

Type 2 diabetes mellitus (T2DM) represents the main cause of chronic kidney disease (CKD) and end-stage renal disease (ESKD), and diabetic kidney disease (DKD) is a major cause of morbidity and mortality in diabetes. Despite advances in the nephroprotective treatment of T2DM, DKD remains the most common complication, driving the need for renal replacement therapies (RRT) worldwide, and its incidence is increasing. Until recently, prevention of DKD progression was based around strict blood pressure (BP) control, using renin-angiotensin system blockers that simultaneously reduce BP and proteinuria, adequate glycemic control and control of cardiovascular risk factors. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are a new class of anti-hyperglycemic drugs shown to improve cardiovascular and renal events in DKD. In this regard, GLP-1RA offer the potential for adequate glycemic control in multiple stages of DKD without an increased risk of hypoglycemia, preventing the onset of macroalbuminuria and slowing the decline of glomerular filtration rate (GFR) in diabetic patients, also bringing additional benefit in weight reduction, cardiovascular and other kidney outcomes. Results from ongoing trials are pending to assess the impact of GLP-1RA treatments on primary kidney endpoints in DKD

Sodium-glucose cotransporter 2 inhibition: towards an indication to treat diabetic kidney disease

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have clearly demonstrated their beneficial effect in diabetic kidney disease (DKD) on top of the standard of care [blood glucose control, renin-angiotensin system blockade, smoking cessation and blood pressure (BP) control], even in patients with overt DKD. However, the indication of this drug class is still blood glucose lowering in type 2 diabetic patients with estimated glomerular filtration rate >45mL/min/1.73m(2). Based on the new evidence, several scientific societies have emphasized the preferential prescription of SGLT2i for patients at risk of heart failure or kidney disease, but still within the limits set by health authorities. A rapid positioning of both the European Medicines Agency and the US Food and Drug Administration will allow patients with overt DKD to benefit from SGLT2i. Clinical experience suggests that SGLT2i safety management may in part mirror renin-angiotensin blockade safety management in patients with overt DKD. This review focuses on the rationale for an indication of SGTL2i in DKD. We further propose clinical steps for maximizing the safety of SGLT2i in DKD patients on other antidiabetic, BP or diuretic medication

Clasificación preliminar de especies de jardín según sus requerimientos hídricos en la región de Murcia

El desarrollo económico y social de la Región de Murcia ha conllevado desde la década de los 80 un considerable aumento de la superficie ajardinada, tanto de carácter público como privado. Esta circunstancia, unida a los graves problemas de escasez de agua, pone de manifiesto la importancia del establecimiento de jardines de bajo consumo hídrico.Este trabajo forma parte del proyecto de investigación regional PR02-03-2 financiado por la Dirección General de Investigación y Transferencia Tecnológica