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The tourism is one of the most important sources of the economy in the Bay of Cadiz. Specifically, the municipality of Chiclana de la Frontera, with a population lower than 90,000 citizens, located in the southeast of Spain. During the summer season the population duplicates leading to an increment in flow at wastewater treatment plants (WWTPs). These facilities have been reported as a source of microplastics (MPs) into marine ecosystems, therefore the aim of the present study is to investigate if the tourism affects the presence, discharge and in the receiving environment. Samples were taken at the influent and effluent of the municipal WWTPs (one located at the urban area and other located at resort area) during 2021 (including low and high season). MPs were collected and extracted from wastewater matrixes following the method recommended by the National Oceanic and Atmospheric Administration and UTS treatment to reduce organic matter and cellulose, respectively. The analysis of the samples was performed according to their abundance, shape, size, and type of polymer, along with the removal rates of MPs at WWTPs. The results showed heterogeneous MPs abundance ranging from 1246.4 to 345.7 MPs/L and 72.9 to 4.2, in the influent and effluent, respectively, increasing the presence of MPs at resort WWTP during high season. Fibers were the predominant shape within all the samples. A total of 17 polymers were identified, by ATR-FTIR, where Acrylates, PE and PA were the largest polymers found. Despite the high MPs retention performance of the WWTPs analyzed (84.1-99.3 %), a combined contribution of approximately 1.4 × 107-5.9 × 108 MPs/d to the aquatic environment was estimated. Finally, these results indicate that the increase of MPs in the wastewater at WWTP-B was related with the population increase as a consequence of summer tourism.

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Pharmaceutical products, as well as insecticides and antimicrobials, have been extensively studied, but knowledge of their effects-especially those caused by their mixtures with microplastics-on aquatic organisms remains limited. However, it should be borne in mind that the state of knowledge on acute and chronic effects in aquatic organisms for pharmaceuticals and pesticides is not similar. In response, this investigation analyzed the presence of microplastics (polyvinyl chloride) and their impacts on the toxicity of chlorpyrifos (an insecticide) and triclosan (an antibacterial) when they coincide in the environment, alongside the two most consumed drugs of their type (hypolipemic and anticonvulsant, respectively), namely simvastatin and carbamazepine, in Artemia salina. LC50 and cholinesterase enzyme activity were calculated to determine the possible neurotoxicity associated with emergent contaminants in the treatments. The LC50 values obtained were 0.006 mg/dm3 for chlorpyrifos, 0.012 mg/dm3 for chlorpyrifos associated with microplastics, 4.979 mg/dm3 for triclosan, 4.957 mg/dm3 for triclosan associated with microplastics, 9.35 mg/dm3 for simvastatin, 10.29 mg/dm3 for simvastatin associated with microplastics, 43.25 mg/dm3 for carbamazepine and 46.50 mg/dm3 for carbamazepine associated with microplastics in acute exposure. These results indicate that the presence of microplastics in the medium reduces toxicity, considering the LC50 values. However, exposure to chlorpyrifos and carbamazepine, both alone and associated with microplastics, showed a decline in cholinesterase activity, confirming their neurotoxic effect. Nevertheless, no significant differences were observed with the biomarker cholinesterase between the toxicant and the toxicant with microplastics.

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Para la monitorización de los pacientes críticos se utiliza comunmenteel ECG de tres o cinco electrodos, que permite lamonitorización de una o dos derivaciones. Se recomienda lamonitorización continua de 12 derivaciones en pacientes conriesgo de padecer isquemia silente (sin dolor precordial) paradetectar cambios en el segmento ST.Objetivo: conocer si un electrocardiograma de 12 derivacionescon cinco electrodos basado en vectores (EASI) es equivalenteal electrocardiograma convencional (ECGc) en pacientescríticos sin patología coronaria.Metodología: estudio descriptivo y prospectivo. Se obtuvieron,durante tres meses ECGc y EASI de los pacientes sin patologiacoronaria a su ingreso en una UCI. Se analizaron datosdemográficos, frecuencia, ritmo, eje, anchura del complejoQRS y de los intervalos PR y QT. Se analizaron las variablescomo media ± desviación estándar (DE), comparadas medianteel test de Wilcoxon al no seguir las muestras ligadas una distribuciónnormal.Resultados: se recogieron 42 pares de ECG, 30 varones, edad65±17 años. No hubo ninguna diferencia respecto a la identificacióndel ritmo. La frecuencia cardiaca fue en ECGc de 89± 21 frente a EASI 87 ± 19 (p = 0,860). El eje ECGc fue 26 ±29 frente a EASI 26 ± 30 (p = 0,771). La anchura del QRSfue en el ECGc (97 ± 21) y EASI (98 ± 22) (p = 0,015). La duracióndel intervalo PR fue en ECGc (151 ± 35) y EASI (152± 35) (p = 0,066) y la del QT fue en el ECGc (358 ± 69) yEASI (359 ± 69) (p = 0,457).Conclusión: existe una diferencia significativa entre los dos métodosen la anchura del QRS, pero sin implicación clínica. Elmétodo EASI equivale al ECGc en la evaluación rutinaria depacientes polivalentes sin patología coronaria (AU)

A three to five electrode ECG is often used to monitor patients,enabling the monitoring of one or two derivations. Continuousmonitoring of 12 derivations in patients with a high risk of silentischemia (without precordial pain) is recommended to detectchanges in the ST segment.Objective: to ascertain whether a 12 lead derived electrocardiogramwith five vector-based electrodes (EASI) is equivalentto a conventional electrocardiogram (ECGc) in critical patientswithout coronary pathology.Methodology: descriptive and prospective study. Conventionaland EASI ECGs of patients without coronary disease wereobtained over the course of three months on admission to anICU. Demographic data, frequency, rhythm, axis, width of theQRS complex and of the PR and QT intervals were analysed.Variables such as mean ± standard deviation (SD) were analysedand compared using the Wilcoxon test as the samples attacheddid not follow a normal distribution.Results: forty two pairs of ECGs were collected, 30 males,age 65±17 years. No differences were found regarding thecardiac rhythm. The cardiac rate recorded by the conventionalECG was 89 ± 21 vs EASI 87 ± 19 (p = 0,860). The conventionalECG axis was 26 ± 29 vs a EASI 26 ± 30 (p = 0,771).QRS width was on conventional ECG (97 ± 21) vs EASI (98± 22) (p = 0,015). PR interval duration was on conventionalECG (151 ± 35) vs EASI (152 ± 35) (p = 0,066) and QT intervalwas on conventional ECGc (358 ± 69) vs EASI (359 ±69) (p = ,457).Conclusion: there is a significant difference between both methodsin terms of QRS widths, without clinical implications.The EASI method is equivalent to the conventional ECG inroutine assessment of polyvalent patients with no coronary disease (AU)

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Objetivos: Describir el perfil de los enfermos ingresados en el área de observación(AO), cuantificar el porcentaje de enfermos dados de alta, ingresados o derivados a otros centros hospitalarios y evaluar, en los enfermos ingresados, los criterios de ingreso hospitalario y la correlación con el diagnóstico al alta de la planta de hospitalización. Método: Se analizaron de forma prospectiva los enfermos ingresados en un AO de 24camas. Las variables del estudio fueron: edad, sexo, comorbilidad, destino (alta, observación, ingreso, traslado a otro hospital), correlación entre el diagnóstico en urgencias y en planta de hospitalización, días de ingreso en planta y el parámetro “ingreso adecuado”, definido como estancia en planta de hospitalización superior a 72 horas. Resultados: Se incluyeron 307 enfermos (edad media 63 ± 20 años, 41% mujeres). El51% presentaba comorbilidad relacionada con el motivo de consulta en urgencias. El motivo de ingreso más prevalente en el AO fue la evolución de dolor torácico (16,6%).El 46% fue dado de alta desde el AO y otro 46% fue ingresado, principalmente en salas de especialidades médicas. Los diagnósticos de alta hospitalaria más frecuentes fueron el síndrome coronario agudo (12,1%), la neumonía (10%), la insuficiencia cardiaca (7,1%), la insuficiencia respiratoria (6,4%) y el accidente cerebrovascular (6,4%). La concordancia diagnóstica entre urgencias y el alta hospitalaria fue del 89,3%, y el porcentaje de “ingreso adecuado” en planta fue del 93%.Conclusiones: Los enfermos ingresados en el AO suelen ser mayores de 60 años, con enfermedades crónicas relacionadas con el motivo de consulta, y la mayoría de ingresos que se realizan desde el AO son adecuados y existe una buena correlación entre el diagnóstico de urgencias y el diagnóstico final al alta (AU)

Objective: To describe the characteristics of patients admitted to our community hospital emergency observation unit; calculate the percentage of patients discharged, admitted, or transferred to other hospitals; and evaluate the reasons for hospital admission and consistency between emergency and hospital ward discharge diagnoses. Methods: Data for patients admitted to a 24-bed observation unit were studied. Variables analyzed were age, sex, comorbidity, destination on discharge from the emergency department (home, observation unit, hospital ward, or transfer to another hospital), consistency between emergency department and hospital ward diagnoses, and admission appropriateness (defined by a stay of > 72 hours on the hospital ward).Results: A total of 307 patients were included. The mean (SD) age was 63 (20) years and 41% were female. Fifty-one percent had a chronic condition related to the reason for seeking emergency care. The reason for observation unit admission that was of highest prevalence was chest pain (16.6%). Forty-six percent were discharged home from the observation unit and 46% were admitted, primarily to specialized medical wards. The most common discharge diagnoses were acute coronary syndrome (12.1%), pneumonia (10%), heart failure (7.1%), respiratory failure (6.4%),and stroke (6.4%). The hospital discharge diagnosis was consistent with the emergency department diagnosis in 89.3%of the cases and admission to a ward was considered appropriate in 93%.Conclusions: Observation unit patients are usually over 60 years old and have chronic diseases related to the reason they require emergency care. Most hospital admissions made from the observation unit are appropriate and there is good consistency between the emergency department diagnosis and the ultimate hospital discharge diagnosis (AU)

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