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Bottled water has emerged as a possible healthier alternative due to concerns about the quality of drinking water sources. However, recent studies have detected worrying concentrations of environmental contaminants in bottled water, including microplastics. Therefore, it is an emerging need to quantify their concentrations in local suppliers which could differ among countries and regions. In this work, we used fluorescence microscopy with Nile Red for the identification and quantification of potential microplastics in twelve brands of bottled water distributed in the Santiago Metropolitan Region of Chile. The average concentration of microplastics was 391 ± 125 p L-1, while the highest concentration observed was 633 ± 33 p L-1. Microplastics between 5 and 20 µm were the major contributors, a size fraction that has been reported to be susceptible to accumulate in the digestive tract or generate potential alterations in the lymphatic and circulatory systems. The estimated daily intake value for per capita was estimated to be 229 p kg-1 year-1 for people weighing 65 kg and 198 p kg-1 year-1 for those weighing 75 kg.

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Introduction: COVID-19 is an infectious disease, transmitted by diverse viral strains from the Coronaviridae family. It can manifest as a mild-moderate condition with general symptoms such as malaise, body aches and fever. However, when it finds a patient with other comorbidities it can enhance its virulence, potentially leading to a severe disease with pulmonary-systemic effects. Obesity recognized as a pandemic nowadays, displays and imminent increase in the risk of developing complications during the course of COVID-19 process. Objective: Identify the prevalence of obesity in patients admitted to the Intensive Care Unit (ICU) that displayed an unfavorable prognostic. Methodology: Observational, retrospective study, data was retrieved from a single medical center in Dominican Republic. In the period of time from March to December 2020 a total of 382 patients hospitalized in ICU with a positive PCR for SARS-CoV-2 was extracted from the electronic medical records. Conclusion: Obesity leads to a homeostatic imbalance that severely affects the body´s immune system, making the patient more susceptible to present severe cases of COVID-19, requiring higher levels of hospitalization and ICU admissions.

Introducción: el COVID-19 es una enfermedad de origen infeccioso viral, transmitida por diversas cepas de la familia Coronaviridae. Su manifestación puede ser leve-moderada con síntomas generales como malestar, dolor corporal y fiebre, sin embargo, la presencia de comorbilidades en pacientes la convierte potencialmente en una enfermedad severa con afectación pulmonar-sistémica. La obesidad, también reconocida como pandemia, representa un factor de riesgo inminente ante una mayor susceptibilidad de adquirir complicaciones durante la enfermedad por COVID-19. Objetivo: identificar la prevalencia de obesidad en pacientes admitidos a Unidad de Cuidados Intensivos (UCI) que mostraron un pronóstico desfavorable. Metodología: se realizó un estudio retrospectivo de tipo observacional, se recolectó la información de un solo centro de salud de la República Dominicana. Durante el período de marzo a diciembre del 2020, se recopiló de los récords médicos electrónicos un total de 382 pacientes hospitalizados en UCI con una prueba positiva de SARS-CoV-2. Conclusión: la obesidad produce un desbalance homeostático afectando especialmente la inmunidad del organismo haciendo al paciente más susceptible a presentar casos severos de COVID-19, requiriendo mayores niveles de hospitalización e ingresos a UCI.

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Introducción: la apnea obstructiva del sueño es una patología respiratoria caracterizada por paradas de la respiración de forma repetida durante el sueño. Esta patología está relacionada con los trastornos hipertensivos, pudiendo agravarlos. Objetivo: determinar el perfil de un paciente hipertenso bajo sospecha clínica de apnea obstructiva del sueño en el Centro de Diagnóstico y Medicina Avanzada y de Conferencias Médicas y Telemedicina (CEDIMAT) durante el periodo enero 2019 ­ febrero 2020. Material y métodos: se realizó un estudio observacional-descriptivo, transversal con datos retrospectivos. Se estudiaron 38 expedientes clínicos de pacientes hipertensos de la consulta de neumología y que cumplen con criterios de sospecha clínica de apnea obstructiva del sueño. Resultados: el rango de edad fue de 40-64 años con un 55.26 %. El 66 % son masculinos. 36.84 % son hipertensos grado I mientras que otro 34.21% tienen sus niveles tensionales normales. El 68.41 % son obesos y un 26.32 % están en sobrepeso. 63.16 % se clasifican como IV en la escala de Mallampati. Conclusión: el perfil de los pacientes hipertensos bajo sospecha clínica de apnea obstructiva del sueño es: sexo masculino, adultez media, obesidad, escala de mallampati categoría IV y el uso de múltiples fármacos en el control de la hipertensión

Introduction: Obstructive sleep apnea is a respiratory disease characterized by repeated stops of breathing during sleep. This pathology is related to hypertensive disorders, which can aggravate them. Objective: To determine the profile of a hypertensive patient under clinical suspicion of obstructive sleep apnea at the Center for Diagnosis and Advanced Medicine and Medical and Telemedicine Conferences (CEDIMAT) during the period January 2019 - February 2020. Material and methods: An observational study of descriptive, cross-sectional type with retrospective data. Thirty-eight clinical records of hypertensive patients from the pulmonology clinic and who meet the criteria for clinical suspicion of obstructive sleep apnea were studied. Results: The age range was 40-64 years with 55.26%. 66% are male. 36.84% are grade I hypertensive while another 34.21% have normal blood pressure levels. 68.41% are obese and 26.32% are overweight. 63.16% are classified as IV on the mallampati scale. Conclusion: The profile of hypertensive patients under clinical suspicion of obstructive sleep apnea is; male sex, middle adulthood, obesity, category IV of mallampati scale and the use of multiple drugs in the control of hypertension

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Resumen Objetivo: Identificar los factores de riesgo de depresión post ictus isquémico (DPI) en pacientes adultos. Material y métodos: Estudio tipo caso y control no pareado. Se incluyeron 81 casos y 81 controles de pacientes del consultorio externo de neurología del Hospital Santa Rosa de Lima, atendidos entre setiembre y diciembre del 2018. Se registraron variables clínicas y epidemiológicas mediante una ficha de datos. Para el diagnóstico de depresión se empleó la Hamilton Depression Rating Scale (HDRS). Se establecieron asociaciones mediante el cálculo de los Odds Ratio (OR) con intervalos de confianza del 95% (IC). Se compararon los casos y controles usando un análisis multivariado de regresión logística. Resultados: Las variables asociadas con DPI fueron: tabaquismo (OR=4,67; IC95%, 1,99-10,92, p<0,001), lesión localizada en el hemisferio izquierdo (OR=3,11; IC 95%, 1,41-6,84, p=0,005) y deterioro cognitivo (OR=3,18; IC95%, 1,42-7,10, p=0,005). Conclusiones: En pacientes con antecedente de ictus isquémico, el tabaquismo, la localización de la lesión en el hemisferio cerebral izquierdo y el deterioro cognitivo, se asociaron con un mayor riesgo de depresión. Se necesitan estudios adicionales para definir mejor la naturaleza de dichas asociaciones.

Summary Objective: To identify risk factors for depression after and ischemic ictus (DII) in adults. Methods: A non-matched case-control study was carried-out including 81 cases and controls, respectively recruited from the neurologic outpatient clinic of Hospital Santa Rosa de Lima from September to December of 2018. Clinical and epidemiological data were gathered and stored in a data base. The Hamilton Depression Rating Scale was used to diagnose depression. Odds rations and 95% CI were calculated and a multivariate logistic regression analysis was used. Results: smoking (OR=4.67; IC95%, 1.99-10.92, p<0.001), lesion located on the left hemisphere (OR=3.11; IC95%, 1.41-6.84, p=0.005) and cognitive deterioration (OR=3.18; IC95%, 1.42-7.10, p=0.005) were independently associated with DII. Conclusions: Smoking, lesions located on the left hemisphere and cognitive deterioration were associated with DII but further studies are needed to elucidate the nature of these associations.

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An analytical methodology has been developed and validated for the purpose of identifying and quantifying four parabens (methylparaben, ethylparaben, propylparaben and n-butylparaben) in water samples. The combination of rotating disk sorptive extraction (RDSE) technology with ultra-high performance liquid chromatography (UHPLC), along with electrospray ionization source (ESI) and time of flight mass spectrometry (TOF/MS) in trap mode, allowed for eliminating derivatization processes and a reduction of the chromatographic time required, achieving a greener analytical method. In this method, detection limits and precision (%RSD) were lower than 0.018 µg L-1 and lower than 9.7% for all the parabens, respectively, being better than similar works. Matrix effect and absolute recoveries were studied in tap and sewage water samples to observe suppressions of the signals for all analytes, and absolute recoveries were around 60%. This methodology was applied to the analysis of two sewage samples (punctual and composite) obtained from locations in Santiago, Chile.

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This work reports for the first time the use of laminar cork as a sorptive phase in a microextraction technique, rotating-disk sorptive extraction (RDSE). Typical hormones (estrone, estradiol, estriol and ethinyl estradiol) were selected as analyte models and extracted from wastewater samples on laminar cork with statistically equivalent extraction efficiency to that provided by Oasis HLB. The cork characterization was performed by confocal fluorescence microscopy (CLSM), Fourier-transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM), allowing the identification of lignin, suberin and polysaccharides (cellulose and hemicellulose) as the main components of the cork. The best conditions for extraction were as follows: rotation velocity of the disk, 2000 rpm; extraction time, 45 min; and sample volume, 20 mL. The analytical features of the developed method show that calibration curves for all analytes have R2 values higher than 0.99. The absolute recoveries were higher than 63%, and the precision, expressed as relative standard deviation, ranged from 2 to 16%. The LOD and LOQ ranges were 3-19 and 10-62 ng L-1, respectively. The proposed method was applied to the analysis of wastewater, and the concentrations of hormones in a wastewater treatment plant in Santiago, Chile, ranged from

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Inorganic polymers in aqueous solutions are being proposed as essential components in new theories concerning nonclassical nucleation and growth of nanominerals relevant to environmental nanogeosciences. The study of those complex natural processes requires multi-technique analytical approaches able to characterize the solutions and their constituents (solutes, oligomers, polymers, clusters and nanominerals) from atomic to micrometric scales. A novel analytical approach involving an electrospray ionization source (ESI) coupled to time-of-flight mass spectrometry (TOF/MS) was developed to identify inorganic polymers in aqueous solution. To this end, the presence of initial Al oligomers and their polymerization processes was studied during a nanomineral aqueous synthesis (hydrobasaluminte, Al4 SO4 (OH)10 ·12-36H2 O). Ensuring the feasibility and robustness of the methodology as well as the stability of the polymers under study (avoiding undesirable fragmentation), a meticulous study of the ESI-TOF MS working conditions was performed. Precision of the methodology was evaluated obtaining relative standard deviations below 3.3%. For the first time in the study of inorganic polymers in the earth sciences, the mass accuracy error (ppm) has been reported and the use of significant decimal figures of the m/z signal has been taken into account. Complementary to this, a four-step polymer assignment methodology and a database with the Al- and Al-SO4 2- polymers assigned were created. Several polymers have been assigned for the first time, including Al (SO4 )+ ·H2 O, Al2 O(SO4 )2+ ·H2 O, Al5 O4 (OH)5 2+ ·2H2 O, and Al3 O5 (OH)2- ·4H2 O, among others. The results obtained in the present study help create a foundation to include mass spectrometry as a routine analytical technique to study mineral formation in aqueous solution.

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A method combining liquid chromatography with a dual-probe ultraspray electrospray ionization (ESI) source and time-of-flight high-resolution mass spectrometry (LC-ESI-TOF/MS) was developed for the simultaneous determination of four steroidal sex hormones, estrone (E1), 17ß-estradiol (E2), 17α-ethinyl estradiol (EE2), and estriol (E3), as well as five of their hydroxylated metabolites, 2-hydroxyestrone (2-OHE1), 4-hydroxyestrone (4-OHE1), 16α-hydroxyestrone (16-OHE1), 2-hydroxyestradiol (2-OHE2), and 4-hydroxyestradiol (4-OHE2), in water samples in a short chromatographic run of 10 min. Derivatization of the analytes was optimized using dansyl chloride as the derivatizing agent. Under optimal positive ionization conditions, the following signals, which had not been previously reported, were observed (with theoretical values of m/z 377.1373 for 2- and 4-OHE1 and 378.1452 for 2- and 4-OHE2), corresponding to doubly derivatized catechol estrogens in the form of [M+2H]2+. These mass spectrometric signals were more abundant than those reported previously for the [M+H]+ forms of these hydroxylated metabolites. Solid-phase extraction (SPE) with an octadecyl-endcapped sorbent was used to pretreat tap water and effluent from a wastewater treatment plant (WWTP) in Santiago, Chile. The method achieved the simple, fast, and sensitive measurement of nine estrogens with quantitative recoveries (higher than 85.4%). Detection and quantification limits were between 1 and 17 ng L-1 and between 3 and 58 ng L-1, respectively, for all compounds in water. The estrogens E1 and E2 were found in WWTP effluent at concentrations of 7 ± 1 and 41 ± 1 ng L-1, respectively, and EE2 was detected at a concentration below the limit of quantitation. This study shows that the proposed method is suitable for the accurate, rapid, and selective determination of all these analytes at trace levels. Graphical abstract ᅟ.

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A combination of rotating disk sorptive extraction (RDSE) using Oasis® HLB as the sorbent phase and gas chromatography mass spectrometry (GC-MS) has been performed for the determination of four of the most widely used parabens: methylparaben, ethylparaben, propylparaben and n-butylparaben. The extraction and derivatization of the analytes in water samples were optimized by using factorial (screening) and Doehlert designs, thus reducing the number of analyses with the concomitant reduction of time, reagents, waste, samples and cost. Thus, a RDSE method using 20mL of sample was performed. The disk was rotated at 2900rpm for 70min at room temperature. After a desorption step and evaporation of solvent, a derivatization method using 5µL of N-methyl-N-(trimethylsilyl)trifluoroacetamide (MSTFA) for 15min at room temperature was used previously to inject the final extract into GC-MS. The detection limits and precision (%RSD) were lower than 0.05µgL- 1 and 9.7% for the studied compounds, respectively. Recoveries were studied using effluent samples of a wastewater treatment plant (WWTP), with values higher than 80% being obtained. The applicability and reliability of this methodology were confirmed through the analysis of tap water and influents from Santiago, Chile, with concentration values ranging from 0.57 to 0.83µgL- 1 in influents. The main advantage of the present RDSE method is that it is significantly faster than its counterpart by SBSE and requires a considerable lower volume of derivatizing agent.

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Chikungunya en la mujer embarazada constituye un estado nosológico que pone en peligro la vida materno-infantil durante el periodo perinatal. Con el objetivo de determinar el perfil clínico epidemiológico de embarazadas con Chikungunya bajo vigilancia epidemiológica, se realizo un estudio descriptivo y epidemiológico retrospectivo con una muestra de fichas epidemiológicas de 100 embarazadas con Chikungunya durante el segundo semestre del año 2014.Los datos obtenidos fueron procesados y analizados utilizando medidas de tendencia central, porcentajes e intervalos de confianza. Los resultados indican un promedio de 27 años de edad, siendo el eje Metropolitano de la ciudad de Maracay el de mayor incidencia con 86% de los casos de la entidad federal. El promedio del tiempo de embarazo fue entre las semanas 36 y 40 en 30% de ellas. La red pública representó 53% de las referencias. Las manifestaciones clínicas incluyen fiebre 94%, artralgias 84%, cefalea 75%, erupción cutánea 64%, náuseas y vómitos 45% y 43% respectivamente y disminución sustancial del hematocrito. En la evolución de las gestantes con Chikungunya no se encontró un comportamiento distinto al de la triada clínica de la enfermedad. Se evidenció un buen control prenatal con un estándar normal de 6 controles prenatales. Un bajo porcentaje de las embarazadas ingresó a la unidad de cuidados intensivos. Las complicaciones más frecuentes fueron la preeclamsia grave y la amenaza de parto pretérmino. El mal llenado de las fichas e historias clínicas impidió conocer con detalle los avances significativos en la toma de decisiones con respecto a la enfermedad.

Chikungunya in pregnant women is a nosological state that endangers life maternal and child during the perinatal period. In order to determine the clinical and epidemiological profile of pregnant women with Chikungunya under epidemiological surveillance, descriptive and retrospective epidemiological study with a sample of 100 pregnant epidemiological chips with Chikungunya was conducted during the second half of the year 2014.Los data were processed and analyzed using measures of central tendency, percentages and confidence intervals. The results indicate an average of 27 years of age, being the Metropolitan axis of the city of Maracay the highest incidence with 86% of cases the federal entity. The average length of pregnancy was between weeks 36 and 40 in 30% of them. The public network represented 53% of the references. Clinical manifestations include fever 94%, arthralgia 84%, headache 75%, 64% rash, nausea and vomiting 45% and 43% respectively and substantially decreased hematocrit. In the evolution of pregnant women with Chikungunya a different triad clinical behavior of the disease was found. good prenatal care with a normal standard 6 prenatal visits was evident. A low percentage of pregnant entered the intensive care unit. The most frequent complications were severe preeclampsia and preterm labor. The poor completion of clinical histories and files kept detailed knowledge significant advances in making decisions regarding the disease.

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A novel analytical approach involving an improved rotating-disk sorptive extraction (RDSE) procedure and ultra-high-performance liquid chromatography (UHPLC) coupled to an ultraspray electrospray ionization source (UESI) and time-of-flight mass spectrometry (TOF/MS), in trap mode, was developed to identify and quantify four non-steroidal anti-inflammatory drugs (NSAIDs) (naproxen, ibuprofen, ketoprofen and diclofenac) and two anti-cholesterol drugs (ACDs) (clofibric acid and gemfibrozil) that are widely used and typically found in water samples. The method reduced the amount of both sample and reagents used and also the time required for the whole analysis, resulting in a reliable and green analytical strategy. The analytical eco-scale was calculated, showing that this methodology is an excellent green analysis, increasing its ecological worth. The detection limits (LOD) and precision (%RSD) were lower than 90ng/L and 10%, respectively. Matrix effects and recoveries were studied using samples from the influent of a wastewater treatment plant (WWTP). All the compounds exhibited suppression of their signals due to matrix effects, and the recoveries were approximately 100%. The applicability and reliability of this methodology were confirmed through the analysis of influent and effluent samples from a WWTP in Santiago, Chile, obtaining concentrations ranging from 1.1 to 20.5µg/L and from 0.5 to 8.6µg/L, respectively.

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BACKGROUND: Astrocytomas of the spinal cord have rarely been reported. We examined our experience, treatment and outcome of patients treated during the last four years. MATERIAL AND METHODS: We reviewed the charts from patients treated for this neoplasm in a multidisciplinary team of Granada, Spain. The information was retrospectively obtained from the patients' hospital records. The patients were evaluated with clinical history, physical exam, spinal magnetic resonance (MR), surgery, location and histology, treatment, and follow-up. RESULTS: In the last four years, we have treated 37 astrocytomas, of which only 3 were intramedullary. All patients underwent surgery, radiotherapy and chemotherapy. Two patients died, but one is alive and practically asymptomatic. CONCLUSION: The optimal treatment remains controversial. Radiotherapy should be considered for tumors with high-grade histopathology, clinically progressive and when a substantial resection cannot be achieved. New therapeutic strategies need to be studied to improve survival.

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La Diabetes Gestacional, definida como la Diabetes Mellitus detectada durante el embarazo, ocurre aproximadamente en 1 a14% de los embarazos y se considera en algunos países la complicación médica más común durante la gestación. Con el objetivo de caracterizar los factores de riesgo para esta enfermedad como: edad, obesidad, dislipidemia, historia familiar de diabetes, antecedentes de hipertensión arterial y estilo de vida, fue desarrollado un estudio descriptivo, mediante el cual fueron revisadas 71 historias médicas de pacientes con diagnóstico de Diabetes Gestacional, durante los años 2001-2007. Los resultados obtenidos evidencian una prevalencia correspondiente al Estado Aragua, de 0,78%, la distribución geográfica por municipios, correspondió principalmente a Girardot, Zamora y Mario Briceño Iragorry. La caracterización obtenida fue: procedencia de zonas urbanas, edad superior a los 25 años, antecedentes en primer grado de familiares con Diabetes mellitus, ocupación oficios del hogar, estado civil soltera y nivel de instrucción secundaria. Las complicaciones más frecuentes fueron infecciones urinarias; hipertensión arterial inducida por el embarazo y amenaza de parto pretérmino; la atención del parto de las pacientes fue vía abdominal y no se reportó mortalidad materna. Se recomienda realizar otras investigaciones epidemiológicas, desarrollar e implementar el programa de Diabetes Gestacional para el control de las pacientes, permitiendo la integración de un equipo interdisciplinario para el estado Aragua.

Gestational Diabetes, defined as diabetes mellitus detected during pregnancy, occurs in approximately 1%-14% of all pregnancies and in some countries is considered the most common medical complication of pregnancy. The goal of the study was to characterize the risk factors for the onset of gestational diabetes, such as age, obesity, dyslipidemia, family history of diabetes, personal history of hypertension, and lifestyle. The study performed was a non-experimental descriptive field study. Seventyone medical histories of patients diagnosed with gestational diabetes were reviewed during the years: 2001-2007. The results showed a prevalence of gestational diabetes for the State of Aragua of 0,78 %, geographical distribution was mainly in the municipalities of Girardot, Zamora and Mario Briceño Iragorry. Characterization findings were: urban residents, age over 25 years, family history of diabetes mellitus in first-degree relatives, homemakers, single women, secondary-school level of education. The most frequent complications were: urinary tract infections, pregnancy induced hypertension and threat of preterm delivery. Patients studied had abdominal deliveries and no maternal mortality was reported. Recommendations include performing additional epidemiological studies, developing and implementing a gestational diabetes program for managing patients, thereby promoting the integration of an interdisciplinary team for the State of Aragua.

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Este trabajo es fruto de una investigación desarrollada en dos etapas. La primera consiste en un análisis sistemático del Programa de Planificación Familiar del Ministerio de Sanidad y Asistencia Social para el año 1991, el cual se disgrega en tres elementos constitutivos: entrada, proceso y salida. ante los hallazgos reflejados en la primera parte surge la necesidad de profundizar el análisis de este Programa por lo que se procede a su Instrumentalización en un segundo capítulo, tomando en cuenta las actividades médicas, administrativas y de motivación para el año 1992

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