Publications by authors named "Eduardo De Miguel"

15 Publications

  • Page 1 of 1

Modelling the Transference of Trace Elements between Environmental Compartments in Abandoned Mining Areas.

Int J Environ Res Public Health 2020 07 15;17(14). Epub 2020 Jul 15.

Prospecting & Environment Laboratory (PROMEDIAM), Universidad Politécnica de Madrid, 28003 Madrid, Spain.

An openly accessible cellular automaton has been developed to predict the preferential migration pathways of contaminants by surface runoff in abandoned mining areas. The site where the validation of the results of the Contaminant Mass Transfer Cellular Automaton (CMTCA) has been carried out is situated on the steep flank of a valley in the Spanish northwestern region of Asturias, at the foot of which there is a village with 400 inhabitants, bordered by a stream that flows into a larger river just outside the village. Soil samples were collected from the steep valley flank where the mine adits and spoil heaps are situated, at the foot of the valley, and in the village, including private orchards. Water and sediment samples were also collected from both surface water courses. The concentration of 12 elements, including those associated with the Cu-Co-Ni ore, were analyzed by ICP-OES (Perkin Elmer Optima 3300DV, Waltham, MA, USA) and ICP-MS (Perkin Elmer NexION 2000, Waltham, MA, USA). The spatial representation of the model's results revealed that those areas most likely to be crossed by soil material coming from source zones according to the CMTCA exhibited higher pollution indexes than the rest. The model also predicted where the probabilities of soil mass transfer into the stream were highest. The accuracy of this prediction was corroborated by the results of trace element concentrations in stream sediments, which, for elements associated with the mineral paragenesis (i.e., Cu, Co, Ni, and also As), increased between five- and nine-fold downstream from the predicted main transfer point. Lastly, the river into which the stream discharges is also affected by the mobilization of mined materials, as evidenced by an increase of up to 700% (in the case of Cu), between dissolved concentrations of those same elements upstream and downstream of the confluence of the river and the stream.
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http://dx.doi.org/10.3390/ijerph17145117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400299PMC
July 2020

Urban Allotment Gardens for the Biomonitoring of Atmospheric Trace Element Pollution.

J Environ Qual 2019 Mar;48(2):518-525

This study evaluates the results of the characterization of air pollution in urban green areas using edible plants. To this purpose, we examined the effect of location (i.e., three different levels of pollution), substrate (peat moss and vermiculite), and plant species (oilseed rape [ L.] and kale [ L.]) on the accumulation of trace elements on leaves. A total of 36 samples of unwashed leaves were digested with HNO-HO and analyzed for 27 elements by inductively coupled plasma mass spectrometry. Considering the location, plants exposed next to the road showed higher contents of traffic-related elements, and additionally, outdoors samples were enriched in marine aerosol ions. Cadmium and Pb concentrations did not exceed the European legal maximum levels for vegetables, so their consumption would be safe for human health. Results support the hypothesis that edible plants such as kale and rapeseed could be used as bioindicators of atmospheric pollution.
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http://dx.doi.org/10.2134/jeq2018.06.0232DOI Listing
March 2019

Applicability of radon emanometry in lithologically discontinuous sites contaminated by organic chemicals.

Environ Sci Pollut Res Int 2018 Jul 2;25(20):20255-20263. Epub 2018 Jun 2.

Prospecting & Environment Laboratory (PROMEDIAM), Universidad Politécnica de Madrid, c/ Alenza 4, 28003, Madrid, Spain.

The applicability of radon (Rn) measurements to delineate non-aqueous phase liquids (NAPL) contamination in subsoil is discussed at a site with lithological discontinuities through a blind test. Three alpha spectroscopy monitors were used to measure radon in soil air in a 25,000-m area, following a regular sampling design with a 20-m grid. Repeatability and reproducibility of the results were assessed by means of duplicate measurements in six sampling positions. Furthermore, three points not affected by oil spills were sampled to estimate radon background concentration in soil air. Data histograms, Q-Q plots, variograms, and cluster analysis allowed to recognize two data populations, associated with the possible path of a fault and a lithological discontinuity. Even though the concentration of radon in soil air was dominated by this discontinuity, the characterization of the background emanation in each lithological unit allowed to distinguish areas potentially affected by NAPL, thus justifying the application of radon emanometry as a screening technique for the delineation of NAPL plumes in sites with lithological discontinuities.
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http://dx.doi.org/10.1007/s11356-018-2372-9DOI Listing
July 2018

Prospective Clinical Integration of an Amplicon-Based Next-Generation Sequencing Method to Select Advanced Non-Small-Cell Lung Cancer Patients for Genotype-Tailored Treatments.

Clin Lung Cancer 2018 01 23;19(1):65-73.e7. Epub 2017 Jun 23.

Medical Oncology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación i+12, Madrid, Spain; Lung Cancer Group, Clinical Research Program, CNIO (Centro Nacional de Investigaciones Oncológicas) and Instituto de Investigación i+12, Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.

Introduction: A substantial fraction of non-small-cell lung cancers (NSCLCs) harbor targetable genetic alterations. In this study, we analyzed the feasibility and clinical utility of integrating a next-generation sequencing (NGS) panel into our routine lung cancer molecular subtyping algorithm.

Patients And Methods: After routine pathologic and molecular subtyping, we implemented an amplicon-based gene panel for DNA analysis covering mutational hot spots in 22 cancer genes in consecutive advanced-stage NSCLCs.

Results: We analyzed 109 tumors using NGS between December 2014 and January 2016. Fifty-six patients (51%) were treatment-naive and 82 (75%) had lung adenocarcinomas. In 89 cases (82%), we used samples derived from lung cancer diagnostic procedures. We obtained successful sequencing results in 95 cases (87%). As part of our routine lung cancer molecular subtyping protocol, single-gene testing for EGFR, ALK, and ROS1 was attempted in nonsquamous and 3 squamous-cell cancers (n = 92). Sixty-nine of 92 samples (75%) had sufficient tissue to complete ALK and ROS1 immunohistochemistry (IHC) and NGS. With the integration of the gene panel, 40 NSCLCs (37%) in the entire cohort and 30 NSCLCs (40%) fully tested for ALK and ROS1 IHC and NGS had actionable mutations. KRAS (24%) and EGFR (10%) were the most frequently mutated actionable genes. Ten patients (9%) received matched targeted therapies, 6 (5%) in clinical trials.

Conclusion: The combination of IHC tests for ALK and ROS1 and amplicon-based NGS is applicable in routine clinical practice, enabling patient selection for genotype-tailored treatments.
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http://dx.doi.org/10.1016/j.cllc.2017.06.008DOI Listing
January 2018

Pseudocirrhosis in metastatic breast cancer.

Gastroenterol Hepatol 2018 02 7;41(2):111-113. Epub 2017 Feb 7.

Servicio de Aparato Digestivo, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España.

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http://dx.doi.org/10.1016/j.gastrohep.2016.12.005DOI Listing
February 2018

Risk assessment from exposure to arsenic, antimony, and selenium in urban gardens (Madrid, Spain).

Environ Toxicol Chem 2017 02 6;36(2):544-550. Epub 2016 Sep 6.

Environmental Geochemistry Research and Engineering Laboratory, Universidad Politecnica de Madrid, Madrid, Spain.

The authors discuss the geochemical behavior of arsenic (As), antimony (Sb), and selenium (Se) in urban gardens and the human health implications associated with urban agriculture. A total of 42 samples from 7 urban gardens in Madrid, Spain, were collected from the top 20 cm of soil. Concentrations of As, Sb, and Se and the main soil properties (i.e., total iron, pH, texture, calcium carbonate, and organic matter) were determined. A significant correlation was found between As and Sb and calcium carbonate, indicating the possibility of surface adsorption or ligand exchange with the carbonate group. Also, Sb seemed to form stable chelates with soil organic matter. On the other hand, Se showed a significant association with clay and iron content. The concentration of Sb in soil exceeded the recommended value for agricultural use in 70% of the urban gardens. A human health risk assessment resulted in acceptable levels of both noncarcinogenic and carcinogenic risks (although with elevated values of the latter), with As as the main risk driver and soil and food ingestion as the main exposure pathways. The numerical results of the risk assessment should be interpreted with caution given the considerable uncertainties in some exposure variables and the lack of quantitative values for the suspected carcinogenicity of Sb and Se. Environ Toxicol Chem 2017;36:544-550. © 2016 SETAC.
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http://dx.doi.org/10.1002/etc.3569DOI Listing
February 2017

Determinants of false-negative results in non-small-cell lung cancer staging by endobronchial ultrasound-guided needle aspiration.

Eur J Cardiothorac Surg 2015 Apr 8;47(4):642-7. Epub 2014 Jul 8.

Hospital Universitari del Parc Taulí, Sabadell, Spain Departament de Medicina, Universitat Autónoma de Barcelona, Bellaterra, Spain Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain.

Objectives: False-negative results of endobronchial ultrasound-guided transbronchial needle aspiration in non-small-cell lung cancer staging have shown significant variability in previous studies. The aim of this study was to identify procedure- and tumour-related determinants of endobronchial ultrasound-guided transbronchial needle aspiration false-negative results.

Methods: We conducted a prospective study that included non-small-cell lung cancer patients staged as N0/N1 by endobronchial ultrasound-guided transbronchial needle aspiration and undergoing therapeutic surgery. The frequency of false-negative results in the mediastinum was calculated. Procedure-related, first, and tumour-related, second, determinants of false-negative results in stations reachable and non-reachable by endobronchial ultrasound were determined by multivariate logistic regression.

Results: False-negative endobronchial ultrasound-guided transbronchial needle aspiration results were identified in 23 of 165 enrolled patients (13.9%), mainly in stations reachable by endobronchial ultrasound (17 cases, 10.3%). False-negative results were related to the extensiveness of endobronchial ultrasound sampling: their prevalence was low (2.4%) when sampling of three mediastinal stations was satisfactory, but rose above 10% when this requirement was not fulfilled (P = 0.043). In the multivariate analysis, abnormal mediastinum on computer tomography/positron emission tomography [odds ratio (OR) 7.77, 95% confidence interval (CI) 2.19-27.51, P = 0.001] and extensiveness of satisfactory sampling of mediastinal stations (OR 0.37, 95% CI 0.16-0.89, P = 0.026) were statistically significant risk factors for false-negative results in stations reachable by endobronchial ultrasound. False-negative results in non-reachable nodes were associated with a left-sided location of the tumour (OR 10.11, 95% CI 1.17-87.52, P = 0.036).

Conclusions: The presence of false-negative ultrasound-guided transbronchial needle aspiration results were observed in nearly 15% of non-small-cell lung cancer patients but in only 3% when satisfactory samples were obtained from three mediastinal stations. False-negative results in stations reachable by endobronchial ultrasound were associated with the extensiveness of sampling, and in stations out of reach of endobronchial ultrasound with left-sided tumours. These results suggest that satisfactory sampling of at least three mediastinal stations by EBUS-TBNA may be a quality criterion to be recommended for EBUS-TBNA staging.
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http://dx.doi.org/10.1093/ejcts/ezu253DOI Listing
April 2015

Probabilistic meta-analysis of risk from the exposure to Hg in artisanal gold mining communities in Colombia.

Chemosphere 2014 Aug 15;108:183-9. Epub 2014 Feb 15.

Environmental Geochemistry Research and Engineering Laboratory, Universidad Politécnica de Madrid, Alenza 4, E-28003 Madrid, Spain.

Colombia is one of the largest per capita mercury polluters in the world as a consequence of its artisanal gold mining activities. The severity of this problem in terms of potential health effects was evaluated by means of a probabilistic risk assessment carried out in the twelve departments (or provinces) in Colombia with the largest gold production. The two exposure pathways included in the risk assessment were inhalation of elemental Hg vapors and ingestion of fish contaminated with methyl mercury. Exposure parameters for the adult population (especially rates of fish consumption) were obtained from nation-wide surveys and concentrations of Hg in air and of methyl-mercury in fish were gathered from previous scientific studies. Fish consumption varied between departments and ranged from 0 to 0.3 kg d(-1). Average concentrations of total mercury in fish (70 data) ranged from 0.026 to 3.3 μg g(-1). A total of 550 individual measurements of Hg in workshop air (ranging from
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http://dx.doi.org/10.1016/j.chemosphere.2014.01.035DOI Listing
August 2014

The relationship between soil geochemistry and the bioaccessibility of trace elements in playground soil.

Environ Geochem Health 2012 Dec 28;34(6):677-87. Epub 2012 Sep 28.

Environmental Geochemistry Research and Engineering Laboratory, Universidad Politécnica de Madrid, Alenza 4, 28003, Madrid, Spain.

A total of 32 samples of surficial soil were collected from 16 playground areas in Madrid (Spain), in order to investigate the importance of the geochemistry of the soil on subsequent bioaccessibility of trace elements. The in vitro bioaccessibility of As, Co, Cr, Cu, Ni, Pb and Zn was evaluated by means of two extraction processes that simulate the gastric environment and one that reproduces a gastric + intestinal digestion sequence. The results of the in vitro bioaccessibility were compared against aqua regia extractions ("total" concentration), and it was found that total concentrations of As, Cu, Pb and Zn were double those of bioaccessible values, whilst that of Cr was ten times higher. Whereas the results of the gastric + intestinal extraction were affected by a high uncertainty, both gastric methods offered very similar and consistent results, with bioaccessibilities following the order: As = Cu = Pb = Zn > Co > Ni > Cr, and ranging from 63 to 7 %. Selected soil properties including pH, organic matter, Fe and CaCO(3) content were determined to assess their influence on trace element bioaccessibility, and it was found that Cu, Pb and Zn were predominantly bound to organic matter and, to a lesser extent, Fe oxides. The former fraction was readily accessible in the gastric solution, whereas Fe oxides seemed to recapture negatively charged chloride complexes of these elements in the gastric solution, lowering their bioaccessibility. The homogeneous pH of the playground soils included in the study does not influence trace element bioaccessibility to any significant extent except for Cr, where the very low gastric accessibility seems to be related to the strongly pH-dependent formation of complexes with organic matter. The results for As, which have been previously described and discussed in detail in Mingot et al. (Chemosphere 84: 1386-1391, 2011), indicate a high gastric bioaccessibility for this element as a consequence of its strong association with calcium carbonate and the ease with which these bonds are broken in the gastric solution. The calculation of risk assessments are therefore dependant on the methodology used and the specific environment they address. This has impacts on management strategies formulated to ensure that the most vulnerable of society, children, can live and play without adverse consequences to their health.
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http://dx.doi.org/10.1007/s10653-012-9486-7DOI Listing
December 2012

Assessment of oral bioaccessibility of arsenic in playground soil in Madrid (Spain): a three-method comparison and implications for risk assessment.

Chemosphere 2011 Sep 23;84(10):1386-91. Epub 2011 May 23.

Environmental Geochemistry Research and Engineering Laboratory, Universidad Politécnica de Madrid, Alenza 4, E-28003 Madrid, Spain.

Three methodologies to assess As bioaccessibility were evaluated using playground soil collected from 16 playgrounds in Madrid, Spain: two (Simplified Bioaccessibility Extraction Test: SBET, and hydrochloric acid-extraction: HCl) assess gastric-only bioaccessibility and the third (Physiologically Based Extraction Test: PBET) evaluates mouth-gastric-intestinal bioaccessibility. Aqua regia-extractable (pseudo total) As contents, which are routinely employed in risk assessments, were used as the reference to establish the following percentages of bioaccessibility: SBET-63.1; HCl-51.8; PBET-41.6, the highest values associated with the gastric-only extractions. For Madrid playground soils--characterised by a very uniform, weakly alkaline pH, and low Fe oxide and organic matter contents--the statistical analysis of the results indicates that, in contrast with other studies, the highest percentage of As in the samples was bound to carbonates and/or present as calcium arsenate. As opposed to the As bound to Fe oxides, this As is readily released in the gastric environment as the carbonate matrix is decomposed and calcium arsenate is dissolved, but some of it is subsequently sequestered in unavailable forms as the pH is raised to 5.5 to mimic intestinal conditions. The HCl extraction can be used as a simple and reliable (i.e. low residual standard error) proxy for the more expensive, time consuming, and error-prone PBET methodology. The HCl method would essentially halve the estimate of carcinogenic risk for children playing in Madrid playground soils, providing a more representative value of associated risk than the pseudo-total concentrations used at present.
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http://dx.doi.org/10.1016/j.chemosphere.2011.05.001DOI Listing
September 2011

Sensitivity of linear endobronchial ultrasonography and guided transbronchial needle aspiration for the identification of nodal metastasis in lung cancer staging.

Ultrasound Med Biol 2009 Aug 21;35(8):1271-7. Epub 2009 Jun 21.

Pneumology Department, Hospital Germans Trias i Pujol, Badalona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.

The aim of this study is to determine the sensitivity of real-time endobronchial ultrasonography (EBUS)-guided transbronchial needle aspiration (TBNA) in lung cancer staging. Short- and long-axis node diameters were measured during EBUS in patients referred for lung cancer staging and sensitivities for the identification of nodal malignancy at TBNA determined. Three hundred fifteen real-time EBUS-guided TBNA nodal sampling procedures were performed in 161 patients and in 87 of them, N2/N3 metastasis was confirmed (50.9%), eliminating the need for mediastinoscopy. The median (interquartile range [IQR]) short-axis diameters of the sampled mediastinal and lobar nodes were 11 (8-15) and 8 (7-12) mm, respectively. TBNA provided satisfactory samples from 269 nodes (85.4%) and a sensitivity of 100% for the identification of malignant TBNA samples was reached for a short-axis diameter cut-off of 5 mm and a short- to long-axis ratio of 0.5. The probability of malignancy was over 90% for nodes with a short-axis diameter >20 mm and 55% for round nodes (short- to long-axis ratio of 1). In 18 out of 50 patients with a normal mediastinal computed tomography (CT) scan, the technique identified enlarged nodes in the mediastinum (36%), mainly in the subcarinal region and confirmed mediastinal malignancy in 8 (10%). Real-time EBUS-guided TBNA obtains satisfactory node samples in almost 90% of cases and improves the identification of enlarged nodes in patients with a normal mediastinum at CT. If sampling all nodes with a short-axis diameter of > or =5 mm and a short- to long-axis ratio > or =0.5, a sensitivity of 100% for the cytologic identification of malignant nodes can be expected.
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http://dx.doi.org/10.1016/j.ultrasmedbio.2009.03.007DOI Listing
August 2009

The role of airway stenting in pediatric tracheobronchial obstruction.

Eur J Cardiothorac Surg 2008 Jun 4;33(6):1069-75. Epub 2008 Mar 4.

Pediatric Airway Unit and Division of Pediatric Surgery, Pediatric Institute of the Heart, Doce de Octubre, University Hospital, Madrid, Spain.

Objective: Tracheobronchial obstruction is infrequent in the pediatric age group but it is associated with significant morbidity and mortality. The purpose of this study is to review the results of a single institution experience with endoscopic stent placement in children with benign tracheobronchial obstruction, and with special concern on safety and clinical effectiveness.

Materials And Methods: Twenty-one patients with severe airway stenosing disease in which stent placement was performed between 1993 and 2006. Inclusion criteria according to the clinical status were: failure to wean from ventilation, episode of apnea, frequent respiratory infections (>3 pneumonia/year), and severe respiratory distress. Additional criteria for stent placement were: failure of surgical treatment, bronchomalacia, and tracheomalacia refractory to previous tracheostomy. Selection of the type of stent depended on the site of the lesion, the patient's age, and the stent availability when time of presentation. The following variables were retrospectively evaluated: age, type of obstruction, associated malformations, stent properties, technical and clinical success, complications and related reinterventions, outcome and follow-up period.

Results: Thirty-three stents were placed in the trachea (n=18) and/or bronchi (n=15) of 21 patients with a median age of 6 months (range, 9 days-19 years). Etiology of the airway obstruction included severe tracheomalacia and/or bronchomalacia in 19 cases (90%), and postoperative tracheal stenosis in two. Twelve children had a total of 20 balloon-expandable metallic stents placed, and 10 had 13 silicone-type stents (one patient had both). In nine patients (42%) more than one device was placed. Stent positioning was technically successful in all but one patient. Clinical improvement was observed in 18 patients (85%) but complications occurred in five of them (27%). Eight patients died during follow-up but only in one case it was related to airway stenting. Thirteen patients (62%) are alive and in good condition with a mean follow-up of 39 months (1-13.8 years).

Conclusions: Although the results were based on a small series, placement of stents in the pediatric airway to treat tracheobronchial obstruction seems to be safe and effective. Stenting is a satisfactory therapeutic option when other procedures have failed or are not indicated.
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http://dx.doi.org/10.1016/j.ejcts.2008.01.034DOI Listing
June 2008

High-frequency jet ventilation in interventional bronchoscopy: factors with predictive value on high-frequency jet ventilation complications.

J Clin Anesth 2006 Aug;18(5):349-56

Department of Anesthesiology, University Hospital, 12 de Octubre Av. Andalucia Km 5.4, 28041 Madrid, Spain.

Study Objective: To evaluate the incidence and impact on clinical outcome of complications observed during high-frequency jet ventilation (HFJV) at interventional bronchoscopy and to identify the perioperative factors that may be associated to an increased incidence of such complications.

Design: Observational retrospective, study with an observational prospective validation of the statistically significant associations.

Setting: University hospital.

Patients: The retrospective study involved 276 patients who underwent an interventional rigid bronchoscopy during general anesthesia and HFJV. Forty consecutive patients were accrued for the prospective validation group. INTERVENTIONS/MEASUREMENTS: Information recorded included patient medical history and perioperative complications observed at HFJV-managed bronchoscopic procedures and their impact on clinical outcome until hospital discharge.

Main Results: At least one complication was detected in 38% of retrospective patients and 55% of prospective patients. Most frequent complications were hypercapnia, hypoxemia, and hemodynamic instability, but just one case of barotrauma in the retrospective group. Despite the high incidence, these complications were transient and did not increase hospital stay, whereas technical failure to widen airway lumen was associated with an adverse prognosis. Several clinical parameters showed a significant association with complications in the univariate analysis. However, the multivariate analysis only evidenced two independent predictive factors: the ASA physical status scale and baseline oxygen saturation.

Conclusions: Classification in ASA physical status IV group and a baseline oxygen saturation of 95% or less independently predicted the development of complications during interventional rigid bronchoscopy with HFJV.
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http://dx.doi.org/10.1016/j.jclinane.2005.12.011DOI Listing
August 2006

Geochemical fingerprints and controls in the sediments of an urban river: River Manzanares, Madrid (Spain).

Sci Total Environ 2005 Mar;340(1-3):137-48

Grupo de Geoquímica Ambiental, E.T.S.I Minas Madrid, Ríos Rosas 21, 28003 Madrid, Spain.

The geochemical fingerprint of sediment retrieved from the banks of the River Manzanares as it passes through the City of Madrid is presented here. The river collects the effluent water from several Waste Water Treatment (WWT) plants in and around the city, such that, at low flows, up to 60% of the flow has been treated. A total of 18 bank-sediment cores were collected along the course of the river, down to its confluence with the Jarama river, to the south-east of Madrid. Trace and major elements in each sample were extracted following a double protocol: (a) "Total" digestion with HNO3, HClO4 and HF; (b) "Weak" digestion with sodium acetate buffered to pH=5 with acetic acid, under constant stirring. The digests thus obtained were subsequently analysed by ICP-AES, except for Hg which was extracted with aqua regia and sodium chloride-hydroxylamine sulfate, and analysed by Cold Vapour-AAS. X-ray diffraction was additionally employed to determine the mineralogical composition of the samples. Uni- and multivariate analyses of the chemical data reveal the influence of Madrid on the geochemistry of Manzanares' sediments, clearly manifested by a marked increase in the concentration of typically "urban" elements Ag, Cr, Cu, Pb and Zn, downstream of the intersection of the river with the city's perimeter. The highest concentrations of these elements appear to be associated with illegal or accidental dumping of waste materials, and with the uncontrolled incorporation of untreated urban runoff to the river. The natural matrix of the sediment is characterised by fairly constant concentrations of Ce, La and Y, whereas changes in the lithology intersected by the river cause corresponding variations in Ca-Mg and Al-Na contents. In the final stretch of the river, the presence of carbonate materials seems to exert a strong geochemical control on the amount of Zn and, to a lesser extent, Cu immobilised in the sediments. This fact suggests that a variable but significant proportion of both elements may be susceptible to reincorporation in the aqueous phase under realistic environmental conditions.
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http://dx.doi.org/10.1016/j.scitotenv.2004.07.031DOI Listing
March 2005

Endobronchial hamartoma.

Chest 2002 Jul;122(1):202-5

Respiratory Department, Hospital 12 de Octubre, Madrid, Spain.

Objectives: To describe clinical, endoscopic, radiographic, and follow-up characteristics of a series of patients in whom endobronchial hamartoma (EH) had been diagnosed.

Methods: Retrospective study of all cases of hamartoma diagnosed by bronchial biopsy between 1974 and 1997 in a tertiary referral hospital in Madrid, Spain.

Results: EH was diagnosed 47 patients during the study period. Four patients were excluded from the study because no clinical history was available. We analyzed the cases of 43 patients (37 men and 6 women), with a mean (+/- SD) age of 62 +/- 12 years. Seven patients had a concurrent lung neoplasm, and the EH was an incidental endoscopic finding. Among the other 36 patients, 31 had a new onset of respiratory symptoms, most commonly, recurrent respiratory infections in 16 patients (44%) and hemoptysis in a further 12 patients (33.4%). Chest radiograph findings were abnormal in 38 of 43 patients. At bronchoscopy, the lesions were equally distributed throughout the right and left lungs with no clear lobar predilection. Endobronchial obstruction was evident in 26 patients (72.2%) without concurrent neoplasm, 17 of whom underwent resection with a rigid bronchoscope and laser, with total resolution in 13 patients. Partial resolution was achieved in four patients, two of whom needed a second endoscopic procedure. Five patients were treated with open lung surgery. Clinical and endoscopic follow-up was performed in 23 patients at 1 to 73 months (mean, 17 months), and recurrence was found in 4 patients.

Conclusion: EH frequently produces respiratory complaints and radiographic abnormalities. Patients with endobronchial obstructions had satisfactory responses to endoscopic therapy.
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http://dx.doi.org/10.1378/chest.122.1.202DOI Listing
July 2002