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Montanes Bermudez R.,Servicio Of Laboratorio | Gracia Garcia S.,Servicio Of Laboratorio | Fraga Rodriguez G.M.,Seccion de Nefrologia Pediatrica | Escribano Subias J.,Asociacion Espanola de Nefrologia Pediatrica AENP | And 5 more authors.
Anales de Pediatria

The appearance of the K/DOQI guidelines in 2002 on the definition, evaluation and staging of chronic kidney disease (CKD) have led to a major change in how to assess renal function in adults and children. These guidelines, recently updated, recommended that the study of renal function is based, not only on measuring the serum creatinine concentration, but this must be accompanied by the estimation of glomerular filtration rate (GFR) obtained by an equation. However, the implementation of this recommendation in the clinical laboratory reports in the paediatric population has been negligible. Numerous studies have appeared in recent years on the importance of screening and monitoring of patients with CKD, the emergence of new equations for estimating GFR, and advances in clinical laboratories regarding the methods for measuring plasma creatinine and cystatin C, determined by the collaboration between the departments of paediatrics and clinical laboratories to establish recommendations based on the best scientific evidence on the use of equations to estimate GFR in this population. The purpose of this document is to provide recommendations on the evaluation of renal function and the use of equations to estimate GFR in children from birth to 18 years of age. The recipients of these recommendations are paediatricians, nephrologists, clinical biochemistry, clinical analysts, and all health professionals involved in the study and evaluation of renal function in this group of patients. © 2013 Asociación Española de Pediatría. Published by Elsevier Espana, S.L. All rights reserved. Source

Calafell Clar R.,Asociacion Espanola de Farmaceuticos Analistas AEFA | Calafell Clar R.,Laboratorio Clinico | Gutierrez Bassini G.,Sociedad Espanola de Hematologia y Hemoterapia SEHH | Gutierrez Bassini G.,Laboratorio Clinico | And 12 more authors.
Revista del Laboratorio Clinico

Introduction: An Interdisciplinary Expert Committee was created by four Spanish Scientific Societies, organisers of external quality assurance programs, to provide laboratories a consensus of minimum analytical quality specifications with the aim of assuring similar analytical performance all over Spain. Material and method: A total of 1,262,623 results was obtained from 3688 laboratories and 24 periods studied (2005 and 2006). For each analyte, the absolute difference between the result and the comparative value (peer group mean), expressed in percentage, was calculated and named "error". From the error frequency distribution, the 95 percentile was considered as "candidate specification". This value was compared with the specification used in Germany and USA and, in the case of being higher than one of them, the "candidate specification" value was increased iteratively, until 90% of participating laboratories had 75% of their results within the "candidate specification". This value was considered to be the specification and the process ended. Results and conclusion: Specifications for 37 analytes (3 immunology, 5 therapeutic drug monitoring, 15 hormones and tumour markers, 14 haematology and coagulation are proposed. They are considered to be the minimum level of quality that each laboratory had to reach, to assure common analytical performance. If the results in the external quality assurance program exceed these specifications, an immediate review should be made and, if necessary, corrective actions should be taken. © 2010 AEBM, AEFA y SEQC. Source

Gonzalez-Estecha M.,Hospital Clinico San Carlos Institute Investigacion Sanitaria Idissc | Bodas-Pinedo A.,Asociacion de Educacion para la Salud ADEPS | Guillen-Perez J.J.,Sociedad Espanola de Sanidad Ambiental SESA | Rubio-Herrera M.A.,Sociedad Espanola de Endocrinologia y Nutricion SEEN | And 24 more authors.
Nutricion Hospitalaria

The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methylmercury, mainly from contaminated fish and shellfish, can have adverse health effects. The study group on the prevention of exposure to methylmercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies, has prepared a consensus document in a question and answer format, containing the group’s main conclusions, recommendations and proposals. The objective of the document is to provide broader knowledge of factors associated with methylmercury exposure, its possible effects on health among the Spanish population, methods of analysis, interpretation of the results and economic costs, and to then set recommendations for fish and shellfish consumption. The group sees the merit of all initiatives aimed at reducing or prohibiting the use of mercury as well as the need to be aware of the results of contaminant analyses performed on fish and shellfish marketed in Spain. In addition, the group believes that biomonitoring systems should be set up in order to follow the evolution of methylmercury exposure in children and adults and perform studies designed to learn more about the possible health effects of concentrations found in the Spanish population, ta-combusking into account the lifestyle, eating patterns and the Mediterranean diet. © 2015, Grupo Aula Medica S.A. All rights reserved. Source

Gonzalez-Estecha M.,Institute Investigacion Sanitaria IdISSC | Bodas-Pinedo A.,Asociacion de Educacion para la Salud ADEPS | Guillen-Perez J.J.,Sociedad Espanola de Sanidad Ambiental SESA | Rubio-Herrera M.A.,Sociedad Espanola de Endocrinologia y Nutricion SEEN | And 21 more authors.
Nutricion Hospitalaria

Mercury is an environmental toxicant that causes numerous adverse effects on human health and natural ecosystems. The factors that determine the existance of adverse effects, as well as their severity are, among others: the chemical form of mercury (elemental, inorganic, organic), dosis, age, period of exposure, pathways of exposure and environmental, nutritional and genetic factors. In the aquatic cycle of mercury, once it has been deposited, it is transformed into methylmercury due to the action of certain sulphate-reducing bacteria, which bioaccumulates in the aquatic organisms and moves into the food chain. The methylmercury content of large, long-lived fish such as swordfish, shark, tuna or marlin, is higher. Methylmercury binds to protein in fish and is therefore not eliminated by cleaning or cooking the fish. Fetuses and small children are more vulnerable to the neurotoxic effects of methylmercury from the consumption of contaminated fish. Methylmercury is absorbed in the gastrointestinal tract and crosses the blood-brain barrier and the placenta. The intake of certain dietary components such as polyunsaturated fatty acids, selenium, fiber, thiol compounds, certain phytochemicals and other nutrients can modify methylmercury bioaccesibility and its toxicity. Apart from environmental factors, genetic factors can influence mercury toxicity and explain part of the individual vulnerability. © 2014 Grupo Aula Medica S.A. All rights reserved. Source

Gonzalez-Estecha M.,Institute Investigacion Sanitaria IdISSC | Bodas-Pinedo A.,Asociacion de Educacion para la Salud ADEPS | Martinez-Garcia M.J.,Sociedad Espanola de Sanidad Ambiental SESA | Trasobares-Iglesias E.M.,Sociedad Espanola de Bioquimica Clinica y Patologia Molecular SEQC | And 22 more authors.
Nutricion Hospitalaria

The beneficial effects of fish consumption are well-known. Nevertheless, there is worldwide concern regard methylmercury concentrations in fish, which is why many countries such as the United States, Australia, New Zealand, Canada and numerous European countries have made fish consumption recommendations for their populations, particularly vulnerable groups, in order to México methylmercury intake. Blood and hair are the best biological samples for measuring methylmercury. The most widely-used method to analyse methylmercury is cold vapor atomic absorption spectrometry, although there are also direct methods based on the thermal decomposition of the sample. In recent years, the number of laboratories that measure mercury by inductively coupled plasma mass spectrometry has increased. In addition, the different kinds of mercury can be distinguished by coupling chromatography methods of separation. Laboratories that analyse mercury in biological samples need to participate in external quality control programmes. Even if mercury emissions are reduced, mercury may remain in the environment for many years, so dietary recommendations are fundamental in order to reduce exposure. It is necessary to propose public health measures aimed at decreasing mercury exposure and to evaluate the benefits of such measures from the economic and social standpoints. © 2015, Grupo Aula Medica S.A. All rights reserved. Source

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