This study was designed to estimate the dietary intake of arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) by the general population of Catalonia, Spain. The concentrations of these elements were determined in food samples randomly acquired in seven cities of Catalonia between June and August 2000. A total of 11 food groups were included in the study. As, Cd, Hg, and Pb levels were measured by ICP-MS and AAS. The dietary intake of these elements was determined by a total diet study. Calculations were carried out on the basis of recent data on the consumption of the selected food items. Trace element intake was estimated for five population groups: children, adolescents, male and female adults, and seniors. The highest dietary intakes of As (223.6 microg/day), Cd (15.7 microg/day), Hg (21.2 microg/day), and Pb (28.4 microg/day) corresponded to male adults. For all analyzed elements, fish and shellfish was the group showing the highest contribution to the respective intakes. In comparison with previous results, a general decrease in As, Cd, Hg, and Pb intake has occurred. The dietary intake of these elements was also compared with the provisional tolerable weekly intake (PTWI). Dietary intakes of As, Cd, Hg, and Pb by the population of Catalonia are currently well below the respective PTWIs.

Polybrominated diphenyl ethers (PBDEs) are used as flame retardants in a variety of materials, including synthetic polymers and textiles. Although these chemicals have been detected in environmental samples and human tissues, there is little information about human exposure to PBDEs through the diet. In the present study, we determined the concentrations of PBDEs in a number of food samples acquired in Catalonia (Spain) during 2000. The dietary intake of PBDEs was estimated for the general population living in this Spanish region. The highest PBDE concentrations were found in oils and fats, fish and shellfish, meat and meat products, and eggs, while the lowest levels corresponded to fruits, vegetables, and tubers. The dietary intake of PBDEs for an adult male was 97.3 ng/day (assuming not detected (ND) = (1)/(2) limit of detection (LOD)) or 81.9 ng/day (assuming ND = 0) The greatest contribution to these values corresponded to fish and shellfish, with approximately one-third of the total intake. TetraBDEs and pentaBDEs were the homologues showing the highest percentages of contribution to the sum of total PBDEs. The comparison of the current dietary intake with the suggested lowest observed adverse effect level value of 1 mg/kg/day for the most sensitive endpoints for toxic effects of PBDEs results in a safety factor over 5 orders of magnitude in relation to PBDE exposure from food.

The dietary intake of 16 polycyclic aromatic hydrocarbons (PAHs) (naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene, pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene, dibenz[a,h]anthracene, benzo[g,h,i]perylene, and indeno[1,2,3-c,d]pyrene) by the general population of Catalonia, Spain, was calculated. Concentrations of PAHs in food samples randomly acquired in seven cities of Catalonia from June to August 2000 were measured. Eleven food groups were included in the study. High-performance liquid chromatography was used to analyze PAHs. The dietary intakes of total and carcinogenic PAHs was calculated for five population groups: children, adolescents, male adults, female adults, and seniors. Among the analyzed PAHs, there was a predominance of phenanthrene (16.7 microg/kg) and pyrene (10.7 microg/kg). By food group, the highest levels of total PAHs were detected in cereals (14.5 microg/kg) and in meat and meat products (13.4 microg/kg). The mean estimated dietary intake of the sum of the 16 PAHs was as follows: male adults, 8.4 microg/day; adolescents, 8.2 microg/day; children, 7.4 microg/day; seniors, 6.3 microg/day; female adults, 6.3 microg/day. The calculated daily intake of PAHs would be associated with a 5/106 increase in the risk for the development of cancer in a male adult with a body weight of 70 kg.

Concentrations of polychlorinated naphthalenes (PCNs) were measured in foodstuffs randomly acquired in seven cities of Catalonia, Spain. A total of 108 samples, belonging to 11 food groups (vegetables, tubers, fruits, cereals, pulses, fish and shellfish, meat and meat products, eggs, milk, dairy products, and oils and fats), were analyzed by high-resolution gas chromatography/high-resolution mass spectrometry (HRGC/HRMS). The levels of tetra-, penta-, hexa-, and hepta-CNs, those of octachloronaphthalene, and the mean sum concentration of tetra-octa-CN were determined. The highest concentration of total PCNs was found in oils and fats (447 pg/g), followed by cereals (71 pg/g), fish and shellfish (39 pg/g), and dairy products (36 pg/g). In general, tetra-CN was the predominant homologue in all food groups except for fruits and pulses, which had greater proportions of hexa-CNs. The dietary intake of total PCNs was subsequently determined. For calculations, recent data on consumption of the selected food items were used. Intake of PCNs was estimated for five population groups of Catalonia: children, adolescents, male and female adults, and seniors. When the dietary intake of total PCNs was expressed in nanogram per kilogram of body weight per day, it was age-dependent, with the highest and lowest values corresponding to children (1.65) and seniors (0.54), respectively. The largest contribution to the daily PCNs intake came from oils and fats and from cereals. The result of the current study is the first published report concerning human exposure to PCNs through the diet.

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From June to August 2000, food samples were randomly acquired in seven cities in Catalonia, Spain. Polychlorinated biphenyl (PCB) concentrations were determined for 108 samples of vegetables, fruits, pulses, cereals, fish and shellfish, meats and meat products, eggs, milk and dairy products, and oils and fats. Levels of 11 PCB congeners (IUPAC 28, 52, 77, 101, 105, 118, 126, 138, 153, 169, and 180) were determined by high-resolution gas chromatography-high-resolution mass spectrometry. For toxic equivalent (TEQ) calculations, World Health Organization (WHO) toxicity equivalent factors (WHO-TEFs) were used. The highest levels of most congeners were found in fish and shellfish (11,864.18 ng/kg [wet weight]), and the next highest levels, which were substantially lower, were found in milk and dairy products (674.50 ng/kg [wet weight]). For the general population of Catalonia, the total dietary intake of PCBs was found to be 150.13 pg WHO-TEQ/day. The largest contribution to this intake came from fish and shellfish (82.87 pg WHO-TEQ/day) and dairy products (29.38 pg WHO-TEQ per day). A relatively large contribution was also noted for cereals (11.36 pg WHO-TEQ/day). Among the PCB congeners determined in this study, PCB 126 showed the largest contribution to total TEQ intake (50.56%). The data obtained in this study should be useful in risk assessment with regard to human PCB exposure through food in Catalonia.

Acute coronary syndromes constitute a variety of myocardial injury presentations that include a subset of patients presenting with myocardial infarction with non-obstructive coronary arteries (MINOCA). This acute coronary syndrome differs from type 1 myocardial infarction (MI) regarding patient characteristics, presentation, physiopathology, management, treatment, and prognosis. Two-thirds of MINOCA subjects present ST-segment elevation; MINOCA patients are younger, are more often female and tend to have fewer cardiovascular risk factors. Moreover, MINOCA is a working diagnosis, and defining the aetiologic mechanism is relevant because it affects patient care and prognosis. In the absence of relevant coronary artery disease, myocardial ischaemia might be triggered by an acute event in epicardial coronary arteries, coronary microcirculation, or both. Epicardial causes of MINOCA include coronary plaque disruption, coronary dissection, and coronary spasm. Microvascular MINOCA mechanisms involve microvascular coronary spasm, takotsubo syndrome (TTS), myocarditis, and coronary thromboembolism. Coronary angiography with non-significant coronary stenosis and left ventriculography are first-line tests in the differential study of MINOCA patients. The diagnostic arsenal includes invasive and non-invasive techniques. Medical history and echocardiography can help indicate vasospasm or thrombosis, if one finite coronary territory is affected, or specify TTS if apical ballooning is present. Intravascular ultrasound, optical coherence tomography, and provocative testing are encouraged. Cardiac magnetic resonance is a cornerstone in myocarditis diagnosis. MINOCA is not a benign diagnosis, and its polymorphic forms differ in prognosis. MINOCA care varies across centres, and future multi-centre clinical trials with standardized criteria may have a positive impact on defining optimal cardiovascular care for MINOCA patients.

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