Pseudoathetosis: report of three patients.

We report on 3 patients with pseudoathetosis, which are involuntary, slow, writhing movements due to loss of proprioception.     

Strategies for Reducing Risks in Smoking: Opportunity or Threat?

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy [NRT]) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among patients who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in Spain are analysed. Tobacco control measures in Spain have only been made recently and are still insufficient. Therefore, the current priority in Spain is to develop control policies that have proven to be more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for developing smoking control policies.     

Relationship between oxidative stress and essential hypertension.

This study investigated the association of blood pressure with blood oxidative stress-related parameters in normotensive and hypertensive subjects. A cross-sectional design was applied to 31 hypertensive patients and 35 healthy normotensive subjects. All subjects were men between the ages of 35 and 60 years. Exclusion criteria were obesity, dyslipidemia, diabetes mellitus, smoking and current use of any medication. All patients underwent 24-h ambulatory blood pressure monitoring and sampling of blood and urine. Antioxidant enzymes activity, reduced/oxidized glutathione ratio (GSH/GSSG), and lipid peroxidation (malondialdehyde) were determined in erythrocytes. Parameters measured in the plasma of test subjects were plasma antioxidant status, lipid peroxidation (8-isoprostane), plasma vitamin C and E, and the blood pressure modulators renin, aldosterone, endothelin-1 and homocysteine. Daytime systolic and diastolic blood pressures of hypertensives were negatively correlated with plasma antioxidant capacity (r=-0.46, p<0.009 and r=-0.48, p<0.007), plasma vitamin C levels (r=-0.53, p<0.003 and r=-0.44, p<0.02), erythrocyte activity of antioxidant enzymes, and erythrocyte GSH/GSSG ratio, with hypertensives showing higher levels of oxidative stress. Blood pressures showed a positive correlation with both plasma and urine 8-isoprostane. Neither plasma vitamin E nor the assessed blood pressure modulator levels showed significant differences between the groups or correlation with blood pressures. These findings demonstrate a strong association between blood pressure and some oxidative stress-related parameters and suggest a possible role of oxidative stress in the pathophysiology of essential hypertension.     

Case-control study of the alpha-synuclein interacting protein gene and Parkinson's disease.

We conducted a case-control study of the alpha-synuclein-interacting protein gene (SNCAIP, also known as synphilin-1) and Parkinson's disease (PD). A total of 319 PD cases and 195 controls were genotyped for four SNCAIP variants, including a microsatellite repeat in intron 4 and three restriction fragment length polymorphisms (RFLP) proximal to the 5' terminal of exons 1, 4, and 6. None of the variants were found associated with PD overall. Global score statistics were not significant for four, three, and two loci haplotypes. All four loci were in linkage disequilibrium for cases, controls, or both groups combined (P < 0.0001). Recursive partitioning showed no interactions between variants of the SNCAIP gene and variants of the alpha-synuclein gene (SNCA) or the parkin (PARK2) gene.     

Deep-freezing versus 4 degrees preservation of avascular osteocartilaginous shell allografts in rats

Osteocartilaginous allografts (distal femurs of rats) were stored at 4 degrees for six, 12, 24, and 48 hours and at -80 degrees for five days and then evaluated for viability of the bone and cartilage. Storage at 4 degrees for 12 or 24 hours had little effect on cartilage viability but decreased bone viability to 40% and 10% of controls, respectively. Storage at -80 degrees for five days resulted in nonviable bone in all cases but showed an either/or response of cartilage, with high viability in two cases and nonviability in the other eight cases. In a second set of experiments, femurs from rats were stored in situ at 4 degrees for 12 or 24 hours or were harvested and stored at -80 degrees for five days, after which they were transplanted into rats of a different strain. The antibody response to each set of femurs was measured at two, six, and 12 weeks after operation. The 4 degrees storage resulted in a moderately decreased immunogenicity, whereas the storage at -80 degrees resulted in significantly reduced immunogenicity.     

Brainstem anaesthesia after peribulbar anaesthesia

Purpose  To present a case of brainstem anaesthesia as a complication of peribulbar anaesthesia. Clinical features  A 75-yr-old woman received peribulbar anaesthesia for cataract surgery. A few seconds after the block was performed, she had a respiratory arrest, became unconscious, and developed hypertension and tachycardia followed by hypotension and bradycardia. Ventilatory and haemodynamic support were performed before the patient regained adequate spontaneous breathing and normal heart rate and blood pressure. Conclusion  Peribulbar anaesthesia generally cames a low risk of serious complications. However, respiratory arrest and brainstem anaesthesia may occur as complications of peribulbar blocks.

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Résumé Objectif  Présenter un cas d’anesthésie du tronc cérébral compliquant une anesthésie péribulbaire. éléments cliniques  Un bloc péribulbaire était réalisé chez une femine de 75 ans pour l’extraction d’une cataracte. Quelques secondes après l’injection, la patiente cessait de respirer et perdait conscience. Elle devenait hypertendue et tachycarde puts hypotendue et bradycarde. La ventilation et la circulation devaient être supportées jusqu’au retour spontané à la normale. Conclusion  En général, l’anesthésie péribulbare comporte un faible risque de complications sérieuses. Un arrêt respiratoire par anesthésie du tronc cérébral est toujours possible.