Aerobiological and allergenic analysis of cupressaceae pollen in Granada (Southern Spain).

Cupressaceae pollen has been cited in recent years as one of the major airborne allergens of the Mediterranean region, prompting us to conduct an exhaustive analysis on the aerobiological behaviour of this pollen in the Iberian Peninsula and the repercussion that it has had on the atopic population. The aerobiological study, performed from 1996 to 2003 in the city of Granada (S. Spain), used a volumetric Hirst collector. The results indicate that this pollen is present in the air most of the year, registering a high incidence during the winter months. This type of pollen behaved irregularly in the air, fluctuating yearly, seasonally, and within the same day. Temperature and humidity were the parameters that most directly influence the variability of this allergen, while rainfall prior to flowering increased pollen production. The predictive models used estimated a high percentage of the levels reached over the short term by this pollen in the atmosphere of Granada. The clinical study performed with atopic patients showed that some 30% of the population with pollinosis are sensitive to Cupressaceae pollen, affecting people of both genders equally. On the other hand, the most sensitive age group was 21-40 years of age, while children and the elderly registered almost negligible values. Most of the sensitive subjects resided within the city or in the metropolitan area, where environmental pollution reached high levels, while the pathology was found to be less frequent in rural zones. The most frequent symptoms were upper-respiratory ailments and an asthmatic profile.     

The 12‐Lead ECG in Patients with Mahaim Fibers

The aim of this review article is to discuss the electrocardiographic presentation of the so called variants of pre‐excitation (“Mahaim fibers”) during sinus rhythm and tachycardia.     

Anterior circulation aneurysms: surgical perspectives

Aneurysms arising from the internal carotid circulation represent 85% of all intracranial aneurysms. The intimate relationship of the internal carotid artery and its branches with the brain and cranial nerves, and the distribution of the internal carotid artery flow, make these aneurysms challenging, and potentially complicated in their surgical management. Great attention to detail, and clear understanding of the operative anatomy of the carotid system, facilitate the safe and successful treatment of these aneurysms. The surgical experience with 475 anterior circulation aneurysms treated from 1980 to 1992 is presented. The aneurysms arose from the internal carotid artery: 230(40%), middle cerebral artery: 152(32%), and anterior cerebral artery: 133(28%). Of aneurysms arising from the internal carotid artery, there were 142(30%) from the posterior communicating artery; internal carotid bifurcation: 29(6%), and anterior choroidal artery: 19(4%). There were 62(13%) giant aneurysms evenly distributed among the middle cerebral, internal carotid bifurcation and anterior cerebral artery. Serious neurological morbidity was observed in 13(3%) patients, who presented a combination of different neurological symptoms including: hemiplegia 3, hemiparesis 6, dysphasia 7, and loss of vision 4. Two patients developed a myocardial infarct and survived. Mortality occurred in 16(3%); these patients died from: a hemispheric infarction 7, severe vasospasm 6, myocardial infarction 2, and pulmonary emboli 1. All aneurysms appeared angiographically obliterated. Vasospasm was observed in 75(16%) patients of which nine were symptomatic, and six of them died. Six major arterial trunks were occluded in the post-operative angiogram, and three patients had occlusion of the internal carotid artery, not identified during surgery. Three of these patients with unexpected occlusions died from a major cerebral infarction, and three had lasting hemipareses and dysphasia. Surgical correction of internal carotid aneurysms can be conducted safely when the anatomical characteristics of the intracranial vessels is preserved, and when these patients are treated with appropriate medical support.     

Clonidine pretreatment modifies the growth hormone secretory pattern induced by shortterm continuous GRF infusion in normal man

OBJECTIVE: The aim of this study was to investigate the effect of a single dose of clonidine on the pattern of GH release in response to a 10-hour continuous GRF infusion in normal man. DESIGN: Plasma GH was analysed in samples withdrawn at 20-minute intervals, from 0900 to 1900 h, according to the following protocols: in a control study, a placebo was given at 1000 h; in other experiments, clonidine (300 micrograms, orally) was given at 1000 h, alone or together with a continuous intravenous infusion of GRF 1-29 (0.3 micrograms/kg/h) starting at this time. In another experiment, the continuous infusion of GRF 1-29 was preceded by placebo administration at 1000 h. PATIENTS: Eight normal volunteers (four women and four men), aged 19-24 years were studied. MEASUREMENTS: Plasma GH levels were measured by RIA. Analysis of the pattern of GH secretion was performed using cluster analysis. RESULTS: Clonidine induced a slight but significant increase in plasma GH values, peaking 60 to 120 minutes later; however, no significant changes were observed in indices of total and pulsatile GH release for the whole sampling period in this study. Continuous GRF administration led to increased episodic GH secretion, by augmenting GH peak amplitude, although peak frequency was not modified. An increase in interpulse GH values was also observed during GRF infusion. Pretreatment with clonidine clearly changed the pattern of GH release during GRF infusion: the amount of GH secreted was significantly higher, the number of GH peaks significantly increased, and almost all the GH was secreted within them. CONCLUSIONS: These data concord with our previous demonstration that clonidine disrupts the hypothalamic-somatotroph rhythm by inhibiting the hypothalamic release of somatostatin. Given that clonidine pretreatment induced a more physiological episodic pattern of GRF-induced GH release, the possibility of combining clonidine and GRF therapy for short stature in children is envisaged.     

Propene polymerization with δ-TiCl3/AlCl(C2H5)2 and δ-TiCl3/Al(C2H5)3 catalyst systems, 1. Effect of external donors

The effect of ethyl benzoate (EB), diisobutyl phthalate (DIBP), dibutyl ether (DBE) and triethoxy(phenyl)silane (EPS) as third components on the propene polymerization with the catalyst systems δ-TiCl₃/AlCl(C₂H₅)₂ and δ-TiCl₃/Al(C₂H₅)₃ was investigated. The influence of external donors on the isotacticity, catalyst activity and average molecular weight (M _v) was tested. If external donors are employed, M _v decreases, the insoluble fraction in boiling isooctane increases and the catalyst activity is strongly influenced by the mole ratio external donor/TiCl₃. The results indicate that all external donors employed have the same qualitative effect on catalytic active centers.     

Hypothalamic hamartoma associated with Laurence-Moon-Biedl syndrome. Case report and review of the literature.

A rare case of a patient with Laurence-Moon-Biedl syndrome associated with hypothalamic hamartoma is described. The English-language literature contains no cases of patients with this association. The clinical manifestations of this syndrome, those of hypothalamic hamartomas, and the appearance of the tumors on magnetic resonance images are discussed.     

Predicting spontaneous early neurological recovery after acute ischemic stroke

We assessed predictors of spontaneous early neurological recovery after acute ischemic stroke by means of multivariate analysis in a cohort of 1,473 consecutive patients treated at one academic center. At hospital discharge, spontaneous neurological improvement or good outcome was defined as grades 0-2 of the Rankin scale, and poor outcome (no improvement or in-hospital death) as grades 3-5. Spontaneous recovery of neurological deficit at the time of discharge from the hospital was observed in 16% of patients with cerebral infarction (n = 238). Dysarthria-clumsy hand syndrome improved in 44% of patients and was the only variable significantly associated with in-hospital functional recovery in three logistic regression models that in addition to lacunar syndromes, included demographic variables, cardiovascular risk factors, and clinical variables [odds ratio (OR) 2.56], neuroimaging findings (OR 2.48), and outcome data (OR 2.39), respectively. Clinical factors related to severity of infarction available at stroke onset have a predominant influence upon in-hospital outcome and may help clinicians to assess prognosis more accurately. Our work gives a contribution into prognostic factors after acute ischemic stroke. With regard to patterns of stroke, dysarthria-clumsy hand syndrome was a significant predictor of spontaneous in-hospital recovery in ischemic stroke patients.