The effects of heavy metals on germination and seedling characteristics in two halophyte species in Mediterranean marshes.

The influence of different concentrations (10-2000 µM) of heavy metals (Cu, Mn, Ni, Zn) was analysed in Atriplex halimus and Salicornia ramosissima germination pattern and seedling size. They are two halophyte species that grow in the Estuary of Huelva (Southwest Iberian Peninsula, Spain), one of the most heavy metal-polluted environments in the world. All of the metals tested affected the final germination percentage in A. halimus and only Ni reduced germination in S. ramosissima. The germination rate was unaffected in both species. The study of seedling development shows that S. ramosissima, an intertidal annual species, has a higher tolerance of metals than A. halimus, a bush that inhabits the upper part of the marshes. Taking into account the metal concentrations in the estuary and the effects of these on the seedling development of the species analysed, we conclude that metals might limit plant colonisation in some parts of the marshes.

General trends in airborne pollen production and pollination periods at a Mediterranean site (Badajoz, southwest Spain).

BACKGROUND: The aim of this study was to determine trends in the airborne pollen concentration and pollination period for the principal sources of pollen in Badajoz (southwest Spain) over 15 years of monitoring (1994-2008). METHODS: Airborne pollen was monitored by continuous sampling with a Hirst volumetric sampler. Pollen trends were investigated by linear regression and correlation analysis using mean annual and monthly pollen concentrations. The aerobiological results were compared with meteorological data (temperature and rainfall). RESULTS: During the study period, the mean total annual rainfall was 66.2 mm lower than normal and the mean annual temperature 0.8 degrees C higher than normal. No temporal trend was found for total airborne pollen concentration, but differences were observed for monthly data, namely, an increase in January, February, and May and a decrease in March and June. For the different pollen types studied, there was a general trend toward increased values in the month with the highest values, and this trend seemed to be related to temperature.The beginning of the main pollen season occurred later, and the end occurred sooner; therefore, the main pollen season seems to be shorter. CONCLUSIONS: Our data reflect trends in the response of plants to changing rainfall stress patterns in Mediterranean countries, and these trends seem to be different from those of temperate countries. Nonetheless, a longer study period will be required to confirm these preliminary conclusions.

[Restless legs syndrome: detection, diagnosis, impact on health and utilization of health care resources]. / El síndrome de piernas inquietas: detección, diagnóstico, consecuencias sobre la salud y utilización de recursos sanitarios.

INTRODUCTION: Despite the high prevalence of Restless Legs Syndrome (RLS) reported, little information is available about this disorder in Spain. The present study was conducted to obtain information on this condition from patients identified by a simple screening questionnaire and subsequent diagnostic confirmation by the Primary Care Practitioner (PCP). MATERIALS AND METHODS: Three-stage, cross-sectional and retrospective (resource utilization), observational study in a sample of adult patients (2,047 subject) attending 10 outpatient Primary Care centers in Madrid, Barcelona and Valencia. A screening questionnaire containing the 4 RLS diagnostic criteria was used. Clinical assessment and RLS diagnosis confirmation was performed using a structured questionnaire. Other variables assessed were quality of life by SF-36 questionnaire scoring; sleep by the MOS sleep scale; symptom severity of RLS symptoms by the IRLS scales; health care resource utilization in the previous 12 months by completion of questionnaire following patient chart review. The diagnosis made by the PCP was confirmed in a small sample of patients by a neurologist expert in Movement Disorders. RESULTS: A total of 19.7% (404 out of 2,047) subjects positively answered the 4 diagnostic questions of the RLS screening questionnaire. Of these, 185 (9.0%) reported moderate to severe symptoms at least twice weekly. The PCP made a diagnosis of RLS in 79 of 154 patients completing the diagnostic interview. Thus, prevalence of RLS estimated in this adult population was 4.6%. The predictive value of the screening RLS questionnaire was 51.3%. Average age of symptom onset was 42 years (range: 20 - over 80 years). RLS symptoms were moderately (50.6%) or extremely (38%) distressing and 73.4% of RLS patients slept poorly at least two nights a week. This diagnosis represents 9.4% of all patients presenting to PCP and experiencing poor sleep. Mean score in the IRLS scale (0 - 40) was 19.4. Average score of SF-36 questionnaire (0-100) was 54.6, lower than the Spanish general reference population (61.4). About one third of the RLS patients had seen a physician because of RLS symptoms. However, a diagnosis was made in only 48% of these and only 5% the diagnosis was RLS. CONCLUSIONS: The DECODE RLS - Spain study shows that many patients with classical RLS symptoms frequently see their PCP without being adequately diagnosed and treated. Screening tools such as that used in this study may contribute to the detection of these patients.

El síndrome de piernas inquietas: detección, diagnóstico, consecuencias sobre la salud y utilización de recursos sanitarios / Restless legs syndrome: detection, diagnosis, impact on health and utilization of health care resources

Introducción: Pese a la elevada prevalencia del síndrome de piernas inquietas (SPI), se cuenta con escasa información sobre este trastorno en nuestro país. El objetivo de este estudio fue obtener información sobre este problema de salud a partir de pacientes identificados mediante un cuestionario de cribado y posterior confirmación diagnóstica por médicos de Atención Primaria (AP). Material y métodos: Estudio en tres etapas, transversal y retrospectivo (utilización de recursos), en una muestra de pacientes adultos (2.047 sujetos) que acudió a consultas ambulatorias de 10 centros de Atención Primaria (Madrid, Barcelona y Valencia). Se utilizó un cuestionario de detección con los 4 criterios diagnósticos de SPI. Se realizó la evaluación clínica y confirmación diagnóstica mediante un cuestionario estandarizado. Otras variables evaluadas fueron: calidad de vida, mediante la puntuación del Cuestionario SF-36 de salud; sueño, mediante la puntuación de la escala de sueño MOS; intensidad de los síntomas de SPI, mediante la puntuación de la escala IRLS; utilización de recursos sanitarios en los 12 meses previos. Confirmación del diagnóstico del médico de AP, por un neurólogo especialista en trastornos del movimiento en una muestra reducida aleatoria de pacientes. Resultados: Un 19,7% (404 de 2.047) de los sujetos respondió positivamente a las 4 preguntas diagnósticas del cuestionario de detección del SPI. De ellos, 185 sujetos (9,0%) presentaban síntomas por lo menos dos veces a la semana, de intensidad moderada a grave. El médico de AP confirmó el diagnóstico de SPI en 79 de los 154 pacientes que completaron la entrevista diagnóstica. La prevalencia en esta población adulta fue del 4,6%. El valor predictivo del cuestionario de detección del SPI fue de un 51,3%. La edad media de inicio de síntomas fue de 42 años (rango: 20-más de 80 años). Los síntomas de SPI fueron moderados en el 50,6% y graves en el 38%. El 73,4% de los pacientes con SPI dormía mal, al menos dos noches por semana. La puntuación media de la escala IRLS (0-40) fue de 19,4. La puntuación media del cuestionario SF-36 (0-100) fue de 54,6, más baja que la de la población española de referencia (61,4). Aproximadamente un tercio de los pacientes había consultado antes con un médico por los síntomas de SPI. No obstante, sólo un 48% contaba con un diagnóstico y sólo en un 5% éste era de SPI. Conclusiones: El estudio DECODE RSL indica que muchos pacientes con síntomas clásicos de SPI visitan frecuentemente a su médico de AP sin ser diagnosticados ni, por lo tanto, recibir un tratamiento adecuado. Herramientas como la utilizada en este estudio pueden ayudar a la detección de estos pacientes (AU)

Introduction: Despite the high prevalence of Restless Legs Syndrome (RLS) reported, little information is available about this disorder in Spain. The present study was conducted to obtain information on this condition from patients identified by a simple screening questionnaire and subsequent diagnostic confirmation by the Primary Care Practitioner (PCP). Materials and methods: Three-stage, cross-sectional and retrospective (resource utilization), observational study in a sample of adult patients (2,047 subject) attending 10 outpatient Primary Care centers in Madrid, Barcelona and Valencia. A screening questionnaire containing the 4 RLS diagnostic criteria was used. Clinical assessment and RLS diagnosis confirmation was performed using a structured questionnaire. Other variables assessed were quality of life by SF-36 questionnaire scoring; sleep by the MOS sleep scale; symptom severity of RLS symptoms by the IRLS scales; health care resource utilization in the previous 12 months by completion of questionnaire following patient chart review. The diagnosis made by the PCP was confirmed in a small sample of patients by a neurologist expert in Movement Disorders. Results: A total of 19.7% (404 out of 2,047) subjects positively answered the 4 diagnostic questions of the RLS screening questionnaire. Of these, 185 (9.0%) reported moderate to severe symptoms at least twice weekly. The PCP made a diagnosis of RLS in 79 of 154 patients completing the diagnostic interview. Thus, prevalence of RLS estimated in this adult population was 4.6%. The predictive value of the screening RLS questionnaire was 51.3%. Average age of symptom onset was 42 years (range: 20 - over 80 years). RLS symptoms were moderately (50.6%) or extremely (38%) distressing and 73.4% of RLS patients slept poorly at least two nights a week. This diagnosis represents 9.4% of all patients presenting to PCP and experiencing poor sleep. Mean score in the IRLS scale (0 - 40) was 19.4. Average score of SF-36 questionnaire (0-100) was 54.6, lower than the Spanish general reference population (61.4). About one third of the RLS patients had seen a physician because of RLS symptoms. However, a diagnosis was made in only 48% of these and only 5% the diagnosis was RLS. Conclusions: The DECODE RLS - Spain study shows that many patients with classical RLS symptoms frequently see their PCP without being adequately diagnosed and treated. Screening tools such as that used in this study may contribute to the detection of these patients (AU)

Differences in the spatial distribution of airborne pollen concentrations at different urban locations within a city.

BACKGROUND: The objective of the present work was to compare pollen counts at three different urban locations within a city to each other and to the counts from a fixed trap. This information could be useful to delimit zones in the urbanized part of the city according to the risk of allergic affections. METHODS: Aerobiological sampling using portable traps was carried out at three points in urban zones of the city of Badajoz (SW Spain) over one year at the same time as continuous sampling using a fixed trap at a point in the nonurban outskirts of the city. The sources of airborne pollen were studied by counting the trees in the streets and squares of the selected zones. A statistical analysis was performed of the differences between the portable and fixed traps and of the temporal and spatial variation in the city as a function of the distribution of the most important pollen sources. RESULTS: Forty-eight pollen types were identified with the fixed trap, and 28 with the portable traps. The grass, olive, and oak pollens come from almost exclusively external sources, there being no spatial differences in their concentrations in the city. Cypress pollen concentrations were much higher at the urban locations than at the fixed trap site. Plane tree pollen levels could be locally very high, reflecting the proximity of the source. Except for ornamental plants, pollen levels were lower at the urban locations than at the site on the outskirts of the city. CONCLUSIONS: (1) Using portable traps at different urban zones in a city could provide information about the spatial variation of atmospheric pollen levels. (2) A knowledge of the often widely variable distribution of ornamental plants with potentially allergenic pollen could be useful in indicating city zones with a greater or lesser incidence of potential pollinosis.

Pollen and spores in the air of a hospital out-patient ward.

BACKGROUND: Aerobiological studies of interest to the allergy specialist are routinely carried out using information from outdoor traps. However, most of our time is spent indoors and it is often the content of this air that is responsible for allergic phenomena. MATERIAL AND METHODS: The air of a hospital outpatient ward was analyzed using two portable volumetric aerobiological traps, one at floor level and the other at a height of 1 meter. Both spores and pollen grains were counted and their values were compared with those outside the building. RESULTS AND CONCLUSIONS: Twenty types of pollen grains were found. Their concentrations ranged from 2.7 and 25.1 grains/m3, with the most frequent being (in order) grasses, evergreen oak (holm and cork oaks), water plantain, and olive. Twenty two different types of spores were found with concentrations of between 175.0 and 1395.8 spores/m3 and the most frequent were Cladosporium, Ustilago and basidiospores. No significant differences were found between the floor level and the meter-high measurements. Comparison with outdoor levels showed that the three most abundant pollen types were correlated, with a ratio of 30:1 between indoor and outdoor levels. For the spores and fungi propagules, the indoor:outdoor ratio was highly variable, depending on the type. Thus, for Aspergillus-Penicillium spores, the concentration was even higher indoors than outdoors, although for most types, lower levels were found indoors, with a mean outdoor:indoor ratio of 4:1. We argue that this relationship reflects the presence of indoor spore sources. Rainfall was correlated with a decline in pollen levels and a rise in spore levels.

Mesenteric actinomycosis with retroperitoneal involvement.

Mesenteric or retroperitoneal actinomycosis is an extremely rare disease. The international databases have revealed only 10 cases affecting the mesenterium and another 52 cases affecting the retroperitoneum. We report a 78-year-old female who was admitted with complaints of abdominal pain. Laboratory examination revealed anemia and the clinical examination revealed an irregular mass in the abdomen. Ultrasound and computed tomography (CT) scans showed a solid mass in the mesenteric-retroperitoneal region. Biopsy of the nonresectable mass revealed the presence of chronic inflammation in the mesenteric area with Actinomyces colonies. The patient was treated with oral amoxicillin, 500 mg every 6 hours for 6 months. The symptoms disappeared, but the mesenteric-retroperitoneal mass remains, but smaller in size. Based on the review of the literature and the case reported here, we conclude that mesenteric-retroperitoneal actinomycosis is difficult to diagnose by means of noninvasive techniques as it can masquerade as a malignant process. An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical intervention. Treatment with penicillin has proven to be effective.