Widespread use of anticoagulant rodenticides in agricultural and urban environments. A menace to the viability of the endangered Bonelli's eagle (Aquila fasciata) populations.

Anticoagulant rodenticides (ARs) are one of the most toxic groups of compounds currently used worldwide for rodent pest control. Toxic baits are often, directly or indirectly, ingested by non-target animals, resulting in secondary poisoning and frequently affecting apex predators. Their presence in many species of raptors is quite common, particularly scavenger species, with some of these acting as sentinels for the presence of these substances in the environment. However, there is less data on the presence of ARs in Bonelli's eagle, one of the most endangered eagle species in Spain and which is experiencing a negative population trend in Europe. This medium-sized eagle feeds predominantly on live species, and rarely consumes carrion. In this study, 17 carcasses of Bonelli's eagles from the Eastern Spain were necropsied. Both first and second generation ARs in their livers were analyzed by HPLC-MS-TOF revealing that all the eagles studied had been exposed to at least 5 ARs, out of a total of 10 ARs analyzed, with 7 being the highest number of ARs detected in a sample. Second generation ARs were the most prevalent, particularly bromadiolone and brodifacoum, with the highest concentrations in 94% of the cases. More than a third of the eagles presented a liver concentration of greater than 200 ng/g ARs, suggesting AR poisoning. The elevated presence of these compounds in Bonelli's eagles could be a new cause of mortality for this species or could explain other causes of death, such as the increased mortality in power lines, and should be taken into account for their conservation. At the same time, the presence of these compounds in the environment also represents a risk to public health, as the most frequent species in the diet of Bonelli's eagle (rabbits and partridges) are also hunted and consumed by hunters and their families.

Effect of zinc oxide doping on the structural and optical characterization of nanostructured molybdenum oxide films.

Undoped and zinc oxide (ZnO) doped molybdenum oxide (MoO3) films were prepared by RF magnetron sputtering technique. The influence of doping and post annealing temperature on the structural and optical properties of these films were investigated systematically using X-ray diffraction (XRD), energy dispersive X-ray analysis (EDAX), scanning electron microscopy (SEM), atomic force microscopy (AFM), UV-VIS spectroscopy and photoluminescence spectroscopy (PL). The XRD patterns indicate the presence of stoichiometric orthorhombic alpha-MoO3 phase in the annealed (573 and 673 K) undoped molybdenum oxide films and in ZnO doped molybdenum oxide film (annealed at 673 K). The crystalline grain size in the films was investigated using Debye Scherrer formula and corrected using Hall-Williamson equation. The SEM and AFM images revealed the distribution of nano leafs, nanorods and nanograins. Nanorods of length 1.4 microm and diameter 149 nm can be observed in ZnO doped films. The optical band gap energy was found to increase with increase in annealing temperature and particle size. These nanostructures show a room temperature PL emission in the UV and visible region.

Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid. / Antidepresivos en la enfermedad de Parkinson. Recomendaciones del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología.

INTRODUCTION: Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. DEVELOPMENT: These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. CONCLUSIONS: Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.

[Chronic idiopathic lithoptysis]. / Litoptisis crónica idiopática.

Broncholiths, which usually arise from calcified peribronchial lymph nodes, can be found by radiography or bronchoscopy. We describe the case of a 19-year-old man who had experienced lithoptysis of bronchial hydroxyapatite calculi for over 6 months and who reported having sandy expectoration since childhood. Exhaustive clinical, radiographic, and endoscopic diagnostic studies detected no calcified lesions in the thorax that could explain the origin of the broncholiths. Therefore, we propose that broncholiths may form by mechanisms similar to those involved in calculi formation in other locations.

Elevated level of carcinoembryonic antigen in nonmalignant pleural effusions.

STUDY OBJECTIVE: Carcinoembryonic antigen (CEA) is the most frequently used tumor marker in pleural fluid. Nevertheless, little is known about the causes of false-positive results. The aim of the study was to analyze the frequency, etiologies, and characteristics of the nonmalignant pleural effusions associated with elevated levels of CEA in pleural fluid. PATIENTS: Two hundred seventy-three consecutive patients with pleural effusions were evaluated, 91 (33%) associated with malignancy, and 182 (67%) due to benign diseases (51 transudates, 38 tuberculosis, 37 parapneumonic, 56 other). RESULTS: A level of CEA in pleural fluid above 10 ng/mL was found in 47% of pleural effusions associated with malignancy. Elevated levels of CEA were also found in 17 of the 182 (9%) nonmalignant pleural effusions: all five empyemas, one of the 23 typical parapneumonic (4%), two of the six borderline complicated (33%), and four of the eight complicated parapneumonic effusions (50%), one of the 38 tuberculous pleurisy (3%), one of the 11 hepatic transudates (9%), in the only patient with urinothorax, in the only patient with acute pancreatitis, and in one patient with postsurgery pleural effusion but with esophageal carcinoma and elevated CEA level in serum. CONCLUSIONS: Although an elevated level of CEA in pleural fluid is suggestive of malignancy, CEA can be elevated in 9% of pleurisy owing to benign diseases, especially in empyemas and in complicated parapneumonic effusions. Identifying the most frequent causes of false-positive results of CEA helps to correctly interpret the findings of this tumor marker.

Pleural fluid to serum cholinesterase ratio for the separation of transudates and exudates.

STUDY OBJECTIVE: To evaluate the usefulness of two new parameters for separating pleural transudates and exudates: pleural fluid cholinesterase level and pleural fluid to serum cholinesterase ratio, and to compare the results with the other well-established criteria. DESIGN: Prospective evaluation of the patients referred for diagnostic thoracentesis. SETTING: Pulmonary sections of a community hospital and a university hospital. PATIENTS: One hundred ninety-three consecutive patients. Forty were excluded for different reasons. MEASUREMENTS: The following criteria for separating the pleural effusions in transudates and exudates were analyzed: Light's criteria, the pleural fluid cholesterol level, the pleural fluid to serum cholesterol ratio, the pleural fluid cholinesterase level, and the pleural fluid to serum cholinesterase ratio. RESULTS: One hundred fifty-three patients had conditions diagnosed. Thirty-five were classified as having transudates and 118 as exudates. The percentage of effusions misclassified by each parameter was as follows: Light's criteria, 7.8%; pleural fluid cholesterol, 7.8%; pleural fluid to serum cholesterol ratio, 6.5%; pleural fluid cholinesterase, 8.5%; and pleural fluid to serum cholinesterase ratio, 1.3%. CONCLUSIONS: The pleural fluid to serum cholinesterase ratio is the most accurate criterion for separating pleural transudates and exudates. If further studies confirm our results, the cholinesterase ratio could be used as the first step in the diagnosis of pleural effusions.

Depression in Parkinson's disease: clinical correlates and outcome.

Depression has been shown to be more common in Parkinson's disease (PD) than in other chronic and disabling disorders. Neurochemical and functional disturbances are important etiopathogenic factors. The prevalence and clinical features associated with depression in PD remain controversial. The purpose of this study is to estimate the prevalence of depressive symptoms in our patients, as related to other clinical data, and to assess clinical outcomes of these symptoms. A series of PD patients were evaluated over a 9-year period, using the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr stage (HY), Schwab and England Scale (SE), Mini-Mental State Examination (MMSE), and Yesavage Geriatric Depression Scale (GDS). Presence of depressive symptoms was considered if GDS score was higher than 10: mild-moderate (MD) for GDS scores between 11 and 20 and moderate-severe (SD) for GDS scores greater than 20. Three hundred and fifty-three patients were included in this study and additional follow up information was obtained for 184 patients. MD and SD were found in 40.2 and 16.7% of PD patients, respectively. Female gender, high HY, high UPDRS total and subtotal, and low MMSE and SE scores were significantly associated with depressive symptoms. According to changes in GDS score, 34% of patients remained stable, 35% showed an improvement, and 30.9% worsened in the follow up study. Gender, age, age of onset, HY, UPDRS, and PD duration are not related to depression outcome.

[A survey of the basic knowledge of chronic respiratory patients]. / Encuesta sobre los conocimientos básicos de los enfermos respiratorios crónicos.

Sixty patients diagnosed as having chronic respiratory diseases were surveyed in order to establish how many knew the name of their disease, the medications they were taking, the name of the medical specialty dedicated to treating their condition and the nature of spirometry. Only 23 patients (38%) knew the name of their disease; among them were all those suffering asthma or silicosis, but only 24% of those with other diseases. Thirty-three (55%) were unable to name their medications. Only 22% knew what a pneumologist does or could define spirometry, although at least 45% of these patients had undergone the procedure. The majority, on the other hand, knew what a cardiologist (70%) does and what an electrocardiogram (80%) is. A large number of patients with chronic respiratory diseases know very little about basic aspects of their conditions. Use of correct terminology appears to be necessary if patient knowledge is to increase.

[Tracheobronchial involvement in non-Hodgkin's lymphoma]. / Afectación traqueobronquial en el linfoma no hodgkiniano.

Tracheobronchial involvement in non-Hodgkin's lymphoma (NHL) has been little described. We present two patients with NHL and endobronchial involvement of different characteristics. In the first case diffuse involvement of the bronchial mucosa was observed in the context of a systemic NHL of 10 years' duration. In the second patient, endobronchial involvement consisted of a mass obstructing the trachea and the right main bronchus which was the first manifestation of lymphoma.

Sunflower meal as cause of chronic copper poisoning in lambs in southeastern Spain.

Sunflower meal with a copper/molybdenum ratio of 10 caused copper toxicosis in lambs. Copper must be analyzed on a dry matter basis in liver and renal cortex. Oral administration of molybdenum and thiosulfate had a certain effectiveness in sick animals. Care must be taken with feedstuffs made from copper-dependent plants.

[Tuberculous meningioma en plaque without extracerebral tuberculosis. A case report]. / Tuberculoma meníngeo en placa sin tuberculosis extracerebral. A propósito de un caso.

INTRODUCTION: Tuberculosis continues to be an intensly extended disease in under developed countries in immunodepressed and immunocompetent persons. In the central nervous system tuberculous lesions are the most frequent cause of space occupying lesions. CLINICAL CASE: We report the case of a young, immunocompetent woman from Guinea, currently living in Spain. Following a seizure, neuro imaging showed there to be a right frontal space occupying lesion. The characteristics of the MR images obtained were fundamental to the determination of the meningeal site of the lesion en plaque and to suggest the aetiology as being an infectious inflammatory process, although a meningioma could not be ruled out. The absence of signs of extracerebral disease, the localization and distribution of the lesion and lack of short term response to medical treatment, which covered the different diagnostic possibilities, made it necessary to do a diagnostic meningeal biopsy. CONCLUSIONS: MR imaging is a great help in the diagnosis of tuberculous lesions of the central nervous system. The differential diagnosis between tuberculous pachymeningitis and meningioma, both in the form of plaques, is extremely difficult without obtaining a biopsy specimen. The finding of epithelioid granulomas with caseous necrosis and/or acid alcohol fast bacilli in the biopsy specimen is diagnostic of tuberculosis. A single meningeal lesion situated in the cortex but with no associated extracerebral disease causes considerable difficulty in diagnosis. Tuberculosis must always be remembered in view of the increasing number of immigrants from under developed countries.

[Cardioembolic infarction: clinical course and characteristics]. / Infarto cardioembólico: características clínicas y evolutivas.

INTRODUCTION: Approximately 20% of all ischemic strokes are due to cardioembolism and occur more frequently in the younger patients. Our objective was to determine the clinical characteristics and course of cardioembolic infarcts (ICCE) comparing them with infarcts due to other aetiologies (ICNCE). PATIENTS AND METHODS: We made a prospective study of 354 patients admitted to hospital over a period of one year, after excluding transient ischaemia and parenchymatous/subarachnoid hemorrhage. Two groups were established: ICCE (29.4%) and ICNCE (70.6%), comparing age, sex, risk factors and course of the illness. Subsequently a study lasing two years was done to assess the recurrence rate. RESULTS: The ICCE patients were older (75.89 compared with 72.58, p = 0.004), often know the exact time of onset of their symptoms (p = 0.015) and usually are admitted to hospital during the first six hours of their illness (p = 0.01). There was a significantly higher incidence of ischemic cardiopathy or auricular fibrillation (p = 0.0052); p = 0.005); more complications arose (p = 0.000); stay in hospital was longer (13.62 as compared to 11.8 days; p = 0.035), there was a lower weekly BI score (p = 0.0023) and higher mortality (p = 0.000). In the subgroup of 70 patients evaluated two years later 11 cases recurred, with no difference observed between the anticoagulant and anti-aggregant groups. CONCLUSION: The ICCE occurs in older patients, they develop worse neurological defects, have a worse short-term prognosis, develop more complications and have significantly greater mortality.

[Diabetes mellitus and stroke]. / Diabetes mellitus e ictus.

INTRODUCTION: Diabetes mellitus (DM) is an important risk factor in cerebral vascular disease since it causes endothelial proliferation and thickening of the plasmatic membrane in the small blood vessels. The pathogenic mechanism is thus different from that of athero-thrombosis or emboli. Our objective was to determine whether there are differences between strokes in diabetic patients and strokes secondary to other diseases. PATIENTS AND METHODS: We made a prospective study of 415 stroke patients admitted to hospital consecutively over one year. Transient ischaemia and subarachnoid hemorrhage were excluded. We analysed age, sex, risk factors, severity (Canadian scale), mortality and functional prognosis one week later. RESULTS: Of the 415 patients, 354 were diagnosed as having cerebral infarcts and 61 parenchymatous hemorrhage. The average age was 72.2 years. The commonest risk factor was arterial hypertension (n = 241). There were 95 patients with DM. Bivariate and multivariate analysis showed independent variables associated with DM to be the onset of cerebrovascular pathology at a younger age (p = 0.009), association with arterial hypertension (p = 0.002) and poor previous quality of life (p = 0.003). We did not find a higher incidence of lacunar infarcts amongst the diabetic patients. CONCLUSIONS: The diabetic patient is younger and often also has arterial hypertension. There was no difference in mortality or type of stroke (ischemic compared with hemorrhagic). No significant relationship was found with lacunar infarcts.

[Working memory and complex activities of everyday life in the initial stages of Alzheimer's disease]. / Memoria de trabajo y actividades complejas de la vida diaria en el estadio inicial de la enfermedad de Alzheimer.

INTRODUCTION: Evaluation of the working memory (WM) permits analysis of the degree of anterograde amnesia and fixation deficit present in patients with Alzheimer s disease (AD). Complex activities of everyday life (AEL) are also affected early. There is a close relation between the degree of cognitive deterioration and loss of functional competence in AEL. OBJECTIVE: To analyze the degree of memory loss and performance in carrying out complex AEL in patients with AD and mild cognitive disorder. PATIENTS AND METHODS: Evaluation of functional disorder, using Pfeffer s functional activity questionnaire (FAQ), and cognitive evaluation, using the WM examination protocol in a group of 36 patients. RESULTS: In the total MT (4.2+/-5.7) there were significant differences between patients with age associated memory impairment (AAMI) (11+/-7) and possible EA (3.2+/-4.6) and between AAMI and probable AD (2.8+/-4.8). The functional evaluation of the AEL (FAQ) gave a mean of 8.5+/-7.1. There were significant differences between probable AD (11+/-8) and possible EA (6+/-4) with the group AAMI 1+/-1.8. There was significant correlation between FAQ and total WM ( 0.70, p= 0.0001). It was found that patients with high FAQ scores had lower total WM scores. CONCLUSION: FAQ and WM have high correlation and are useful instruments for the evaluation of patients with cognitive deterioration at the initial stages.

[Pleural effusion: criteria for distinguishing between transudates and exudates]. / Derrame pleural: criterios para diferenciar trasudados y exudados.

The first step in the diagnostic study of a pleural effusion is to classify as a transudate or exudate. Light's criteria (pleural fluid/serum proteines > 0.5; lactatedehydrogenase [LDH] > 2/3 of the upper normal limit in serum; pleural fluid/serum LDH > 0.6) usually used, incorrectly classify some cases, especially transudates. For this reason, different alternative criteria has been proposed: pleural fluid cholesterol, pleural fluid/serum cholesterol ratio, pleural fluid/serum bilirubin ratio, and serum/pleura albumin ratio. Althought the first results suggested better results that those obtained with the Light's criteria, after the analysis of the different studys we conclude that a method to diferentiate perfectly transudates and exudates is not yet available.

[Primary microcytic carcinoma of the trachea]. / Carcinoma microcítico primario de tráquea.

Primary microcytic tumors of the trachea are very rare. Among them, primary microcytic carcinoma of the trachea has been described very few times. We present the case of a 44-year-old man with hemoptysis and asthenia, in which the thoracic radiography was normal. However, the bronchofibroscopy detected a microcytic carcinoma localized at the distal third of the trachea with adenopathies and hepatic metastasis. Complete remission was achieved with chemotherapy, remaining the patient free from the disease 10 months after the diagnosis.

[Pleural exudate as presentation of constrictive pericarditis]. / Exudado pleural como presentación de pericarditis constrictiva.

An exudative pleural effusion is a very infrequent form of presentation of constrictive pericarditis, and it can induce diagnostic difficulties. We present a 71 year-old woman with a pleural effusion attributed to be due to congestive heart failure which does not respond to the treatment. The pleural fluid had biochemical characteristics of an exudate. The echocardiographic study showed severe constrictive pericarditis, and after the pericardectomy the pleural effusion completely resolved. The diagnostic suspicion of constrictive pericarditis in cases of exudative pleural effusion is of special interest because an specific and effective treatment is available.

Structural, spectroscopic and electrical studies of nanostructured porous ZnO thin films prepared by pulsed laser deposition.

ZnO thin films are grown on quartz substrates at various substrate temperatures (ranging from 573 to 973 K) under an oxygen ambience of 0.02 mbar by using pulsed laser ablation. Influence of substrate temperature on the structural, morphological, optical and electrical properties of the ZnO thin films are investigated. The XRD and micro-Raman spectra reveal the presence of hexagonal wurtzite structure of ZnO with preferred orientation (002). The particle size is calculated using Debye-Scherer equation and the average size of the crystallites are found to be in the range 17-29 nm. The AFM study reveals that the surface morphology of the film depends strongly on the substrate temperature. UV-Visible transmittance spectra show highly transparent nature of the films in visible region. The calculated optical band gap energy is found to be decrease with increase in substrate temperatures. The complex dielectric constant, the loss factor and the distribution of the volume and surface energy loss of the ZnO thin films prepared at different substrate temperatures are calculated. All the films are found to be highly porous in nature. The PL spectra show very strong emission in the blue region for all the films. The dc electrical resistivity of the film decreases with increase in substrate temperature. The temperature dependent electrical measurements done on the film prepared at substrate temperature 573 K reveals that the electric conduction is thermally activated and the activation energy is found to be 0.03911 eV which is less than the reported values for ZnO films.