Phenological and seismological impacts on airborne pollen types: A case study of Olea pollen in the Region of Murcia, Mediterranean Spanish climate.

The rationale of this paper was to investigate whether earthquakes impact airborne pollen concentrations, considering some meteorological parameters. Atmospheric pollen concentrations in the Region of Murcia Aerobiological Network (Spain) were studied in relation to the occurrence of earthquakes of moment magnitude (up to Mw = 5.1) and intensity (intensity up to grade VII on the European Macroseismic Scale). In this study, a decade (2010-2019) was considered across the cities of the network. Earthquakes were detected in 12 out of 1535 days in the Olea Main Pollen Season in Cartagena, 49 out of 1481 days in the Olea Main Pollen Season in Lorca, and 39 out of 1441 days in the Olea Main Pollen Season in Murcia. The Olea pollen grains in this network were attributed to the species Olea europaea, i.e., the olive tree, a taxon that appears widely in the Mediterranean basin, in both cultivated and wild subspecies. Differences between the Olea concentration on days with and without earthquakes were only found in Lorca (Kruskal-Wallis: p-value = 0.026). The low frequency and intensity of the earthquakes explained these results. The most catastrophic earthquake felt in Lorca on May 11th, 2011 (IVII, Mw = 5.1, 9 casualties) did not result in clear variations in pollen concentrations, while meteorology (e.g., African Dust Outbreak) might have conditioned these pollen concentrations. The research should be broadened to other active seismological areas to reinforce the hypothesis of seismological impact on airborne pollen concentrations.

The effects of continentality, marine nature and the recirculation of air masses on pollen concentration: Olea in a Mediterranean coastal enclave.

Olea pollen concentrations have been studied in relation to the typology of air masses, pollen grain sources and marine nature during advections in a coastal enclave in the south-eastern Iberian Peninsula. Since Spain is the world's leading olive producer, and olive growing extends throughout the Mediterranean basin, this location is ideal for the study of long-distance transport events (LTD) during the main pollen season (MPS). The air masses were classified using the calculation of 48-h back trajectories at 250, 500 and 750 m above ground level using the HYSPLIT model. After that, the frequency of LDT events from Africa and Europe was found to be 8.7% of the MPS days. In contrast, regional air masses were found in 38.6% of the MPS days. This was reflected in pollen concentrations, with significantly higher concentrations (p-value <0.05) on days with regional air masses compared to days with European air masses. Regarding the source areas, the importance of nearby sources with intense olive cultivation was confirmed (i.e., Andalusia). This proximity was relevant beyond the attenuations observed when the advections acquired a marine nature as the air mass back trajectories moved over the sea (p-value <0.001). The review of air mass typologies, source areas and pollen concentrations resulted in establishing peak dates and the detection of LDT associated with these peak dates. Distortions in the typical path of each air mass explained alterations in pollen concentrations on consecutive days. The recirculation and loops of the air mass back trajectories varied the pollen load that every type of air mass could originally contain.

Conservative treatment in patients with mild to moderate carpal tunnel syndrome: A systematic review. / Tratamiento conservador en pacientes con síndrome del túnel carpiano con intensidad leve o moderada. Revisión sistemática.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. It is characterised by the compression of the median nerve in the carpal tunnel. CTS presents a high prevalence and it is a disabling condition from the earliest stages. Severe cases are usually treated surgically, while conservative treatment is recommended in mild to moderate cases. The aim of this systematic review is to present the conservative treatments and determine their effectiveness in mild-to-moderate cases of CTS over the last 15 years. METHODS: A systematic review was performed according to PRISMA criteria. We used the Medline, PEDro, and Cochrane databases to find and select randomised controlled clinical trials evaluating the effects of conservative treatment on the symptoms and functional ability of patients with mild to moderate CTS; 32 clinical trials were included. There is evidence supporting the effectiveness of oral drugs, although injections appear to be more effective. Splinting has been shown to be effective, and it is also associated with use of other non-pharmacological techniques. Assessments of the use of electrotherapy techniques alone have shown no conclusive results about their effectiveness. Other soft tissue techniques have also shown good results but evidence on this topic is limited. Various treatment combinations (drug and non-pharmacological treatments) have been proposed without conclusive results. CONCLUSIONS: Several conservative treatments are able to relieve symptoms and improve functional ability of patients with mild-to-moderate CTS. These include splinting, oral drugs, injections, electrotherapy, specific manual techniques, and neural gliding exercises as well as different combinations of the above. We have been unable to describe the best technique or combination of techniques due to the limitations of the studies; therefore, further studies of better methodological quality are needed.

Analysis of airborne Olea pollen in Cartagena (Spain).

Olive cultivation is of great importance in Southern Europe but olive pollen is the leading cause of allergy in many regions where it is grown. The best preventive measure for allergic patients is to avoid exposure. Thus, aerobiological monitoring networks must supply realistic pollen classes for the different types of allergic pollen. Even though those pollen classes are defined, they do not necessarily fit local data. Altogether, they should use predictive models to assess flowering intensity in advance. In this study, the Olea pollen degree of exposure classes (OPDEC) are defined based on percentiles and a predictive model is suggested for Cartagena, Spain. 24year (1993-2016) Olea pollen counts series was used to characterize the Main Pollen Season (MPS). The aerobiological samples were processed following the methodology proposed by Hirst and developed by the Spanish Aerobiology Network. The aerobiological database was completed with the meteorological data supplied by AEMET (Spanish State Meteorological Agency). MPS evolution over time, and its relation with temperature and rainfall, has been analysed. The study showed an increase in MPS duration and the amount of Olea pollen grains collected both in MPS and the peak day. The OPDEC should fit local data to improve preventive measures. Based on the 24year series, the proposed OPDEC for Cartagena are: Low (≤10grains/m3), Medium (between 10 and 50grains/m3), High (between 51 and 100grains/m3) and Very High (≥100grains/m3). Olea pollen estimations in the MPS and in the peak day were obtained by means of three Regression Methods and climatic factors. The analysis reveals that the Bagging for Regression Trees (BRT) method is a good predictive alternative and stablishes the importance for each meteorological variable.

Cognitive neurorehabilitation based on interactive video technology.

Cognitive impairment is the main cause of disability in developed societies. New interactive technologies help therapists in neurorehabilitation in order to increase patients' autonomy and quality of life. This work proposes Interactive Video (IV) as a technology to develop cognitive rehabilitation tasks based on Activities of Daily Living (ADL). ADL cognitive task has been developed and integrated with eye-tracking technology for task interaction and patients' performance monitoring.

Música y cerebro (II): evidencias cerebrales del entrenamiento musical / Music and brain (II): evidence of musical training in the brain

La música es un estímulo multimodal muy potente que transmite información visual, auditiva y motora a nuestrocerebro, el cual cuenta con una red específica para su procesamiento, compuesta por regiones fronto-temporoparietales. Esta activación puede resultar muy provechosa en el tratamiento de diversos síndromes y enfermedades, ya sea rehabilitando o bien estimulando conexiones neuronales alteradas. Revisamos también las peculiaridades del cerebro del músico y vemos cómo el cerebro se adapta según las necesidades para mejorar su ejecución musical (AU)

Music is a very powerful multimodal stimulus that transmits visual, auditory and motor information to our brain, which in turn has a specific network for processing it, consisting in the frontotemporoparietal regions. This activation can be very beneficial in the treatment of several syndromes and diseases, either by rehabilitating or by stimulating altered neuronal connections. We also review the peculiarities of the musician’s brain and we look at how the brain adapts according to the needs that must be met in order to improve musical performance (AU)

[Transversal study on the prevalence of Metabolic Bone Disease (MBD) and Home Parenteral Nutrition (HPN) in Spain: data from NADYA group]. / Estudio transversal sobre la prevalencia de la Enfermedad Metabólica Ósea (EMO) y Nutrición Parenteral Domiciliaria (NPD) en España: datos del Grupo NADYA.

UNLABELLED: Patients with intestinal failure who receive HPN are at high risk of developing MBD. The origin of this bone alteration is multifactorial and depends greatly on the underlying disease for which the nutritional support is required. Data on the prevalence of this disease in our environment is lacking, so NADYA-SEMPE group has sponsored this transversal study with the aim of knowing the actual MBD prevalence. MATERIAL AND METHODS: Retrospective data from 51 patients from 13 hospitals were collected. The questionnaire included demographic data as well as the most clinically relevant for MBD data. Laboratory data (calciuria, PTH, 25 -OH -vitamin D) and the results from the first and last bone densitometry were also registered. RESULTS: Bone mineral density had only been assessed by densitometry in 21 patients at the moment HPN was started. Bone quality is already altered before HPN in a significant percentage of cases (52%). After a mean follow up of 6 years, this percentage increases up to 81%. Due to retrospective nature of the study and the low number of subjects included it has not been possible to determine the role that HPN plays in MBD etiology. Only 35% of patients have vitamin D levels above the recommended limits and the majority of them is not on specific supplementation. CONCLUSIONS: HPN is associated with very high risk of MBD, therefore, management protocols that can lead to early detection of the problem as well as guiding for follow up and treatment of these patients are needed.

Wernicke's encephalopathy induced by total parental nutrition.

Wernicke's encephalopathy is an acute neurological syndrome due to thiamine deficiency, which is characterized by a typical triad of mental status changes, oculomotor dysfunction and ataxia. Despite the fact that Wernicke's encephalopathy, in developed countries, is frequently associated with chronic alcoholism, there have been a number of published cases associating this encephalopathy with parenteral feeding without vitamin supplementation. Diagnosis is primarily a clinical one, and can be supported by laboratory tests and imaging studies; treatment should start as soon as possible, for the morbidity and mortality (almost 20%) associated with this syndrome is high. Thiamine supplementation, along with other vitamins, is recommended for patients in risk of developing this syndrome.

Documento de Consenso sobre el posible empleo de Ácido Conjugado Linoleico (CLA), como complemento alimenticio, en la infancia y la adolescencia / Consensus Document of possible use of Conjugated Linoleic Acid (CLA), as dietary supplement in childhood and adolescence

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Acute health problems among subjects involved in the cleanup operation following the Prestige oil spill in Asturias and Cantabria (Spain).

The purpose of this study was to evaluate exposure conditions and acute health effects in subjects participating in the Prestige oil spill cleanup activities and the association between these and the nature of the work and use of protection devices in the regions of Asturias and Cantabria (Spain). The sample comprised 400 subjects in each region, selected from a random sampling of all persons involved in cleanup activities, stratified by type of worker and number of working days. Data were obtained via a structured questionnaire and included information on specific tasks, number of working days, use of protective materials, and acute health effects. These effects were classified into two broad groups: injuries and toxic effects. Data analysis was performed using complex survey methods. Significant differences between groups were evaluated using Pearson's chi(2) test. Unconditional logistic regression was used to compute odds ratios and 95% confidence intervals. Bird cleaners accounted for the highest prevalence of injuries (19% presented with lesions). Working more than 20 days in highly polluted areas was associated with increased risk of injury in all workers. Occurrence of toxic effects was higher among seamen, possibly due to higher exposure to fuel oil and its components. Toxic effects were more frequent among those working longer than 20 days in highly polluted areas, performing three or more different cleaning activities, having skin contact with fuel oil on head/neck or upper limbs, and eating while in contact with fuel or perceiving disturbing odors. No severe disorders were identified among individuals who performed these tasks. However, potential health impact should be considered when organizing cleanup activities in similar environmental disasters.

Heavy metals in human bones in different historical epochs.

The concentration of the metals lead, copper, zinc, cadmium and iron was determined in bone remains belonging to 30 individuals buried in the Region of Cartagena dating from different historical periods and in eight persons who had died in recent times. The metals content with respect to lead, cadmium and copper was determined either by anodic stripping voltammetry or by atomic absorption spectroscopy on the basis of the concentrations present in the bone remains. In all cases, zinc and iron were quantified by means of atomic absorption spectroscopy. The lead concentrations found in the bone remains in our city are greater than those reported in the literature for other locations. This led to the consideration of the sources of these metals in our area, both the contribution from atmospheric aerosols as well as that from the soil in the area. Correlation analysis leads us to consider the presence of the studied metals in the analysed bone samples to be the consequence of analogous inputs, namely the inhalation of atmospheric aerosols and diverse contributions in the diet. The lowest values found in the studied bone remains correspond to the Neolithic period, with similar contents to present-day samples with respect to lead, copper, cadmium and iron. As regards the evolution over time of the concentrations of the metals under study, a clear increase in these is observed between the Neolithic period and the grouping made up of the Bronze Age, Roman domination and the Byzantine period. The trend lines used to classify the samples into 7 periods show that the maximum values of lead correspond to the Roman and Byzantine periods. For copper, this peak is found in the Byzantine Period and for iron, in the Islamic Period. Zinc shows an increasing tendency over the periods under study and cadmium is the only metal whose trend lines shows a decreasing slope.

Myocardial infarction risk in relation to zinc concentration in toenails.

Zn is an essential mineral. The role of Zn in atherosclerosis is not clear. Epidemiological studies, which have reported contradictory results, are limited by the use of serum Zn levels as a marker of intake. We assessed the association of toenail Zn, which integrates dietary Zn intake over 3 to 12 months, with the risk of a first myocardial infarction. Toenail Zn concentrations were determined by neutron activation analysis in the European multi-centre case-control study on antioxidants, myocardial infarction and breast cancer. This multi-centre case-control study included 684 cases and 724 controls from eight European countries and Israel. Toenail Zn levels of controls (adjusted for age and study centre) were positively associated with age, alpha-tocopherol and Se, but not with additional dietary variables or with classical risk factors for CHD. Average toenail Zn was 106.0 mg/kg in cases (95 % CI 103.1, 108.9) and 107.5 mg/kg in controls (95 % CI 104.5, 110.7). After controlling for cardiovascular risk factors and for centre, the adjusted odds ratios of myocardial infarction for quintiles 2-5 of toenail Zn with respect to the first quintile were 0.97 (95 % CI 0.59, 1.58), 1.15 (95 % CI 0.72, 1.85), 0.91 (95 % CI 0.56, 1.50), and 0.85 (95 % CI 0.52, 1.39). The P for trend was 0.45. In conclusion toenail Zn levels (reflecting long-term dietary intake) were not significantly associated with acute myocardial infarction.

[Neurohagiography. Lamberto Caesaraugustanus, the cephalophoric: holy patron of Spanish neurology?]. / Neurohagiografía. Lamberto Caesaraugustanus, el cefalóforo: patrono de la neurología española?

Until now Neurology has lacked a patron saint who, taking the most advantage of the rich cultural tradition inherited from our past and independently of the religious ideology of each one, can be helpful approach in the neurologist figure to different people. An Ad Hoc Committee from the Neurology History Study Group of the SEN has researched the medical hagiography with any kind of neurological relationship (neurohagiography), in order to make a hagiography study of every saint related to our speciality, with the added luck of proposing a patron for Neurology with hispanic origin. In this pioneer study of historiographic research different documents related with the medical hagiography have been studied, especially the Index ac Status Causarum, and information coming from different national ecclesiastic archives. A total of 342 saints share the patronage of 137 diseases, of which a 27,7% are related in some way to Neurology. Headache constitutes the prime cause of the invocations, with 20 saints. Another 11 saints plead for epilepsy; to these we also must add another six for so called possessed patients. Therefore, two of the three main causes of invocation (headache, fever and epilepsy) come up to chronic processes. Of all the saints with a hispanic origin candidates to the patronage of the neurologists San Lamberto Caesaraugustanus stands out, who died in the year 303 during Diocletian persecution. Belonging to the selected standing of "cephalophoric martyrs" (those beheahed who carry their own head in their hands), he was able to walk an important distance (about six kilometres) with his head split from the body, a fact only understood as a suprahuman phenomenon thanks to which he has becomes the brain transplant pioneer.

Omega-3 fatty acids in adipose tissue and risk of myocardial infarction: the EURAMIC study.

Omega-3 fatty acids have potential antiatherogenic, antithrombotic, and antiarrhythmic properties, but their role in coronary heart disease remains controversial. To evaluate the association of omega-3 fatty acids in adipose tissue with the risk of myocardial infarction in men, a case-control study was conducted in eight European countries and Israel. Cases (n=639) included patients with a first myocardial infarction admitted to coronary care units within 24 hours from the onset of symptoms. Controls (n=700) were selected to represent the populations originating the cases. Adipose tissue levels of fatty acids were determined by capillary gas chromatography. The mean (+/-SD) proportion of alpha-linolenic acid was 0.77% (+/-0.19) of fatty acids in cases and 0.80% (+/-0.19) of fatty acids in controls (P=0.01). The relative risk for the highest quintile of alpha-linolenic acid compared with the lowest was 0.42 (95% confidence interval [CI] 0.22 to 0.81, P-trend=0.02). After adjusting for classical risk factors, the relative risk for the highest quintile was 0.68 (95% CI 0.31 to 1.49, P-trend=0.38). The mean proportion of docosahexaenoic acid was 0.24% (+/-0.13) of fatty acids in cases and 0.25% (+/-0.13) of fatty acids in controls (P=0. 14), with no evidence of association with risk of myocardial infarction. In this large case-control study we could not detect a protective effect of docosahexaenoic acid on the risk of myocardial infarction. The protective effect of alpha-linolenic acid was attenuated after adjusting for classical risk factors (mainly smoking), but it deserves further research.

Tissue stores of individual monounsaturated fatty acids and breast cancer: the EURAMIC study. European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Breast Cancer.

The strongest evidence that monunsaturated fat may influence breast cancer risk comes from studies of southern European populations, in whom intake of oleic acid sources, particularly olive oil, appears protective. No previous study has examined the relation of adipose tissue fatty acid content to breast cancer in such a population. We used adipose biopsies with diverse fat intake patterns gathered in 5 European centers, including southern Europe (Malaga, Spain), to test the hypothesis that stores of oleic acid or other monounsaturates are inversely associated with breast cancer. Gluteal fat aspirates were obtained from 291 postmenopausal incident breast cancer patients and 351 control subjects, frequency-matched for age and catchment area. Logistic regression was used to model breast cancer by monounsaturates, with established risk factors controlled for. Oleic acid showed a strong inverse association with breast cancer in the Spanish center. The odds ratio for the difference between 75th and 25th percentiles was 0.40 (95% CI: 0.28, 0.58) in Malaga and 1.27 (0.88, 1.85) in all other centers pooled, with a peak at 2.36 (1.01, 5.50) for Zeist. Palmitoleic and myristoleic acids showed evidence of an inverse association outside Spain, and cis-vaccenic acid showed a positive association in 3 centers. These data do not support the hypothesis that increasing tissue stores of oleic acid are protective against breast cancer in non-Spanish populations. This finding implies that the strong protective associations reported for olive oil intake in dietary studies may be due to some other protective components of the oil and not to the direct effect of oleic acid uptake. Alternatively, high olive oil intake may indicate some other protective aspect of the lifestyle of these women.

Sensitization to Zygophyllum fabago pollen. A clinical and immunologic study.

Zygophyllum fabago is a herbaceous plant found widely in the Mediterranean area. There are no previous reports of its allergenicity. An aerobiologic and clinical survey was conducted in Murcia, southern Spain, to determine the quantity of airborne pollen and establish the possible role of this pollen as a cause of allergic symptoms. With a Hirst volumetric trap, we determined the atmospheric concentrations of this pollen in 1993, 1994, 1995, and 1996. Of 1180 patients tested, 181 (15.34%) had a positive skin test. To determine its allergenicity, we divided 47 patients into three groups: in group 1, all the patients had symptoms of rhinoconjunctivitis plus asthma; in groups 2 and 3, rhinoconjunctivitis. In group 1, we performed a bronchial provocation test (BPT); in groups 2 and 3, we performed nasal provocation (NPT) and conjunctival provocation (CPT) tests, respectively. SDS-PAGE was used to characterize the antigenic fractions and RAST inhibition to determine cross-reactivity with other pollens. The pollen dispersion period is from May to September (445 grains/m3). BPT was positive in 13 of 15 patients, NPT in 14 of 16 patients, and CPT in 13 of 16 patients. RAST inhibition revealed cross-reactivity with Mercurialis, Ricinus, Olea, and Betula. SDS-PAGE identified 25 IgE antibody-binding components, five of which (60, 65, 41, 38, and 15.5/14.7 kDa) were recognized by 40% of the sera. By SDS-PAGE immunoblotting with sunflower antiprofilin rabbit serum and affinity chromatography we established that the Z. fabago extract has profilin. This study shows that this pollen becomes airborne and elicits an IgE response which triggers respiratory symptoms in allergic subjects.

Adipose tissue omega-3 and omega-6 fatty acid content and breast cancer in the EURAMIC study. European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Breast Cancer.

The fatty acid content of adipose tissue in postmenopausal breast cancer cases and controls from five European countries in the European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Cancer (EURAMIC) breast cancer study (1991-1992) was used to explore the hypothesis that fatty acids of the omega-3 family inhibit breast cancer and that the degree of inhibition depends on background levels of omega-6 polyunsaturates. Considered in isolation, the level of omega-3 or omega-6 fat in adipose tissue displayed little consistent association with breast cancer across study centers. The ratio of long-chain omega-3 fatty acids to total omega-6 fat showed an inverse association with breast cancer in four of five centers. In Malaga, Spain, the odds ratio for the highest tertile relative to the lowest reached 0.32 (95% confidence interval 0.13-0.82). In this center, total omega-6 fatty acid was strongly associated with breast cancer. With all centers pooled, the odds ratio for long-chain omega-3 to total omega-6 reached 0.80 for the second tertile and 0.65 for the third tertile, a downward trend bordering on statistical significance (p for trend = 0.055). While not definitive, these results provide evidence for the hypothesis that the balance between omega-3 and omega-6 fat may play a role in breast cancer.