Spatial and temporal variations in airborne Ambrosia pollen in Europe.

The European Commission Cooperation in Science and Technology (COST) Action FA1203 "SMARTER" aims to make recommendations for the sustainable management of Ambrosia across Europe and for monitoring its efficiency and cost-effectiveness. The goal of the present study is to provide a baseline for spatial and temporal variations in airborne Ambrosia pollen in Europe that can be used for the management and evaluation of this noxious plant. The study covers the full range of Ambrosia artemisiifolia L. distribution over Europe (39°N-60°N; 2°W-45°E). Airborne Ambrosia pollen data for the principal flowering period of Ambrosia (August-September) recorded during a 10-year period (2004-2013) were obtained from 242 monitoring sites. The mean sum of daily average airborne Ambrosia pollen and the number of days that Ambrosia pollen was recorded in the air were analysed. The mean and standard deviation (SD) were calculated regardless of the number of years included in the study period, while trends are based on those time series with 8 or more years of data. Trends were considered significant at p < 0.05. There were few significant trends in the magnitude and frequency of atmospheric Ambrosia pollen (only 8% for the mean sum of daily average Ambrosia pollen concentrations and 14% for the mean number of days Ambrosia pollen were recorded in the air). The direction of any trends varied locally and reflected changes in sources of the pollen, either in size or in distance from the monitoring station. Pollen monitoring is important for providing an early warning of the expansion of this invasive and noxious plant.

Rare complication of the cervical spine trauma--traumatic esophageal fistula: case report and review of the literature.

BACKGROUND AND STUDY AIMS: Esophageal fistula due to cervical spine trauma is a rare, potentially fatal complication, which changes significantly the treatment and the prognosis of the trauma patient. There is scarce data regarding this associated pathology of cervical trauma and it consists only of isolated cases, most of them being reported as a complication of the surgical treatment. We present the case of a female patient who suffered a fall from a wagon and who was diagnosed at presentation with cervical fracture and esophageal fistula. Patient: A 65 years old female who suffered a fall from a train wagon presented for intense neck pain and bilateral brachial paresis. The MRI exam showed a C6-C7 fracture with bilateral facet dislocation in the context of a degenerative, spondylotic cervical spine. It also showed an anterior fragment from the C7 body, in contact with esophageal adventitia. The patient underwent surgery. RESULTS: A C6 corpectomy was performed, with arthrodesis with bone graft and cervical plate fixation. 24 hours after the procedure, the clinical signs of an esophageal fistula appeared and a CT-scan revealed the typical aspects of that complication. The patient underwent a second surgery in collaboration with the general surgeon with a good outcome and complete neurological recovery. CONCLUSION: In the case of cervical spine trauma the imaging exploration has to look for potential signs of lesions to the neighboring vital structures. Although a rare complication of cervical trauma, esophageal fistula represents a formidable complication and requires immediate surgical sanction, the only factor decisive for a good prognosis.

Neurosurgical approach in orbital pathology -unicentric study.

UNLABELLED: Orbital pathology represents a unique entity because is located in a border region that requires neurosurgery, ophthalmology and oncology collaboration. The modern surgery includes the orbital surgery and skull base surgery. MATERIAL AND METHODS: This study presents neurosurgical approaches in 17 cases of orbital pathology in a period of 4 years in the Neurosurgery Department of Emergency Hospital "Prof. Dr. N. Oblu" lasi. In most cases our team performed a fronto-temporal and pterional approach with orbital roof resection and tumor abl ation. In our study there were 10 women (58.8%) and only 7 men (41.1%). 16 patients presented with exophthalmia, head each (8 patients), diplopia (3 patients), amblyopia (4 patients), ptosis (1 patients), rinoreea (1 patients) and nerveVIl paresis (2 patients). RESULTS: Postoperative there were remissions of exophthalmia and the other symptoms and there were not registered any complications. CONCLUSIONS: However the technique and cranial approach can be evaluated on case-by-case situation and depends on the location and extension of the lesion. The goals were patient safety, symptoms remission and tumor removal.

Pathology of the optic nerve injury.

UNLABELLED: The optic nerve injury is produced by damaging the optic nerve within a craniocerebral trauma. The anatomo-pathology and the pathology of posttraumatic visual impairments are fundamental data for the therapeutic indications. The microscopic examination reveals only the particular cases of very serious or severe extensive lesions. Damage to the vessels of the optic nerve, damage and break of the optical fibers are responsible for immediate visual impairments and secondary hematomas and edemas involving. The factors for the late appearance of visual impairments are numerous and often confounding. MATERIAL AND METHODS: In the present research, we have a female patient D.A., aged 29, diagnosed with closed fracture in the right frontal lobe, irradiated to the optic canal; blindness in the right eye. RESULTS: Break of the optical fibers is a result of bone fragments or of traction and torsion. Damage to the vessels of the optic nerve represents the main cause of blindness for most authors. Traction and torsion of the vessels at the moment of injury may cause thrombosis and small hemorrhages which lead to severe ischemia of the, optical fibers. CONCLUSIONS: The optic nerve injury is produced by damaging the optic nerve within a craniocerebral trauma, through an indirect mechanism most of the times.

[Statistical data on head trauma with frontal sinus involvement at the Emergency Hospital Clinic "Prof. Dr. Nicolae Oblu", Iasi, Romania]. / Elemente de statistica a traumatismelor craniocerebrale cu implicarea sinusurilor aerice frontale în Spitalul Clinic de Urgenta "Prof. Dr. Nicolae Oblu" Iasi.

UNLABELLED: We present here some interesting points of view concerning head and brain injury with frontal sinus involvement. MATERIAL AND METHODS: In general neurosurgical practice the frontal sinus traumatic involvement is about 3-5 per cent from all head trauma; we proposed to realise a extensive 5 years study to finnaly sumarise the characteristical elements for our geographical area. The amount of patients hospitalized in our clinic was about 80 000 in five years. RESULTS: Concerning our statistical data, there are 677 patients with frontal sinus injury, 490 from this were complicated with brain pathology. CONCLUSIONS: We concluded there are differences between our series and the other studies from developed countries, in our region the domestical (agricultural works) causes are about 10% higher.

[Posterior fossa meningiomas--topographic and anatomopathologic aspects]. / Aspecte topografice si anatomopatologice ale meningioamelor de fosa posterioara.

UNLABELLED: Meningiomas are the most frequent met intracranial tumors. Many authors tried to order them according to location, origin and histopathologic type. MATERIAL AND METHOD: Our study is focused on posterior fosa meningiomas, initially classified according to their origin based on IRM and surgical findings in order to identify correlations between demographic data, topographic tumor origin and anatomopathologic characteristics for each subgroup. 35 posterior fosa meningioma patients that have been subject to neurosurgery in Iasi "Prof.Dr. N. Oblu" Hospital Neurosurgery Clinic between January 1st 2005 and December 1st 2009 were assessed. RESULTS: In our study group the majority of patients were females, with an average age in their early 60's. Benign meningiomas (1st degree) represented the unique subtype in tumors located in cerebellum convexity and foramen magnum. Other locations have different characteristic subtypes (fibrous vs. angiomatous meningioma).

[Papillary edema in expansive intra-cranial tumors]. / Edemul papilar in procesele expansive intracraniene.

UNLABELLED: The aim was: correlation between frequency of papillary edema in intra-cranial tumours and to verify Romanian medical legislation for ophthalmoscopy. This paper is a retrospective study for a period of 2 years (2005-2006). We included in study 446 patients treated in Hospital "Sf Treime" Iasi, Romania for expansive intra-cranial tumours. Ocular signs and symptoms (especially papillary edema) were observed for these patients. Mean age was 50.76+/- 18.30 years and in 46.87% of cases we found papillary edema in different stages. CONCLUSIONS: papillary edema depends after localization and size of intra-cranial tumours, histological aspects and its aggressivity.

[Neurological and abdominal lesional associations in polytrauma]. / Asocieri lezionale neurologice si abdominale in politraumatisme.

UNLABELLED: Polytraumatisms have always been a concern in human history, their number increasing especially during wars. Their forecast depends on many factors, starting from means of transportation, first aid's promptitude, technical endowment which evolved a lot within the years. Amongst the thoracal-abdominal, the cranial-cerebral and vertebral-medullary injuries, the cranial-cerebral and the abdominal injuries are the most severe ones. We hereby present the evaluation scales according to various criteria (seriousness, prognosis, clinical valutation). In the case of abdominal and neurosurgical injuries the symptomatology can be modified by addition or defalcation, which may cause diagnostic errors with consequences upon morbidity and mortality. MATERIAL AND METHOD: We hereby present a study accomplished within three departments: Piatra Neamt Emergency Hospital, Piatra Neamt Coronary Office and Iasi Neurosurgery Clinic, and we find the injury associations in polytrauma cases. RESULTS: We notice a prevalence of the male sex, of the country people, of traffic accidents, of the active age 20-60 years old. The association within abdominal trauma and neurological injuries is of 16.97% in Iasi Neurosurgery Clinic. After being solved, the neurological injuries are sent to surgery departments, for solution or surveillance. CONCLUSION: In order to optimize the medical assistance for traumatized persons we hereby recommend a polytrauma centre establishment.

[Celioscopic exploration in polytrauma with neurosurgical component]. / Explorarea caelioscopica in politraumatismele cu componenta neurochirurgicala.

UNLABELLED: Caelioscopic surgery has been introduced in the medical practice for only two decades and imposed as a method due to its multiple advantages, expanding its application to therapy and exploration. If, initially the traumatic pathology of the abdomen has been used, this paper proposes the expansion of this method in polytraumatisms with neuralsurgical components, and not only. MATERIAL AND METHOD: This paper presents a study made on 67 cases with the Emergency Hospital of Piatra Neamt, of which 22 patients (33%) after the caelioscopic exploration requested surgical intervention. RESULTS: In 26 cases we have limited to caelioscopic exploration and eventually, peritoneal drainage, and 19 cases have only been monitored. Thus it is covered a segment of pathology to which paraclinical exploration, respectively abdominal echography and CT, does not provide a certain diagnosis in post-traumatic abdominal lesions. This method is relatively easy for a general surgeon and can be successfully applied in neural-surgical lesion associations, within a good cooperation of guard teams and much better within a polytraumatic centre. This is how morbidity and even mortality can be significantly reduces.

Cheyne stokes respiration in stroke patients.

Cerebral-vascular events represent a major cause of mortality worldwide. Resulting respiratory complications are common and possibly composing a marker of severe neurological disorder. Cheyne-Stokes respiration is a disorder characterised by recurrent central apnoeas during sleep, alternating with a crescendo-decrescendo pattern of tidal volume, thus constituting an additional burden to the patient. In this paper the authors review the physio-pathological background, clinical presence and latest therapy-related data on Cheyne Stokes respiration in stroke patients.

Current trends in minimally invasive neurosurgery: neuro-endoscopy.

Minimal invasive neurosurgery refers to the technological advances accomplished in refining surgical access thus enabling neurosurgeons to reduce the morbidity and improve the accuracy and quality of neurosurgical procedures. Neuro-endoscopy comprises a promising minimal invasive technique being applied in an increasing amount of cases as diseases of cerebrospinal fluid dynamics, brain and spinal tumours, cysts, infections, evacuation of haematomas et al. Representing an important scientific modality neuro-endoscopy favours the rapid recovery of the patient and improves its postoperative quality of life. Personnel training is compulsory so that a safe operative performance is performed. Greater experience in the field would be necessary for broadened applications. Neuro-endoscopy presents exciting scientific possibilities in the future.

Mechanical ventilation in vascular coma patients.

Vascular coma is one of the leading complications in patients suffering cerebrovascular accidents and it is therefore entirely appropriate that we should consider what critical care has to offer in this devastating disease process. Vascular coma patients need ventilatory assistance; Intubation and mechanical ventilation represent a life saving intervention. As critical care is subjected to progressive changes, careful definition of the role of mechanical ventilation, its types, and the ability of such a form of life sustaining support to affect patient outcome in multi-sided directions is mandatory.

[Spontaneous intracerebral haemorrhage. An update of conservative treatment]. / Actualitati în tratamentul conservator al hematomului intracerebral spontan.

In our article we analysed the current conservative therapeutic options in spontaneous intracerebral haemorrhage as well as a few controversies regarding the efficiency of some types of treatment. Spontaneous intracerebral haemorrhage represents a major neurosurgical emergency. In spite of the severe prognosis of the disease, there is reason for optimism. There are important improvements in treatment of arterial hypertension, and cerebral lesions. The aim of the conservative medical treatment is to maintain good oxygenation, decreased arterial pressure, control of the intracranial hypertension, cerebral oedema, prevention of seizures. All these contribute to improving the vital and functional prognosis.

[Complications of intracerebral hemorrhage caused by arterial hypertension]. / Complicatiile hemoragice intracerebrale ale hipertensiunii arteriale.

Intracerebral hematoma represent a frequent complication of hypertension. It is accompanied by significant mortality and complications. It is mainly a surgical condition but we prefer conservative therapeutic options in cases where feasible. The conservative treatment gives better results but surgery becomes obsolete in cases when medical treatment fails.

[Role of calcium and magnesium ions in cerebrospinal fluid in alcoholic-traumatic coma]. / Rolul determinarii ionilor de calciu si magneziu în LCR în coma etilico-traumatica.

The goal of investigation was to determine the role of calcium and magnesium ions in the cerebrospinal fluid in ethylic-traumatic coma. We measured the level of calcium in the cerebrospinal fluid within simple photometric test and the magnesium level within xylidyl blue photometric test. We found a high mortality in patients with high level of calcium in cerebrospinal fluid and low level of magnesium in cerebrospinal fluid. At patients with ethylic-traumatic coma high levels of calcium in cerebrospinal fluid are caused by the excitatory amino acids cascade and increased of hematoencephalic barrier permeability. Decreased levels of magnesium in cerebrospinal fluid are associated with convulsions and a poor prognosis of the patients. These analyses are very important for establishment of prognosis in patients with ethylic-traumatic coma.

[Tumors of the third ventricle]. / Tumorile ventriculului III.

This paper presents 17 cases of tumours of the third ventricle which have been hospitalized, explored and treated in the Neurosurgical Clinic of the St. Trinity Hospital during the last ten years (1986-1996). There are emphasized the histopathological features of these tumours, according to pathological anatomy exams and to the dates in the literature, the main elements of the clinical picture typical for these tumours, the main paraclinical investigating methods, possibilities of healing and postoperative results. Finally, there are presented the results on these 17 clinical observation as well as a presentation of the further possibilities in diagnosis and treatment which will improve substantially the number of healed cases, diminishing the incidence of postoperative morbidity and mortality.

[The evolution of the incidence of glial brain tumors in Moldova in 1981-1991: the effect of excessive accidental hyper-radioactivity]. / Evolutia incidentei tumorilor gliale cerebrale în Moldova în perioada 1981-1991: influenta hiperradioactivitatii accidentale excesive.

The authors discussed the effects of nuclear accident from Chernobyl (1986) upon the histotypes of cerebral glial tumors, first diagnosed during 1981-1991 at the Department of Pathology, Neurosurgical Hospital, Iasi. It's microscopic diagnosis was determined according to the World Health Organization criterion (1979). The investigations established a tendency to diminish the incidence of astrocytomas and to increase the oligo-astrocytic tumors number, after 1986. Malignant astrocytomas did not presented any modifications with statistical significance during the eleven studied years.