Heat and drought determine flower female allocation in a hermaphroditic Mediterranean plant family.

In animal-pollinated hermaphroditic species, larger and xenogamous flowers increase male-biased resource allocation, whereas smaller and selfing flowers invest disproportionally more resources to female function. In Cistaceae, an entomophilous and hermaphroditic Mediterranean family, this pattern generally follows a phylogenetic signal. However, resource allocation to carpels is independent of phylogeny, which suggests trait divergences among closely related species during the diversification into different environmental conditions. We tested this hypothesis across 37 species of Cistaceae along a temperature and precipitation gradient, including semiarid, dry, subhumid and humid sites. We quantified the proportions of dry mass and nutrient investment to carpels and tested the influence of the climatic gradient and site-specific precipitation on the interspecific variation in carpel resource allocation. Lowest and highest percentages of resource allocation to carpels ranged from 1.5-4.2% to 24.2-36.6%, respectively. The proportion of resources comprised in carpels significantly decreased with increasing precipitation/decreasing temperature. Thus, carpels comprised proportionally more resources under drier and hotter conditions, especially in semiarid sites. Our results demonstrate how the extent of climatic constraints is more important than phylogenetic relationships in determining stress-induced differences in carpel resource allocation across species of Cistaceae in a Mediterranean environment. We suggest that allocation of proportionally more resources to carpels in drier and hotter sites lies within a strategy to deal with the most stressful conditions by means of a high reproductive effort.

One for all and all for one: retention of colour-unchanged old flowers increases pollinator attraction in a hermaphroditic plant.

Long-lived flowers increase pollen transfer rates, but these entail high water and carbon maintenance costs. The retention of pollinated and reward-free old flowers enhances pollinator visitation to young receptive flowers by increasing floral display size. This mechanism is associated with acropetal inflorescences or changes in flower colour and openness, but the retention of unchanging solitary flowers remains overlooked. We examined pollination-dependent variation in floral longevity and determined stigmatic receptivity, pollen viability and pollen removal rates among flower ages in Kielmeyera regalis, a Neotropical savanna shrub. We also evaluated the effects of floral display size on pollinator visitation rates. Lastly, we determined whether old flowers are unvisited and exclusively increase pollinator attraction to young flowers through flower removal experiments. Regardless of pollination treatment, flowers lasted fully open with no detectable physical changes for 3 days. Over time, stigmas remained receptive but >95% of pollen was removed. Pollinator visitation significantly increased with floral display size and intermediate percentages (15-30%) of newly opened flowers. Accordingly, the retention of reward-free and unvisited old flowers increased young flower-pollinator interaction. Our results reveal the importance of a prolonged floral longevity in increasing pollinator attraction toward newly opened receptive flowers without changes in flower colour and form. We conclude that the retention of pollinated, reward-free and unvisited colour-unchanged old flowers in K. regalis is a strategy that counteracts the water use costs associated with the maintenance of large flowers with increased mate opportunities in a pollen-limited scenario.

Phylogeny determines flower size-dependent sex allocation at flowering in a hermaphroditic family.

In animal-pollinated hermaphroditic plants, optimal floral allocation determines relative investment into sexes, which is ultimately dependent on flower size. Larger flowers disproportionally increase maleness whereas smaller and less rewarding flowers favour female function. Although floral traits are considered strongly conserved, phylogenetic relationships in the interspecific patterns of resource allocation to floral sex remain overlooked. We investigated these patterns in Cistaceae, a hermaphroditic family. We reconstructed phylogenetic relationships among Cistaceae species and quantified phylogenetic signal for flower size, dry mass and nutrient allocation to floral structures in 23 Mediterranean species using Blomberg's K-statistic. Lastly, phylogenetically-controlled correlational and regression analyses were applied to examine flower size-based allometry in resource allocation to floral structures. Sepals received the highest dry mass allocation, followed by petals, whereas sexual structures increased nutrient allocation. Flower size and resource allocation to floral structures, except for carpels, showed a strong phylogenetic signal. Larger-flowered species allometrically allocated more resources to maleness, by increasing allocation to corollas and stamens. Our results suggest a major role of phylogeny in determining interspecific changes in flower size and subsequent floral sex allocation. This implies that flower size balances the male-female function over the evolutionary history of Cistaceae. While allometric resource investment in maleness is inherited across species diversification, allocation to the female function seems a labile trait that varies among closely related species that have diversified into different ecological niches.

[Palliative care and intensive medicine in health care at the end of life in the XXI century]. / Cuidados paliativos y medicina intensiva en la atención al final de la vida del siglo XXI.

The basic aim of Intensive Care Medicine is care for the critical patient, that is, persons with a disease or condition that is life-threatening but with possibilities of recovery. In spite of the treatments, even those involving life support, cure is frequently not achieved and this is when the question is raised of withdrawing treatment due to criteria of futility. Once that decision is taken, efforts must be directed towards applying the necessary care to achieve an end to life without pain or suffering, endeavouring to ensure that the patient is accompanied by his loved ones. Studies show the shortcomings in training and health care that exist in caring for patients at the end of their lives within the sphere of the Intensive Care Units. This article reviews the contribution that can be made by Palliative Care in improving care for patients that die in the ICU and for their relatives. The ontology of palliative care aims to achieve an improvement of symptoms, the prevention of possible complications, to determine and respect the welfare of the patient, and to help the family in the final process and in mourning. It therefore involves different disciplines from the health field which must work with common aims. In situations of the end of life the knowledge and sensitivity of the professionals must be at the service of faithful commitment to the patient, making it possible to redirect therapeutic efforts towards the proposed aims.

Cuidados paliativos y medicina intensiva en la atención al final de la vida del siglo XXI / Palliative care and Intensive Medicine in health care at the end of life in the XXI century

El objetivo fundamental de la Medicina Intensiva es la atenciónal paciente crítico, es decir, personas con una enfermedad ocondición amenazante para su vida pero con posibilidades derecuperación; a pesar de los tratamientos, incluidos los de soportevital, con frecuencia no se consigue la curación y es entoncescuando se plantea la retirada de los mismos por criterios de futilidad.Una vez adoptada esa decisión los esfuerzos deben dirigirsea aplicar los cuidados necesarios para conseguir un final de lavida sin dolor ni sufrimiento, procurando que el paciente estéacompañado de sus seres queridos. Estudios realizados muestranlas lagunas formativas y asistenciales que existen en la atención alos pacientes en el final de la vida dentro del ámbito de las Unidadesde Medicina Intensiva. El presente artículo revisa la aportaciónque los Cuidados Paliativos pueden ofrecer para mejorar laasistencia a los enfermos que fallecen en UMI y a sus familiares.La ontología de cuidados paliativos tiene como objetivos la mejoríasintomática, la prevención de las posibles complicaciones,conocer y respetar los criterios de bienestar del paciente y laatención a la familia en el proceso final y en el duelo. Por tanto,implica a diversas disciplinas del campo de la salud y las impelena trabajar con objetivos comunes. En situaciones de final de lavida el conocimiento y la sensibilidad de los profesionales tienenque estar al servicio del compromiso de fidelidad con el pacienteque permita reorientar los esfuerzos terapéuticos hacia los objetivospropuestos

The basic aim of Intensive Care Medicine is care for thecritical patient, that is, persons with a disease or condition thatis life-threatening but with possibilities of recovery. In spite ofthe treatments, even those involving life support, cure isfrequently not achieved and this is when the question is raisedof withdrawing treatment due to criteria of futility. Once thatdecision is taken, efforts must be directed towards applying thenecessary care to achieve an end to life without pain orsuffering, endeavouring to ensure that the patient isaccompanied by his loved ones. Studies show the shortcomingsin training and health care that exist in caring for patients at theend of their lives within the sphere of the Intensive Care Units.This article reviews the contribution that can be made byPalliative Care in improving care for patients that die in the ICUand for their relatives. The ontology of palliative care aims toachieve an improvement of symptoms, the prevention ofpossible complications, to determine and respect the welfare ofthe patient, and to help the family in the final process and inmourning. It therefore involves different disciplines from thehealth field which must work with common aims. In situations ofthe end of life the knowledge and sensitivity of the professionalsmust be at the service of faithful commitment to the patient,making it possible to redirect therapeutic efforts towards theproposed aims

Dietary intake of hexachlorobenzene in Catalonia, Spain.

To assess the dietary intake of hexachlorobenzene (HCB) by the population of Catalonia, Spain, a total-diet study was carried out. Concentrations of HCB were determined in food samples randomly acquired in seven cities of Catalonia between June and August 2000. A total of 11 food groups were included in the study. HCB levels were determined by HRGC/HRMS. Estimates of average daily food consumption were obtained from recent studies. HCB intake was estimated for five population groups: children (aged 4 to 9 years), adolescents (aged 10 to 19 years), male and female adults (aged 20 to 65 years), and seniors (aged >65 years). In general, HCB residues in foods were rather low excepting dairy products with a mean concentration of 0.869 ng/g wet weight. Total dietary intakes of HCB (microgram per kilogram body weight/day) were the following: children (0.0064), adolescents (0.0031), female adults (0.0025), male adults (0.0024) and seniors (0.0019). All these values are considerably lower than the WHO tolerable daily intake (TDI), which is 0.17 microg kg(-1) day(-1) for non-cancer effects and 0.16 microg kg(-1) day(-1) for neoplastic effects in humans.

Polybrominated diphenyl ethers (PBDEs) in foodstuffs: human exposure through the diet.

Polybrominated diphenyl ethers (PBDEs) are used as flame retardants in a variety of materials, including synthetic polymers and textiles. Although these chemicals have been detected in environmental samples and human tissues, there is little information about human exposure to PBDEs through the diet. In the present study, we determined the concentrations of PBDEs in a number of food samples acquired in Catalonia (Spain) during 2000. The dietary intake of PBDEs was estimated for the general population living in this Spanish region. The highest PBDE concentrations were found in oils and fats, fish and shellfish, meat and meat products, and eggs, while the lowest levels corresponded to fruits, vegetables, and tubers. The dietary intake of PBDEs for an adult male was 97.3 ng/day (assuming not detected (ND) = (1)/(2) limit of detection (LOD)) or 81.9 ng/day (assuming ND = 0) The greatest contribution to these values corresponded to fish and shellfish, with approximately one-third of the total intake. TetraBDEs and pentaBDEs were the homologues showing the highest percentages of contribution to the sum of total PBDEs. The comparison of the current dietary intake with the suggested lowest observed adverse effect level value of 1 mg/kg/day for the most sensitive endpoints for toxic effects of PBDEs results in a safety factor over 5 orders of magnitude in relation to PBDE exposure from food.

[Polyuria as postoperative complication of frontal meningioma]. / Poliuria en el postoperatorio de un meningioma frontal.

We report the case of a 56-year-old man with a frontal meningioma who underwent scheduled surgery under balanced general anesthesia without complications and was then transferred to the intensive care postoperative recovery unit for observation. On the day of admission he developed polyuria and a decrease in central venous pressure. Plasma sodium and osmolarity were in the normal ranges but urine analysis showed hyponatremia and hypo-osmolarity, suggesting cerebral salt wasting syndrome. Physiological saline solution was infused to maintain osmolarity and plasma concentrations of sodium within normal ranges. Diuresis peaked on the sixth day after surgery at 17,600 mL in 24 hours and decreased gradually to normal on the eleventh day after admission. Elevated plasma concentrations of atrial natriuretic peptides confirmed the diagnosis. Correct management is essential when neurosurgery patients develop altered plasma and urinary sodium concentrations and osmolarity. Differential diagnosis involves considering diabetes insipidus, inappropriate secretion of antidiuretic hormone and salt wasting syndrome. Transfer to an intensive care postoperative recovery unit and early treatment are important for lowering the risk of complications and death.

Concentrations of arsenic, cadmium, mercury, and lead in common foods and estimated daily intake by children, adolescents, adults, and seniors of Catalonia, Spain.

This study was designed to estimate the dietary intake of arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) by the general population of Catalonia, Spain. The concentrations of these elements were determined in food samples randomly acquired in seven cities of Catalonia between June and August 2000. A total of 11 food groups were included in the study. As, Cd, Hg, and Pb levels were measured by ICP-MS and AAS. The dietary intake of these elements was determined by a total diet study. Calculations were carried out on the basis of recent data on the consumption of the selected food items. Trace element intake was estimated for five population groups: children, adolescents, male and female adults, and seniors. The highest dietary intakes of As (223.6 microg/day), Cd (15.7 microg/day), Hg (21.2 microg/day), and Pb (28.4 microg/day) corresponded to male adults. For all analyzed elements, fish and shellfish was the group showing the highest contribution to the respective intakes. In comparison with previous results, a general decrease in As, Cd, Hg, and Pb intake has occurred. The dietary intake of these elements was also compared with the provisional tolerable weekly intake (PTWI). Dietary intakes of As, Cd, Hg, and Pb by the population of Catalonia are currently well below the respective PTWIs.

Poliuria en el postoperatorio de un meningioma frontal / Polyuria following frontal meningioma surgery

Presentamos el caso de un varón de 56 años diagnosticado de un meningioma frontal. Se intervino quirúrgicamente de forma programada bajo anestesia general balanceada sin incidencias y fue trasladado a reanimación para el control postoperatorio. El primer día de ingreso inició una clínica de poliuria con descenso de la presión venosa central, en la analítica el sodio y osmolaridad plasmática se encontraban dentro de los límites de la normalidad pero en orina presentaba una hipernatriuria con osmolaridad disminuida por lo que se orientó el cuadro clínico como un síndrome pierde sal de origen cerebral. Se realizaron reposiciones con suero fisiológico con lo que se consiguió mantener la osmolaridad y el sodio plasmático dentro de los valores normales. La diuresis llegó a ser máxima el sexto día postoperatorio de 17.600 ml en 24 horas, disminuyendo progresivamente hasta normalizarse el onceavo día de ingreso. La determinación hormonal del péptido natriurético atrial plasmático elevado confirmó el diagnóstico. Es necesario una orientación clínica correcta de los pacientes neuroquirúrgicos que presentan alteraciones del sodio y la osmolaridad en plasma y orina. El diagnóstico diferencial debe realizarse entre la diabetes insípida, el síndrome de secreción inadecuada de ADH y el síndrome pierde sal. El ingreso en unidades de reanimación en el postoperatorio y la administración del tratamiento adecuado precoz es importante para disminuir la morbimortalidad de estos pacientes (AU)

Artritis crónica juvenil: a propósito de un caso post-enteritis por Campylobacter jejuni / Juvenile chronic arthritis developed after a Campylobacter jejuni enteritis. A case report

La artritis crónica juvenil es la enfermedad reumática más frecuente en niños. El diagnóstico precoz y el tratamiento energético de los pacientes con mal pronóstico sirven para mejorar la calidad de vida y la evolución. Presentamos un caso de artritis crónica juvenil que se presentó después de una enteritis por Campylobacter jejuni. (AU)

[Frequency and risk of bronchopulmonary neoplasia related to asbestos]. / Frecuencia y riesgo de neoplasia broncopulmonar relacionada con asbesto.

BACKGROUND: The goal of this study was to determine the prevalence of asbestos-related lung cancer and the importance of the occupational exposure to this inorganic fibre as a risk factor. PATIENTS AND METHODS: We performed a cross-sectional study of 82 patients with lung cancer (mean age 62 SD 9 years) and 53 patients without pleuropulmonary disease (63 SD 13 years). The occupational exposure to asbestos was determined by a questionnaire. We determined the concentration of asbestos bodies (AB) in bronchoalveolar lavage (BAL) (93 patients) or lung tissue (42 patients) after chemical digestion, with the results being expressed as AB/mL BAL or AB/g dry lung, respectively. A concentration higher than 1 AB/mL or 1,000 AB/g was considered as marker of high asbestos burden in lung tissue, which could be potentially responsible for pleuropulmonary disease. The importance of asbestos occupational exposure as a risk factor for lung cancer was determined using logistic regression models. RESULTS: 25 patients with lung cancer reported occupational exposure to asbestos (30%) and in 13 out of them AB were detected in BAL or lung tissue (24%), at high concentrations in 3 cases (4%). Six patients from the group without pleuropulmonary disease reported occupational exposure to asbestos (11%) and in 13 out of them AB were found in some samples (24%), with no case having high concentrations. In the univariate logistic regression analysis, diagnosis of bronchial neoplasia was associated with both smoking (OR 10.10, 95% CI 3.50-29.13) and occupational exposure to asbestos (OR 3.69, 95% CI 1.39-9.77). The association between asbestos exposure and lung cancer persisted statistically significant after adjustment for smoking (OR 2.80, 95% CI 1.00-7.84). CONCLUSION: In Spain, lung cancer was related to occupational exposure to asbestos in 4% of cases, and it appeared to exist a synergistic effect of smoking. Occupational exposure to this inorganic fibre doubles the risk of suffering from lung cancer.

Insecticidal activity of Maytenus species (Celastraceae) nortriterpene quinone methides against codling moth, Cydia pomonella (L.) (Lepidoptera: tortricidae).

The insecticidal effects of nortriterpene quinone methides (pristimerin, tingenonee, and 20-alpha-hydroxytingenone) are reported for the first time. The natural products were isolated from Maytenus sp. (Celastraceae) and their effects tested on larvae of codling moth (Cydia pomonella, Lepidoptera: Tortricidae). The three metabolites produce the same effects on codling moth larvae that azadirachtin does, although at higher concentrations. 20-alpha-Hydroxytingenone was the most active compound, showing lethal, antifeedant, and insect growth regulation activities. Pristimerin showed also a high antifeedant activity together with its molt effect suppression. Tingenone showed the lowest activity. The differences in the activity of the three products are related to the structure of the E ring.

Factors associated with second eye cataract surgery.

AIMS: To analyse the clinical and sociodemographic characteristics associated with second eye cataract surgery. METHODS: An observational, longitudinal study of patients scheduled for first eye cataract surgery that did not involve a combined procedure was carried at two teaching hospitals and one non-teaching hospital in Barcelona, Spain. Patients were followed for 2 years after first eye cataract surgery to assess whether and when they had undergone second eye cataract surgery. Clinical characteristics, perceived health characteristics (perceived visual function and overall health status), and sociodemographic characteristics were compared between two patient groups-those with surgery in only one eye and those who had undergone surgery in both eyes by the end of the 2 year follow up period. RESULTS: Of the 242 patients studied, 125 (51.7%) underwent second eye surgery during the 2 year observation period. Patients with visual acuity 6/18 (0.3) or worse in the second eye compared with those with visual acuity over 6/12 (0.5) and patients younger than 65 years compared with patients aged 65-74 were more likely to undergo second eye surgery (adjusted odds ratio 3.9 and 1. 8, respectively). 52 (44.5%) patients in the only one eye surgery group had a visual acuity less than 6/18 (0.3) in the second eye. CONCLUSIONS: Worse visual acuity in the second eye and younger ages are strongly associated with both eyes cataract surgery. There may be a potential increase of demand for this procedure in the near future since almost half of the patients with only one eye surgery presented a low visual acuity in the second eye.

Water and temperature relations and microconidial germination of Fusarium moniliforme and Fusarium proliferatum from maize.

The effects of water activity (aW, 0.994-0.85 = 0.4-21.0 (-)MPa water potential), temperature (5-42 degrees C), and their interactions on microconidial germination of three isolates each of Fusarium moniliforme and Fusarium proliferatum were determined in vitro on a maize meal extract medium. Temporal germination rates of microconidia of isolates of both species were significantly influenced by both aW and temperature. Germination was very rapid at > 0.94 aW with an almost linear increase with time. Germination rates of microconidia of F. moniliforme were slower than those of F. proliferatum isolates at marginal aW levels and 5-25 degrees C, while at higher temperature (30-37 degrees C), the former germinated more rapidly than the latter. The aW minima for germination of isolates of both species was 0.88, with none occurring at 0.85 aW over a 40-day incubation period. At 37 degrees C, isolates of F. moniliforme had slightly lower aW minima than those of F. proliferatum. The narrowest range of aW for germination was at 5 degrees C, and none occurred at 42 degrees C. The effect of aW x temperature interactions on the lag phases (h) prior to germination and the germination rates (h-1) were estimated using the Gompertz model and the Zwietering equation. This showed that lag phases were shorter at 25-30 degrees C and 0.994-0.98 aW, and were increased to 10-500 h at marginal temperatures (5-10 degrees C) for F. proliferatum and longer for F. moniliforme. At marginal aW levels (0.92-0.90), lag times were increased to > 250 h. Germination rates (h-1) were different for the two species. Microconidia of F. moniliforme germinated optimally at 25-37 degrees C and 0.96-0.98 aW, but this changed to 30 degrees C at 0.90-0.94 aW, while germination of microconidia of F. proliferatum remained optimum at 30 degrees C, regardless of aW. There were statistically significant (P < 0.01) effects of aW, temperature, isolate, and two- and three-way interactions for F. proliferatum, but there were no intraisolate effects for F. moniliforme. The ecological significance of these data for understanding colonization patterns of these important fumonisin-producing fungi are discussed.

[Efficacy and tolerance of the treatment of tuberculosis in the aged]. / Eficacia y tolerancia del tratamiento de la tuberculosis senil.

We analyzed 55 confirmed cases of tuberculosis in patients over 65, a sample that amounted to 9% of all patients seen in our practice over a period of 5 years. Mean age was 72.4 and the male/female ratio was 4/1. The most frequently associated diseases were tobacco addiction (49%), chronic obstructive pulmonary disease (33%), alcoholism (25%) and prior diagnosis of tuberculosis (20%). Lung involvement was the most common clinical presentation (76%), followed by pleural (9%) and skeletal (7%) involvement. The clinical picture was non specific, with 13% remaining asymptomatic. Cough was the most frequent symptom (45%) and unilateral apical fibrosis with ulceration was the most frequent radiological finding. Pleural discharge and cavitation were demonstrated in 14 and 22%, respectively. Scarring was visible on X-rays in 44%. The tuberculin test was positive in 88% of the cases in which it was performed. Mean delay in diagnosis was 3.4 months; 62% were diagnosed by sputum test, 11% by culture, and 27% histology. In 4% death was directly caused by tuberculosis. Three patients withdrew from treatment, in one case treatment failed, and there was one relapse detected at follow-up. We observed adverse side effects in 33%, and found no statistically significant differences between the 2 therapeutic protocols used (2 months RHS/7 months RH and 2 months RHZS/4 months RH). The incidence of tuberculosis among the elderly is low in our practice and the entity behaves much as it does in the rest of the adult population. Both the efficacy and tolerance of treatment can be considered optimal.

Maximum respiratory pressures in trumpet players.

We studied whether experienced trumpet players can develop higher pressures with their inspiratory and expiratory muscles than untrained subjects. Twelve male trumpet players (mean age, 22.4 +/- 3.3 years) participated in the study. All of them had played the trumpet for at least 4 years and were nonsmokers. Twelve healthy male subjects (mean age, 23.3 +/- 3.1 years) participated as a control group. There were no differences in spirometric parameters between both groups. Maximum respiratory pressures were higher in the trumpet player group (trumpet players: Pmax 151.3 +/- 19.8 cm H2O; Pemax, 234.6 +/- 53.9 cm H2O; control group: Pemax, 106.7 +/- 10.4 cm H2O; Pemax, 189.6 +/- 14.6 cm H2O). We concluded that in young trumpet players, maximum respiratory pressures are higher than in young people who do not play wind instruments. This is most probably a consequence of respiratory muscle training with a wind instrument.