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INTRODUCTION: Depression occupies a substantial part of medical visit attendance. However, medical practitioners have very little time so that a brief, quick and reliable procedure to evaluate the intensity of symptoms and their changes could be useful. Our objective has been to analyze the reliability of a self-applied Visual Analogue Scale (VAS) to measure symptom intensity in depressed patients within this context. MATERIAL AND METHODS: One hundred depressed outpatients (ICD-10) stated their clinical situation on a VAS. The psychiatrist evaluated them using a Global Clinical Impression (GGI) and Hamilton Depression Rating Scale (HDRS-17). RESULTS AND CONCLUSIONS: The patient's VAS showed high correlation with the HDRS-17 and with the GCI used by the psychiatrist (r = 0.63 and r=0.58; p=0.000). This suggests that the use of a VAS in Primary Care could be useful and reliable for these purposes within the medical contexts of those having little time availability. Key-words: Depression, primary care, medical patients, assessment, evaluation.

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OBJECTIVE: The significance of hyperhomocysteinemia in type 2 diabetes is further complicated by the multiple ways of considering impaired renal function and vitamin status. The aim of our study was to analyze the relationship between total homocysteine (tHcy) in a population of type 2 diabetic patients and chronic complications. We also analyzed the relationship between tHcy and the body composition of these patients and other cardiovascular risk factors. DESIGN: In a cross-sectional study, a total of 155 patients with diabetes mellitus attending in our diabetes service (90 females/65 males) were enrolled in a consecutive way. MATERIAL AND METHODS: All enrolled patients underwent the following examinations: (i) biochemical cardiovascular risk factors including total cholesterol, triglyceride, lipoprotein (a), low-density lipoprotein (LDL-cholesterol), high-density lipoprotein (HDL-cholesterol), glucose, HbA(1c), fibrinogen, homocysteine, vitamin B12, folate, and microalbuminuria; and (ii) fat mass assessed by body mass index, weight, percentage of fat mass, and tricipital skinfold. RESULTS: Patients were divided in two groups (Group I: tHcy> or =15 micromol/l; Group II: tHcy<15 micromol/l). Smoking habit was similar in both groups. A prevalence of cerebrovascular accident was present in 3.3% in the total group. This prevalence was not different in both groups (7.4% vs. 2.3%; ns) (OR 3.3; 95% CI 0.49-19.68). The prevalence of coronary heart disease in the total group was 5.8% without statistical differences between groups (3.5% vs. 6.3%; ns) (OR 0.57; 95% CI 0.065-4.53). Concerning macrovascular complications, only peripheral vascular disease prevalence was higher in Group I (16% vs. 3.1%; P<0.05; OR 5.33; 95% CI 1.18-21.5). A prevalence of nephropathy was higher in Group I (93.3% vs. 12.8%; P<0.05; OR 7.15; 95% CI 2.9-17.9). No statistical differences were detected in prevalence of retinopathy (global group 41.9%) (42.5% vs. 40.9%; ns) (OR 1.75; 95% CI 0.78-3.9). Also, peripheral neuropathy was similar in both groups (7.1% vs. 6.5%; ns) (OR 1.1; 95% CI 0.15-8.2). No correlation was detected among homocysteine and anthropometric parameters (body mass index, weight, percentage of fat mass, fat mass, and tricipital skinfold). Elevated levels of fibrinogen, lipoprotein (a), microalbuminuria, and blood pressure were detected in Group I. CONCLUSION: The present study shows that elevation of plasma tHcy levels in type 2 diabetic patients is associated with a higher prevalence of peripheral arteriopathy and nephropathy. Our data suggest that hyperhomocysteinemia is not associated with fat mass but it is associated with high levels of fibrinogen, lipoprotein (a), microalbuminuria, and blood pressure levels.

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El virus de Epstein Barr (VEB) es el agente etiológico habitual de la mononucleosis infecciosa clásica. En este artículo recogeremos los resultados de dos ensayos utilizados en nuestro laboratorio para el diagnóstico serológico de la mononucleosis infecciosa producida por el VEB (Clearview IM y Enzywell Epstein Barr VCA IgM) junto a los de dos ensayos adicionales (Enzywell Epstein Barr EA IgG y Enzywell Epstein Barr EBNA IgG) al efecto de valorar sus ventajas relativas en el diagnóstico de la mononucleosis. La importancia del diagnóstico estriba en sus potenciales complicaciones en el paciente, que podrían llegar a provocar su muerte (AU)

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BACKGROUND: The effects of fluctuations in pollen counts have important implications for health services. Little research on the clinical implications of the vertical distribution of pollen in allergy symptoms has been carried out. METHODS: We have investigated the allergic symptoms of a population of 17 171 patients coming from our health area (Valladolid, Spain) and living in the city and villages. We compared the prevalence of sensitization to different pollens: Graminae, trees and shrub in relation with the floor of the building where they were living. RESULTS: Relative risk of pollen sensitization (confidence index, CI 95%) was higher in patients who were living at high floors than in those patients who were living in lower floors or at street level, independently of rural or urban conditions The chi-square showed a lineal trend in this relationship in the case of sensitization to grass pollen: chi(2): 1794, P > 0.00001 CONCLUSIONS: On the basis of our local investigations, natural pollen sensitization appears to increase with height where the patient lives. This paper reports clinical results on the influence of vertical pollen distribution in pollen allergy.

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BACKGROUND: Allergy to grass pollen is a highly prevalent allergic disease. Hay fever is more predominant in urban than in rural areas, despite the increasingly smaller areas of surrounding grassland. The effect of vehicle exhaust pollutants, mainly diesel particles, and other industrial sources of atmospheric pollution leading to plant damage has been implicated in this phenomenon. OBJECTIVE: This study compared the in vivo and in vitro allergenicity of pooled samples of Lolium perenne grass pollen harvested from 10 different urban areas with that of samples of the same pollen from 10 neighboring rural areas. METHODS: Lolium perenne pollen from different parts of a city and from a nearby rural area was harvested in 1999 and 2000 during the peak pollination period. Protein composition was compared by SDS-PAGE and in vivo and in vitro IgE-binding capacity was compared by skin-prick tests, RAST-inhibition and measurement of the major allergen, Lol p 5. RESULTS: In the two years under study, urban samples contained approximately twice the protein content of the rural samples. Biological activity and Lol p 5 content was higher in urban pollen than in rural pollen and showed differences in the two years under study. CONCLUSIONS: The protein content and allergenicity of Lolium perenne pollen was higher in urban areas than in rural areas. These differences might explain why allergy to grass pollen is more prevalent in urban areas. This finding should be taken into account in diagnosis, preventive measures and specific immunotherapy.

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BACKGROUND: The prevalence of asthma has increased from the 1950s to the 1990s. The relationship between diet and asthma is an area of controversy that has never been fully evaluated. Attempts at dietary prevention of asthma have produced conflicting results. We have recently identified allergens from cereals that show cross-reactivity with proteins in grass pollen. An early intake of cereals in the diet during early life might cause IgE sensitization to cereals. It is not known whether such sensitization predisposes the development of allergy to pollen. METHODS: To test this hypothesis, a cross-sectional study and an observational case-control analysis of reviewed data were carried out on 16381 patients who had been admitted to our Allergy Unit between 1989 and 1999. All the patients underwent allergy tests to identify asthma risk-factors. All information in our data base was analysed using the SPSS computer system. RESULTS: There has been an increase of 7.8% in incidences of allergic asthma and a 7.3% increase in asthma due to grass pollen in the last decade. Grass-pollen asthma was associated with sensitization to cereals. The early introduction of cereals in the diet of children was found to be a risk factor for grass-pollen asthma (OR = 5.95; 95% CI 3.89-9.10). CONCLUSIONS: These findings document the progression of allergic asthma during a decade in a large sample of people who were influenced by similar environmental conditions and studied with the same diagnostic methods. This study represents the largest database of patients in which a common food is shown to be a risk factor for asthma.

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BACKGROUND: No cases of occupational asthma caused by the inhalation of antigens from Anisakis simplex have been published. OBJECTIVE: The purpose of this study was to evaluate the possibility that A simplex can play a role in the asthma experienced by 2 workers when handling fish and fish flour. METHODS: Skin prick and bronchial challenge tests with A simplex were performed. We also carried out measurements of specific IgE to A simplex and immunoblotting. RESULTS: Both patients had strong positive skin test responses, challenge test responses, and specific IgE to A simplex. Immunoblotting showed that both patients also had IgE against several bands in the fish flour extract, suggesting contamination by Anisakis allergens. CONCLUSION: These 2 patients provide evidence for occupational asthma caused by A simplex, based on in vivo and in vitro tests for Anisakis-specific IgE.

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