[The sign of the cross: a very rare automatism in temporal lobe epilepsy. Two case reports]. / La señal de la cruz: un automatismo muy poco frecuente en la epilepsia del lóbulo temporal. Descripción de dos casos.

INTRODUCTION: In the evaluation of drug-resistant epilepsy (DRF), a detailed analysis of the semiology is essential to establish a diagnostic hypothesis of the location of the epileptogenic zone. Cross-sign (CS) is a very infrequent complex manual automatism described for the first time in 2008 and rarely reported in the literature. CASE REPORT: We present two cases from our series of patients monitored by videoEEG, one of whom also studied with deep electrodes, in which we describe the location of the discharge while performing the CS. A bibliographic review is also carried out to try to establish a localizing and/or lateralizing value of this sign. CONCLUSION: The sign of the cross is a rare ictal automatism that occurs in patients with temporal lobe epilepsy. The hand used to make the sign of the cross is the dominant one, regardless of the origin of the crises.

TITLE: La señal de la cruz: un automatismo muy poco frecuente en la epilepsia del lóbulo temporal. Descripción de dos casos.Introducción. En la evaluación de la epilepsia farmacorresistente, el análisis detallado de la semiología es fundamental para establecer una hipótesis diagnóstica de la localización de la zona epileptógena. La señal de la cruz es un automatismo manual complejo muy infrecuente descrito por primera vez en 2008 y poco referido en la bibliografía. Caso clínico. Presentamos dos casos con presencia de la señal de la cruz de nuestra serie de pacientes monitorizados mediante videoelectroencefalograma, uno de ellos estudiado también con electrodos profundos, en los que describimos la localización de la descarga en el momento de realizar la señal de la cruz. Se realiza también una revisión bibliográfica para intentar establecer un valor localizador y/o lateralizador de este signo. Conclusión. La señal de la cruz es un raro automatismo ictal que ocurre en pacientes con epilepsia del lóbulo temporal. La mano empleada para la señal de la cruz es la dominante, independientemente del origen de las crisis.

Selection of patients for percutaneous closure in nonlacunar cryptogenic stroke associated with patent foramen ovale. Data from the NORDICTUS cooperative registry.

INTRODUCTION: There is an extending use of percutaneous closure of patent foramen ovale (PFO) as therapy for PFO-associated cryptogenic strokes. The aim of our study was to investigate the clinical practice of percutaneous closure of PFO and to analyse the variables for decision-making on the selection of patients for this procedure. METHOD: A prospective observational multicentric survey was conducted using all the cases of cryptogenic stroke/transient ischaemic attack associated with PFO recorded in the NORDICTUS hospital registry during the period 2018-2021. Clinical data, radiological patterns, echocardiogram data and factors related to PFO-associated stroke (thromboembolic disease and paradoxical embolism criteria) were recorded. The indication for closure was analysed according to age (≤/> 60 years) and the characteristics of the PFO. RESULTS: In the group ≤ 60 years (n = 488), 143 patients (29.3%) underwent PFO closure. The most influential variables for this therapy were detection of a high-risk PFO (OR 4.11; IC 2.6-6.5, P < .001), criteria for paradoxical embolism (OR 2.61; IC 1.28-5.28; P = .008) and previous use of antithrombotics (OR 2.67; IC 1.38-5.18; P = .009). In the > 60 years group (n = 124), 24 patients had PFO closure (19%). The variables related to this option were history of pulmonary thromboembolism, predisposition to thromboembolic disease, paradoxical embolism criteria, and high-risk PFO. CONCLUSIONS: The detection of a high-risk PFO (large shunt, shunt with associated aneurysm) is the main criterion for a percutaneous closure-based therapy. Other conditions to consider in the eligibility of patients are the history of thromboembolic disease, paradoxical embolism criteria or the previous use of antithrombotics.

Encephalopathy and encephalitis during acute SARS-CoV-2 infection. Spanish Society of Neurology COVID-19 Registry. / Encefalopatías y encefalitis durante la infección aguda por SARS-CoV2. Registro de la Sociedad Española de Neurología SEN COVID-19.

OBJECTIVES: Since the beginning of the COVID-19 pandemic, the Spanish Society of Neurology has run a registry of patients with neurological involvement for the purpose of informing clinical neurologists. Encephalopathy and encephalitis were among the most frequently reported complications. In this study, we analyse the characteristics of these complications. PATIENTS AND METHODS: We conducted a retrospective, descriptive, observational, multicentre study of patients with symptoms compatible with encephalitis or encephalopathy, entered in the Spanish Society of Neurology's COVID-19 Registry from 17 March to 6 June 2020. RESULTS: A total of 232 patients with neurological symptoms were registered, including 51 cases of encephalopathy or encephalitis (21.9%). None of these patients were healthcare professionals. The most frequent syndromes were mild or moderate confusion (33%) and severe encephalopathy or coma (9.8%). The mean time between onset of infection and onset of neurological symptoms was 8.02 days. Lumbar puncture was performed in 60.8% of patients, with positive PCR results for SARS-CoV-2 in only one case. Brain MRI studies were performed in 47% of patients, with alterations detected in 7.8% of these. EEG studies were performed in 41.3% of cases, detecting alterations in 61.9%. CONCLUSIONS: Encephalopathy and encephalitis are among the complications most frequently reported in the registry. More than one-third of patients presented mild or moderate confusional syndrome. The mean time from onset of infection to onset of neurological symptoms was 8 days (up to 24hours earlier in women than in men). EEG was the most sensitive test in these patients, with very few cases presenting alterations in neuroimaging studies. All patients treated with boluses of corticosteroids or immunoglobulins progressed favourably.

Investigating low-valent compositions in the Na3V2O2x(PO4)2F3-2x family: structural transitions and their consequences.

A member of the family of compounds with the formula Na3V2O2x(PO4)2F3-2x is synthesized by carbothermal reduction and 2 consecutive hydrothermal processes. The initial structural and spectroscopic characterization indicates that there are two phases in the as-synthesized material, a mixed valent phase with an intermediate V oxidation state adopting a P42/mnm space group at about 66%, and another phase with a V oxidation state close to V3+ adopting an Amam space group at about 33%. The role of each species in the electrode function is interrogated using in situ synchrotron X-ray diffraction and these data indicate that soon after charge begins, the Amam phase transforms into the P42/mnm phase. Further structural evolution of the material shows a prevailing two-phase reaction at lower potentials and a significant solid solution region during the high potential feature in the electrochemical curve with a final two-phase region at the end of charge. The conversion of the Amam component into P42/mnm showed no reversibility upon discharge. This phase-mixed electrode appears to illustrate that the mixed valent P42/mnm phase dominates electrochemical behavior during cycling and this may prove vital when preparing members in the sodium vanadium fluorophosphate family, especially if there is an energetically preferred phase for cycling.

The effect of partial substitution of Ni by Mg on the structural, magnetic and spectroscopic properties of the double perovskite Sr2NiTeO6.

In this report, the structural, magnetic and spectroscopic properties of the freeze-drying synthesized Sr2Ni1-xMgxTeO6 (x = 0.0, 0.1, 0.2, 0.3 and 0.5) oxides are analyzed by means of X-ray powder diffraction (XRPD) and neutron powder diffraction (NPD), electron paramagnetic resonance, diffuse reflectance and magnetic susceptibility. The XRPD and NPD data analysis using the mode-crystallography approach have revealed that at room temperature (RT), all the compositions are monoclinically distorted with the space group I2/m. The high and low temperature analyses have shown that these materials suffer a series of three structural phase transitions. The EPR results have shown that the spectra of all the compositions are centred at g≈ 2.28, indicating a slightly distorted octahedral environment of Ni(2+), which is in agreement with the crystal structure analysis. The increase of the Mg(2+) content in Sr2Ni1-xMgxTeO6, provokes a decrease of the dipolar interaction effects and thus, the resonance becomes narrower. This resonance does not completely disappear which leads to the idea that the long-range magnetic order is not completely established when x≥ 0.3. The substitution of the Ni(2+) (S = 1) ions by Mg(2+) (S = 0) ions, also induces a weakening of the antiferromagnetic interactions, which is reflected in the diminishing of the absolute value of θ and the Néel temperature TN. The magnetic structure determination revealed the existence of an antiferromagnetic coupling for x- and z-spin components of the nickel atoms.

Tuning the Size of Palladium Nanoparticles in Organic and Aqueous Solutions: Influence of Aminated and Thiolated Ligands.

Highly monodispersed palladium nanoparticles have been synthesized by a two-phase reduction method using two different capping agents, alkylamines and alkanethiols. The influence of ligand type in the properties of palladium nanoparticles have been analyzed in detail by means of several techniques as Infrared and Ultraviolet-Visible Spectroscopy, X-ray Diffraction and Transmission Electron Microscopy. It is shown how the size can be tuned easily between 2 and 4 nm by using alkylamines ligands with carbon chains of different lengths, while keeping up high purity and crystallinity. The transfer of these nanoparticles to water phase has been achieved by the ligand exchange process. In contrast, when alkanethiols are used as stabilizers no correlation between carbon chain length and size has been observed. This distinct chemical reactivity between palladium and mentioned ligands produces some particular electronic and magnetic properties that are analyzed by Electron Magnetic Resonance. The presence of free radicals associated with palladium and capping agent bond has been confirmed. No evidences of ferromagnetic behavior coming from Palladium nanoparticles have been found out in any of the studied samples.

Cardiac arrhythmias in stroke unit patients. Evaluation of the cardiac monitoring data. / Arritmias cardiacas en la unidad de ictus: análisis de los datos de la monitorización cardiaca.

INTRODUCTION: Cardiac arrhythmias are frequent in acute stroke. Stroke units are widely equipped with cardiac monitoring systems. Pre-existing heart diseases and heart-brain interactions may be implicated in causing cardiac arrhythmias in acute stroke. This article analyses cardiac arrhythmias detected in patients hospitalised in a stroke unit. METHOD: Prospective observational study of consecutive patients admitted to a stroke unit with cardiac monitoring. We collected clinical data from patients and the characteristics of their cardiac arrhythmias over a 1-year period (2013). Time of arrhythmia onset, associated predisposing factors, and the therapeutic decisions made after detection of arrhythmia were examined. All patients underwent continuous cardiac monitoring during no less than 48hours. RESULTS: Of a total of 332 patients admitted, significant cardiac arrhythmias occurred in 98 patients (29.5%) during their stay in the stroke unit. Tachyarrhythmia (ventricular tachyarrhythmias, supraventricular tachyarrhythmias, complex ventricular ectopy) was present in 90 patients (27.1%); bradyarrhythmia was present in 13 patients (3.91%). Arrhythmias were independently associated with larger size of brain lesion and older age. In 10% of the patient total, therapeutic actions were taken after detection of significant cardiac arrhythmias. Most events occurred within the first 48hours after stroke unit admission. CONCLUSIONS: Systematic cardiac monitoring in patients with acute stroke is useful for detecting clinically relevant cardiac arrhythmias. Incidence of arrhythmia is higher in the first 48hours after stroke unit admission. Age and lesion size were predicted appearance of arrhythmias. Detection of cardiac arrhythmias in a stroke unit has important implications for treatment.

Structural phase transitions and magnetic and spectroscopic properties of the double perovskites Sr2Co1-xMgxTeO6 (x = 0.1, 0.2 and 0.5).

The structural and magnetic properties of a series of ordered double perovskites with the formula Sr(2)Co(1-x)Mg(x)TeO(6) (x = 0.1, 0.2 and 0.5) are investigated by X-ray diffraction, low temperature neutron diffraction, electron paramagnetic resonance and magnetic susceptibility. The progressive substitution of the paramagnetic Co(2+) high spin ion by the diamagnetic Mg(2+), of about the same size, induces changes in the room temperature crystal structure, from a distorted P2(1)/n phase for the undoped Sr(2)CoTeO(6) oxide to the I4/m of the end member (Sr(2)MgTeO(6)). These perovskites experience structural transitions on heating, the temperature at which the transitions occur being smaller as x increases. The novel approach of mode-crystallography is used for the analysis. All oxides show antiferromagnetic exchange interactions between Co(2+) ions but the long range antiferromagnetic order is not achieved for the phase with x = 0.5. The low temperature neutron diffraction data have been evaluated using a full symmetry analysis. Results are consistent with an unquenched orbital contribution of a high spin Co(2+) ion.

Effect of Carbon Coating on the Physicochemical and Electrochemical Properties of Fe2O3 Nanoparticles for Anode Application in High Performance Lithium Ion Batteries.

Nanoparticulate Fe2O3 and Fe2O3/C composites with different carbon proportions have been prepared for anode application in lithium ion batteries (LIBs). Morphological studies revealed that particles of Fe2O3 in the composites were well-dispersed in the matrix of amorphous carbon. The properties of the γ-Fe2O3 nanoparticles and the correlation with the particle size and connectivity were studied by electron paramagnetic resonance, magnetic, and Mössbauer measurements. The electrochemical study revealed that composites with carbon have promising electrochemical performances. These samples yielded specific discharge capacities of 1200 mAh/g after operating for 100 cycles at 1C. These excellent results could be explained by the homogeneity of particle size and structure as well as the uniform distribution of γ-Fe2O3 nanoparticles in the in situ generated amorphous carbon matrix.

Functionalized Fe3O4@Au superparamagnetic nanoparticles: in vitro bioactivity.

The interaction of nanoparticles with cells has been a focus of interest during the past decade. We report the fabrication and characterization of hydrosoluble Fe3O4@Au nanoparticles functionalized with biocompatible and fluorescent molecules and their interaction with cell cultures by visualizing them with confocal microscopy. Gold covered iron oxide nanoparticles were synthesized by reducing metal salts in the presence of oleylamine and oleic acid. The functionalization of these particles with an amphiphilic polymer provides a water soluble corona as well as the possibility to incorporate different molecules relevant for bio-applications such as poly(ethylene glycol), glucose or a cadaverine derived dye. The particle size, and the presence of polymer layers and conjugated molecules were characterized and confirmed by transmission electron microscopy, thermogravimetric measurements and infrared spectroscopy. A complete magnetic study was performed, showing that gold provides an optimum coating, which enhances the superparamagnetic behaviour observed above 10-15 K in this kind of nanoparticle. The interaction with cells and the cytotoxicity of the Fe3O4@Au preparations were determined upon incubation with the HeLa cell line. These nanoparticles showed no cytotoxicity when evaluated by the MTT assay and it was demonstrated that nanoparticles clearly interacted with the cells, showing a higher level of accumulation in the cells for glucose conjugated nanoparticles.

Supercritical hydrothermal synthesis, thermal, spectroscopic and magnetic studies of two new polymorphs of Mn(SeO3).

Two new manganese(II) selenite polymorphs with formula Mn(SeO3) have been synthesised using supercritical hydrothermal conditions. The crystal structure of both compounds (1) and (2) has been solved from single-crystal X-ray diffraction data. The structures consist of a three-dimensional framework formed by MnO6 octahedra and (SeO3)2- selenite anions with trigonal pyramidal geometry. Compound (1) shows chains of elongated, corner-sharing MnO6 octahedra. These chains are linked alternately by Mn2O10 dimers of edge-sharing octahedra. Conversely, compound (2) exhibits MnO6 octahedra sharing edges with three further octahedra, giving rise to a complex three-dimensional framework. The IR spectra show the characteristic bands of the selenite anion. Studies of luminescence and diffuse reflectance spectroscopy, performed at 6 K and at room temperature, respectively, have been carried out for both compounds. The Dq and Racah parameters are Dq= 830, B= 500 and C= 3790 cm(-1) for (1) and Dq= 795, B= 520 and C= 3785 cm(-1) for (2). The EPR spectra of both compounds are isotropic with a g-value of 1.99(1), which remains unchanged with variation in temperature. Magnetic measurements indicate the presence of antiferromagnetic couplings as the major interactions in both phases, but with compound (2) exhibiting at low temperature a canting of antiferromagnetically aligned spins. The estimated J-exchange parameters are J/k=-2.2 and -1.93 for (1) and (2), respectively, with J'= -0.87 and -0.55 K.

Analysis of genetic heterogeneity of hepatitis C viruses in Central America reveals a novel genetic lineage. Brief report.

Hepatitis C virus (HCV) has high genomic variability and at least six different types have been reported. The genotypes distribution is currently unknown among HCV strains circulating in Central America. In order to study the degree of genetic variability of strains isolated in Costa Rica, sequence data obtained from the 5' non coding region from 7 patients from Costa Rica were compared with published sequences from 57 strains of all types. The phylogenetic analysis revealed the existence of type 1 strains of a novel genetic lineage, recently described for some South American countries, and indicates an increasing diversification of HCV.

Weak M(II)-azide-4,4'-bipy ferromagnets based on unusual diamondoid (M = Mn) and 2D arrays (M = Co, Ni).

Four compounds of general formula [M(4,4'bipy)(N(3))2](n) (M = Mn (1), Zn (2), Co (3), Ni (4)) have been synthesized and magnetostructurally characterized by means of X-ray diffraction analysis, IR and ESR spectroscopies, and measurements of the magnetic susceptibility and magnetization. Compound 1 (C(10)H(8)N(8)Mn) crystallizes in the tetragonal P4(3)2(1)2 space group, Z = 4, with a = 8.229(2), b = 8.229(2), and c = 16.915(2) A. It exhibits an acentric 3D structure where Mn(II) ions are linked through EE-azide groups resulting in a diamondoid network. The 4,4'bipy ligands are coordinated on the axial positions of the octahedral spheres reinforcing the intermetallic connections. Weak ferromagnetism arising from spin canting is observed for compound 1. Compounds 2, 3, and 4 are proposed to be isomorphous and would consist of a 2D array where alternating EO + EE/EO + EE/EO + EO azide-chains are linked by 4,4'bipy ligands resulting in pi-pi stacked pyridyl-columns. The azido ligand dispositions in compounds 3 and 4 make possible systems of type -AF-AF-F-, which would give rise to a topological ferromagnetic behavior.

Dicubane-like tetrameric cobalt(II)-pseudohalide ferromagnetic clusters.

Three tetrameric cobalt(II)-pseudohalide complexes have been structurally and magnetically characterized. Compounds 1 and 2 are isomorphous and exhibit the general formula [Co2(dpk-OH)(dpk-CH3O)(L)(H2O)]2A2-4H2O where dpk = di-2-pyridyl ketone, L = N3(-) and A = BF4(-) for 1, and L = NCO(-) and A = ClO4(-) for 2. The ligands dpk-OH(-) and dpk-CH3O(-) result from solvolysis and ulterior deprotonation of dpk in water and methanol, respectively. Both compounds exhibit cationic tetramers consisting of a dicubane-like core with two missing vertexes where the Co(II) ions are connected through end-on pseudohalide and oxo-bridges. A similar tetranuclear core has been found for 3 whose formula is [Co2(dpk-OH)(dpk-CH3O)(NCO)2]2. In this case, the tetramers are neutral and exhibit a terminal cyanate in place of the coordinated molecule of water for 1 and 2. The tetrameric units for 2 and 3 represent the first examples of any kind of cubanes exhibiting cyanate bridges as well as the first Co(II) compounds exhibiting intermetallic bridges through these pseudohalide groups. Measurements of the magnetic susceptibility indicated the presence of ferromagnetic Co(II)-Co(II) interactions in the three compounds.

Structural analysis and magnetic properties of the 1D and 3D compounds [Mn(dca)2nbipym] (M = Mn, Cu; dca = dicyanamide; bipym = bipyrimidine; n = 1,2).

Compounds [Mn(dca)2bipym] (1), [Cu2(dca)4bipym] (2), and [Mn2(dca)4bipym] (3) have been synthesized and structural (2, 3) and magnetically characterized. Compound 1 is isomorphous with [Mn(dca)2bipy]. Compound 2 crystallizes in the monoclinic P2(1)/c space group, Z = 4, with a = 7.5609(9), b = 11.477(42), and c = 11.792(2) A and beta = 106.565(6) degrees. Compound 3 crystallizes in the monoclinic system, space group P2(1)/n, with a = 7.396(3) A, b = 11.498(7) A, and c = 12.349(9) A and beta = 106.61(5) degrees. While compound 1 is one-dimensional, with the manganese(II) ions bridged by double mu1,5-dicyanamide ligands, the structural arrangement in compounds 2 and 3 is three-dimensional based on ladder-like moieties. These units, whose steps are bipym groups, extend through mu1,5-dca bridges and are connected to another four on the plane perpendicular to the extension of the ladders to form the 3D arrangement. Magnetic susceptibility measurements show antiferromagnetic couplings in all cases, increasing for 1, 3, and 2, respectively.

Hydrothermal synthesis and structural characterization of the (C(n)H(2n+6)N(2)[Mn(3)(HPO(3))4] (n = 3-8) new layered inorganic-organic hybrid manganese(II) phosphites. Crystal structure and spectroscopic and magnetic properties of (C(3)H(12)N(2)[Mn(3)(HPO(3))4].

The (C(n)H(2n+6)N(2))[Mn(3)(HPO(3))(4)] (n = 3-8) compounds have been prepared by hydrothermal synthesis and characterized by X-ray diffraction data and spectroscopic techniques. The crystal structure of (C(3)H(12)N(2))[Mn(3)(HPO(3))(4)] has been solved from single-crystal X-ray diffraction. The unit-cell parameters are a = 9.502(1), b = 5.472(1), c = 14.523(4) A, beta = 95.01(3) degrees, monoclinic, C2/m, with Z = 2. The compound shows a layered structure stacked along the c-axis with the alkyldiammonium cations placed in the interlayer space. The sheets are formed by Mn(3)O(12) trimer units extended in the ab-plane and connected by (HPO(3))(2-) anions. The study of the (C(n)H(2n+6)N(2))[Mn(3)(HPO(3))(4)] (n = 4-8) phases by X-ray powder diffraction indicates an isotype relation with the propanediammonium compound. The Dq and Racah parameters calculated for (C(3)H(12)N(2))[Mn(3)(HPO(3))(4)] are Dq = 880, B = 660 and C = 3610 cm(-1). The ESR spectra show isotropic signals with a g-value of 2.008. Magnetic measurements indicate the presence of antiferromagnetic interactions inside the [Mn(3)(HPO(3))(4)](2-) sheets. The J/K value has been estimated to be -15 K by considering that the system behaves like an isolated trimer at high temperatures.

Fiebre de origen desconocido: aproximación al plan diagnóstico / Fever of unknown origin: approach to the plan I diagnose

Con el propósito de identificar cuál es el plan diagnóstico para Fiebre de Origen Desconocido (FOD), se presenta el caso de un paciente con Síndroem Mielodisplásico como causa del FOD. Se revisa series de diferentes hospitales, encontrándose que las causas principales son las infecciones, neoplasias y colagenopatías. Se observa que las publicaciones sobre FOD abordan el diagnóstico de una manera genérica y difusa. Aquí por el contrario se enfatiza en que la hipótesis diagnóstica debe guiar la solicitud de pruebas para tal efecto en cada hospital debería identificarse la frecuencia de este transtorno. Este dato epidemiológico junto al conocimiento de la fisiopatología de la fiebre y con los datos positivos del paciente pueden permitir configurar diagnósticos correctos para FOD.