Clinical and sociodemographic profile of epilepsy in adults from a reference centre in Colombia. / Perfil clínico y sociodemográfico de la epilepsia en adultos de un centro de referencia de Colombia.

OBJECTIVES: To describe the sociodemographic and clinical characteristics of a cohort of patients with epilepsy from a reference centre in Colombia. METHODS: Cross-sectional study including patients diagnosed with epilepsy who attended our epilepsy centre (Neurocentro) between 2013 and 2016. Data were gathered from patients' medical histories. RESULTS: We gathered data from a total of 354 patients diagnosed with epilepsy. Median age was 37 years; 52% were men. Seizures were focal in 57% of the patients and generalised in 38%; seizure type was not determined in 6% of the sample. The most frequent aetiology was cryptogenic (21%), followed by traumatic (14%). Median time of disease progression and age at onset were 23 and 11 years, respectively. Psychiatric comorbidities were found in 18% of the patients and 40% had some degree of cognitive impairment. Around 40% of our sample reported adverse reactions to antiepileptic drugs at some point during treatment. Antiepileptic drugs were administered in monotherapy in 36% of the patients. Around 37% had drug-resistant epilepsy and 14% underwent surgery. CONCLUSIONS: Psychiatric comorbidities, cognitive impairment, adverse drug reactions, and drug-resistant epilepsy are common among epileptic patients in Colombia. Knowledge of the factors with an impact on epilepsy may lay the foundations for improving management of these patients on the administrative level and improving quality of life.

Endothelin 1, its endothelin type A receptor, connective tissue growth factor, platelet-derived growth factor, and adrenomedullin expression in lungs of pulmonary hypertensive and nonhypertensive chickens.

Twenty-four 1-d-old broilers were distributed in 2 groups, pulmonary hypertensive broilers (PHB) and pulmonary nonhypertensive broilers (NPHB), to estimate possible differences between them in the expression of endothelin 1 (ET-1) and its type A receptor, connective tissue growth factor, platelet-derived growth factor, and adrenomedullin expression in the lungs. For this purpose, total RNA extraction and real-time PCR analysis were used. Endothelin 1 mRNA levels in the lungs of PHB were significantly higher than the corresponding level in NPHB (P < 0.001). In contrast, the opposite was true for ET-1 type A receptor mRNA levels (P < 0.001). Connective tissue growth factor mRNA levels in the lungs of PHB were significantly higher than in the lungs of NPHB (P < 0.01). However, no differences were encountered between the 2 groups of broilers in platelet-derived growth factor mRNA expression (P > 0.05). Adrenomedullin mRNA levels in the lungs of PHB were significantly higher than in NPHB (P < 0.01). It has been demonstrated for the first time that ET-1, connective tissue growth factor, and adrenomedullin are upregulated in the lungs of PHB. Furthermore, it is suggested that these peptides may play a major role in pulmonary hypertension pathophysiology. Present data might provide clues for future research directions such as genetic selection and therapeutic intervention to revert the process of pulmonary vasoconstriction and vascular remodeling. Major research goals could be to find endothelium-derived factors that probably trigger endothelial dysfunction, as well as possible interactions with already identified molecules which also intervene in the pulmonary response to hypoxia.

[Hemiballism: report of eight cases]. / Hemibalismo: relato de oito casos.

We report eight cases of hemiballism. Six patients had diabetes mellitus, one patient presented with porencephaly after cranial trauma and one patient had a HIV-associated fungic granuloma (cryptococcus). In the diabetic group three patients had non-ketotic hyperglycemia; two of them with striatal hemorrhage, and the remaining three presented with an ischemic stroke. Hemichorea occurred in 75% of our patients, predominantly in the right side of the body. Six patients had good improvement with treatment with haloperidol and two patients had to undergo a thalamotomy, one of them with good results. In our series of eight patients with hemiballismus we observed an association with diabetes mellitus and stroke, and good clinical improvement.

[Dupuytren's and Ledderhose's diseases associated with chronic use of anticonvulsants. Case report]. / Doenças de Dupuytren e de Ledderhose associadas ao uso crônico de anticonvulsivantes. Relato de caso.

We present the case of a patient that after chronic use of anticonvulsant drugs without proven epilepsy, developed Dupuytren's and Ledderhose's diseases. We discuss the most frequent predisposing factors, and their relationship with chronic use of anticonvulsants, particularly phenobarbitone.

[Stroke in young adults: analysis of 164 patients]. / Acidente vascular cerebral em pacientes jovens: análise de 164 casos.

We retrospectively analyzed the epidemiological features of 164 out-clinic patients with a first-onset stroke between 15 and 49 years old. Ischemic stroke occurred in 141 patients, hemorrhagic stroke in 16 patients, and venous thrombosis in 7 patients. Forty-eight percent of ischemic strokes were atherothrombotic, but no etiology was found in 32% of patients with ischemic stroke. Systemic arterial hypertension was the most frequent etiology in the hemorrhagic stroke group. The most frequent risk factors were systemic arterial hypertension, smoking, hypercholesterolemia, alcoholism and diabetes mellitus. Although stroke in young adults deserves some specific etiological investigation, we found that ordinary risk factors such as hypertension, tobacco use, hypercholesteremia and diabetes were prevalent in our population. It seems that prevention campaigns should be the target of our work.

Neuro-Behçet: report of three clinically distinct cases.

We report three patients who collectively have very representative clinical forms of neuro-Behçet and different neurological findings. The first case, male, 49 years old, presents symptoms similar to multiple sclerosis. The second case, male 15 years old, presents with parenchymatous compromise and an association with antiphospholipid antibody. And the third case, female 25 years old, presents an acute meningitis. Neuro-Behçet must always be included as a differential diagnosis of neurological disorders that have any difficulties in establishing a definite diagnosis.