The effects of a single session of upper alpha neurofeedback for cognitive enhancement: a sham-controlled study.

The minimization of the non-specific factors of neurofeedback (NF) is an important aspect to further advance in the understanding of the effects of these types of procedures. This paper investigates the NF effects of a single session (25 min) of individual upper alpha enhancement following a sham-controlled experimental design (19 healthy participants). We measured immediate effects after the training and 1-day lasting EEG effects (eyes closed resting state and task-related activity), as well as the event-locked EEG effects during the execution of a mental rotation task. These metrics were computed in trained (upper alpha) and non-trained EEG parameters (lower alpha and lower beta). Several cognitive functions were assessed such as working memory and mental rotation abilities. The NF group showed increased upper alpha power after training in task-related activity (not significantly sustained 1 day after) and higher pre-stimulus power during the mental rotation task. Both groups improved cognitive performance, with a more prominent improvement for the NF group, however a single session seems to be insufficient to yield significant differences between groups. A higher number of training sessions seems necessary to achieve long-lasting effects on the electrophysiology and to enhance the behavioral effects.

The effects of individual upper alpha neurofeedback in ADHD: an open-label pilot study.

Standardized neurofeedback (NF) protocols have been extensively evaluated in attention-deficit/hyperactivity disorder (ADHD). However, such protocols do not account for the large EEG heterogeneity in ADHD. Thus, individualized approaches have been suggested to improve the clinical outcome. In this direction, an open-label pilot study was designed to evaluate a NF protocol of relative upper alpha power enhancement in fronto-central sites. Upper alpha band was individually determined using the alpha peak frequency as an anchor point. 20 ADHD children underwent 18 training sessions. Clinical and neurophysiological variables were measured pre- and post-training. EEG was recorded pre- and post-training, and pre- and post-training trials within each session, in both eyes closed resting state and eyes open task-related activity. A power EEG analysis assessed long-term and within-session effects, in the trained parameter and in all the sensors in the (1-30) Hz spectral range. Learning curves over sessions were assessed as well. Parents rated a clinical improvement in children regarding inattention and hyperactivity/impulsivity. Neurophysiological tests showed an improvement in working memory, concentration and impulsivity (decreased number of commission errors in a continuous performance test). Relative and absolute upper alpha power showed long-term enhancement in task-related activity, and a positive learning curve over sessions. The analysis of within-session effects showed a power decrease ("rebound" effect) in task-related activity, with no significant effects during training trials. We conclude that the enhancement of the individual upper alpha power is effective in improving several measures of clinical outcome and cognitive performance in ADHD. This is the first NF study evaluating such a protocol in ADHD. A controlled evaluation seems warranted due to the positive results obtained in the current study.

EEG-based upper-alpha neurofeedback for cognitive enhancement in major depressive disorder: a preliminary, uncontrolled study.

Conditioning of the upper-alpha rhythm to improve cognitive performance in healthy users by means of neurofeedback (NF) has been evaluated by several studies, however its effectiveness in people with severe cognitive deficits, such as depressive subjects, remains underexplored. This paper reports on a preliminary uncontrolled study to assess the effects of an upper-alpha NF intervention on patients with major depressive disorder (MDD). The NF effects on the EEG and cognitive performance were assessed. The EEG results showed that patients were able to modulate the upper-alpha rhythm in task-related EEG and during training, in both cases across the executions of the NF sessions, and pre and post within each session. The behavioral results showed the effectiveness of this intervention in a variety of cognitive functions such as working memory, attention, and executive functions.

Double-blind single-session neurofeedback training in upper-alpha for cognitive enhancement of healthy subjects.

This paper reports on a single-session neurofeedback (NF) training procedure on the user-specific upper alpha band for cognitive enhancement in healthy users. A double-blind study was designed using a NF group and an active control group. Control group performed as the NF group but received sham feedback, minimizing the non-specific factors of training. This design aimed to (i) investigate upper alpha as a NF parameter, (ii) evaluate the NF effects on upper alpha during the execution of a cognitive task, and (iii) evaluate the effects on cognitive performance by means of a cognitive task and a battery of psychological tests. Results of EEG analysis show the key role of the feedback: only the NF group enhanced upper alpha during the training, and it led to a desynchronization increase during the execution of the cognitive task. Regarding the behavioral results, a strong learning effect was observed, with the NF group performing better in almost all measurements but many of them without statistical significance.

Cryoglobulinemic glomerulonephritis in chronic hepatitis B infection.

Hepatitis B virus (HBV) infection is an uncommon cause of cryoglobulinemia. Renal cryoglobulinemia has been rarely reported in the setting of chronic hepatitis B infection. We describe a case of chronic hepatitis B infection with cryoglobulinemic glomerulonephritis (Gn) and provide information about the treatment and the evolution over a 30-month follow-up. A 41-year-old woman with chronic hepatitis B infection developed nephrotic syndrome and acute renal failure; other investigations revealed type 2 cryoglobulinemia; HBV DNA was detected in the cryoprecipitate. Renal biopsy showed findings of cryoglobulinemic Gn. She was given lamivudine, corticosteroids, plasma exchange, and mycophenolate mofetil. The renal function improved, nephrotic syndrome remitted, and HBV DNA became undetectable; there was no compromise of the liver function.

Postinfectious diffuse proliferative glomerulonephritis and acute renal failure in an HIV patient.

Postinfectious proliferative glomerulonephritis may occur in HIV-infected patients, although it is not a common cause of severe acute renal failure in them. We report a woman with HIV infection, who developed hypocomplementemic acute nephritic syndrome 10 days after an upper respiratory infection. Systemic diseases were excluded. The serum creatinine level increased to 6.6 mg/dl. Renal biopsy showed diffuse endocapillary proliferative glomerulonephritis, with mesangial and capillary walls, granular deposits of IgG and C3 by immunofluorescence. She was given corticosteroids with progressive normalization of her renal function. No opportunistic infections have occurred during 1-year follow-up.

A useful experimental model of short bowel syndrome.

The short bowel syndrome is a well-known human clinical entity that produces serious metabolic disorders. This syndrome arises after a massive resection of more than 50% of the small intestine, when the intestine attempts to minimize the consequent irregularities by means of compensatory mechanisms. Many reports suggest that an exocrine and endocrine pancreatic dysfunction is associated with enterohormones and an abnormal altered nutrient flow. In this report, we present an experimental model of short bowel syndrome in rats. A massive intestine resection was performed in rats, followed by a histological study of the small intestine. We report the histological changes related to the compensatory changes that occurred in the remaining intestine. The residual intestine produces a hyperplasic response, and hypertrophy was seen in the portion proximal to the anastomosis. We believe this experimental model of short bowel syndrome could be a very useful tool for studying the enterohormonal changes related to an abnormal blood flow of nutrients.

A Useful Experimental Model of Short Bowel Syndrome.

The short bowel syndrome is a well-known human clinical entity that produces serious metabolic disorders. This syndrome arises after a massive resection of more than 50% of the small intestine, when the intestine attempts to minimize the consequent irregularities by means of compensatory mechanisms. Many reports suggest that an exocrine and endocrine pancreatic dysfunction is associated with enterohormones and an abnormal altered nutrient flow. In this report, we present an experimental model of short bowel syndrome in rats. A massive intestine resection was performed in rats, followed by a histological study of the small intestine. We report the histological changes related to the compensatory changes that occurred in the remaining intestine. The residual intestine produces a hyperplasic response, and hypertrophy was seen in the portion proximal to the anastomosis. We believe this experimental model of short bowel syndrome could be a very useful tool for studying the enterohormonal changes related to an abnormal blood flow of nutrients.

A Useful Experimental Model of Short Bowel Syndrome.

The short bowel syndrome is a well-known human clinical entity that produces serious metabolic disorders. This syndrome arises after a massive resection of more than 50% of the small intestine, when the intestine attempts to minimize the consequent irregularities by means of compensatory mechanisms. Many reports suggest that an exocrine and endocrine pancreatic dysfunction is associated with enterohormones and an abnormal altered nutrient flow. In this report, we present an experimental model of short bowel syndrome in rats. A massive intestine resection was performed in rats, followed by a histological study of the small intestine. We report the histological changes related to the compensatory changes that occurred in the remaining intestine. The residual intestine produces a hyperplasic response, and hypertrophy was seen in the portion proximal to the anastomosis. We believe this experimental model of short bowel syndrome could be a very useful tool for studying the enterohormonal changes related to an abnormal blood flow of nutrients.

Aportaciones del Alumnado al estado actual de la calidad de la docencia en Anatomía / Student's contribution to the current situation of the teaching quality evaluation in anatomy

Con el presente trabajo nos hemos planteado el desarrollo de un sistema de recogida de información acerca de las expectativas y valencias en la docencia universitaria en los alumnos. Para ello hemos diseñado una encuesta específica donde se analizan los aspectos concretos que intervienen en el aprendizaje de la Anatomía, así como el valor subjetivo que el Alumno aporta a los mismos. De los resultados obtenidos hemos extraído el concepto de "Calidad referida" que es aquella que perciben los Alumnos. Los factores que los Alumnos piensan que dan Calidad a la enseñanza, como receptores finales del sistema, difieren de los aspectos contextuales que las actuales encuestas estudian. Consideramos que las opiniones del Alumnado no quedan suficientemente expuestas en la redacción actual de las encuestas, a pesar de que suponen un poderoso elemento de retroalimentación en la mejora de la calidad. Sobre la base de nuestro criterio de "Calidad referida" los Alumnos definen más claramente los aspectos relevantes que afectan al aprendizaje. Para ello pensamos que las encuestas deben ser específicas bajo las peculiaridades de cada área de conocimiento. Los resultados de dichas encuestas probablemente serían más útiles para los Docentes, a los que aportaría un conocimiento cierto de las expectativas del Alumnado (AU)

Ontogenic attendance of neuropeptides in the embryo chicken retina.

We have examined the ontogeny of somatostatin-, Glucagon-, Vasoactive Intestinal Polypeptide-, Substance P-, Neuropeptide Y, and Calcitonin gene-related peptide-Iike structures in the chicken retina by immunocytochemistry. Neuroblastic cells containing Substance P-Iike immunoreactivity (IR) first appeared at embryonic day 5 in the peripheral portion of the retina. Somatostatin-like immunoreactivity was detected as early as embryonic day 11 in the innermost level of the inner neuroblastic layer. The distribution pattern of amacrine cells containing Vasoactive Intestinal Peptide-Iike immunoreactivity was similar to that for Neuropeptide Y- and Calcitonin gene-related peptide-Iike immunoreactive cells. These three types of IR cell appeared at embryonic day 13. Glucagon-like immunoreactive cells first appeared in the retina at embryonic day 15, in the innermost part of the inner nuclear layer. From the 13th to 15th day of incubation, the number and intensity of Calcitonin gene-related peptide-, Somatostatin-, Neuropeptide Y- and Substance P-Iike immunoreactive cells increased and then decreased progressively before hatching. Glucagon immunoreactive cells increased in number on the last day before hatching. After embryonic day 15, the amacrine cells containing Vasoactive intestinal peptide-Iike immunoreactivity decreased notably in number. Our study showed that development of these immunoreactive structures was different for each neuropeptide. These differences in development may reflect the diverse neurophysiological roles of these neuroactive peptides, which could act as neurotransmitters/neuromodulators at the chick retinal level. Their presence may indicate roles as neuronal differentiation or growth factors.

[Influenza vaccination of human immunodeficiency virus-infected patients with severe immunodepression. Impact on CD4 lymphocytes and plasma viral load]. / Vacuna antigripal en pacientes infectados por el virus de la inmunodeficiencia humana con inmunodepresión grave. Efecto sobre los linfocitos CD4 y sobre la carga viral plasmática.

BACKGROUND: The aim of this study was to assess the effect of influenza vaccination on plasma HIV viral load and CD4 T-lymphocytes in patients with advanced HIV disease. PATIENTS AND METHOD: Observational study carried out in HIV-infected patients with a CD4 cell count < 200 X 10(6)on highly active antiretroviral therapy(HAART). Influenza vaccine was voluntarily offered and plasma viral load and CD4 cell counts were measured at baseline, 4 weeks and 12 weeks in vaccinated and control subjects. RESULTS: Sixteen patients were analysed, 10 of them being immunized with the influenza vaccine. A significant decline in CD4 cell counts at 4 and 12 weeks and an increasing trend of viral load were seen in all immunized patients who had a high viral load at the time of vaccination (n = 6), but not in those with an undetectable viral load. The mean decrease of CD4 T-lymphocytes in these 6 patients was 49.8%. Three patients showed a huge drop of the CD4 cell count (over 60% of baseline). CONCLUSIONS: Influenza vaccination of severely immunocompromised HIV-infected patients who are failing to HAART might be associated with an immunological impairment.

[Genotypic resistance to antiretroviral drugs in patients with therapeutic failure to highly active antiretroviral therapy]. / Resistencias genotípicas a los fármacos antirretrovirales en fracasos terapéuticos con pautas de alta eficacia.

BACKGROUND: To assess genotypic resistance mutations in patients with virological failure with highly active antiretroviral therapy (HAART) METHODS: Genotyping of reverse transcriptase (RT) and protease (PRO) HIV-1 genes were carried out in 33 adherent patients failing on HAART. RESULTS: Resistance mutations were found in 32 of the 33; 27 of them (81.8%) being primary mutations: 26 (78.8%) in the RT gene and 60 (60.6%) in the PRO gene. Overall, 66.6% had genotypic resistance to two drugs and 60.6% showed resistance to drugs belonging to the two main classes of antiretroviral drugs. At the time of treatment failure, 72.7% had on their therapeutic regimen one antiretroviral drug to which they had resistance mutations, 48.5% had genotypic resistance to two drugs of the therapeutic regimen and 21.2% to three drugs. CONCLUSIONS: Most adherent patients failing on HAART carry drug resistant genotypes. These patients may constitute a reservoir of multidrug resistant HIV that may limit treatment options in the future.

Corynebacterium pseudodiphtheriticum: an easily missed respiratory pathogen in HIV-infected patients.

Despite being a well-known respiratory pathogen for immunocompromised patients, Corynebacterium pseudodiphtheriticum has uncommonly been reported to occur in persons with infection attributable to HIV virus. We report three cases of respiratory tract infection attributable to C. pseudodiphtheriticum in HIV-infected patients and review the four previous cases from the medical literature. All of them were male with a median CD4 lymphocyte count of 110 cells/mm3 (range, 18-198/mm3); five of the seven cases occurred in persons for whom AIDS was diagnosed previously. The onset of symptomatology was usually acute and the most common radiographic appearance was alveolar infiltrate (six patients) with cavitation (two patients) and pleural effusion (two patients). In five of the seven cases, C. pseudodiphtheriticum was isolated from bronchoscopic samples and in the remaining two cases was recovered from lung biopsy (one patient) and sputum (one patient). In the three patients reported herein and in one previous case from the medical literature, quantitative culturing of bronchoscopic samples obtained through either bronchoalveolar lavage or protected brush catheter procedures yielded more than 10(3) CFU/mL. All the strains tested were susceptible to penicillin and vancomycin. Resistance to macrolides was common. Recovery was observed in six of the seven patients. C. pseudodiphtheriticum should be regarded as a potential respiratory pathogen in HIV-infected patients. This infection presents late in the course of HIV disease and it seems to respond well to appropriate antibiotic treatment in most of the cases. This easily overlooked pathogen should be added to the list of organisms implicated in respiratory tract infections in this population.

The neural marker neuron-specific enolase in the development of embryo chicken retina: a morphological description.

The localisation and distribution of Neuron-specific enolase is reported in the avian Gallus domesticus retinal development by using immunocytochemistry. Neuron specific enolase was found to be present from the early days of incubation to the post-hatch period. The results obtained using this neural marker showed the development pattern of the distribution and the sequence of differentiation of the retinal neural structures. Like the finding of the members of the phylogenetic scale, this enzyme should prove to be a useful tool in the neural development of the chicken retina.

[Symptomatic hemobilia following hepatic biopsy. Value of ultrasonography in the diagnosis and control of this complication]. / Hemobilia sintomática tras biopsia hepática. Valor de la ecografía en el diagnóstico y control de esta complicación.

Hemobilia is the term which describes the presence of blood in the biliary tract. We describe a case of symptomatic hemobilia after percutaneous liver biopsy which resolved spontaneously. We review the physiopathology of this complication and we highlight the role of abdominal ultrasonography not only in the diagnosis but also in the follow-up of hemobilia. In our case, abdominal ultrasonography was able to identify the probable point of bleeding.