Assessment of Hippocampal-Related Behavioral Changes in Adolescent Rats of both Sexes Following Voluntary Intermittent Ethanol Intake and Noise Exposure: A Putative Underlying Mechanism and Implementation of a Non-pharmacological Preventive Strategy.

Ethanol (EtOH) intake and noise exposure are particularly concerning among human adolescents because the potential to harm brain. Unfortunately, putative underlying mechanisms remain to be elucidated. Moreover, implementing non-pharmacological strategies, such as enriched environments (EE), would be pertinent in the field of neuroprotection. This study aims to explore possible underlying triggering mechanism of hippocampus-dependent behaviors in adolescent animals of both sexes following ethanol intake, noise exposure, or a combination of both, as well as the impact of EE. Adolescent Wistar rats of both sexes were subjected to an intermittent voluntary EtOH intake paradigm for one week. A subgroup of animals was exposed to white noise for two hours after the last session of EtOH intake. Some animals of both groups were housed in EE cages. Hippocampal-dependent behavioral assessment and hippocampal oxidative state evaluation were performed. Results show that different hippocampal-dependent behavioral alterations might be induced in animals of both sexes after EtOH intake and sequential noise exposure, that in some cases are sex-specific. Moreover, hippocampal oxidative imbalance seems to be one of the potential underlying mechanisms. Additionally, most behavioral and oxidative alterations were prevented by EE. These findings suggest that two frequently found environmental agents may impact behavior and oxidative pathways in both sexes in an animal model. In addition, EE resulted a partially effective neuroprotective strategy. Therefore, it could be suggested that the implementation of a non-pharmacological approach might also potentially provide neuroprotective advantages against other challenges. Finally, considering its potential for translational human benefit might be worth.

Dentate gyrus expression of nestin-immunoreactivity in patients with drug-resistant temporal lobe epilepsy and hippocampal sclerosis.

PURPOSE: Granule cells pathology in dentate gyrus, have received considerable attention in terms of understanding the pathophysiology of temporal lobe epilepsy with hippocampal sclerosis. The aim of this study was to determine the nestin (an intermediate filament protein expressed by newly formed cells), immunoreactivity (IR) in granular cells layers of hippocampal tissue extirpated during epilepsy surgical procedure, in patients with drug-resistant epilepsy. METHODS: Hippocampal sections of 16 patients with hippocampal sclerosis and drug-resistant temporal lobe epilepsy were processed using immunoperoxidase with antibody to nestin. Archival material from 8 normal post-mortem hippocampus, were simultaneously processed. Reactive area for nestin-IR, the total number of positive nestin cells per field (20×), and the MGV (mean gray value) was determined by computerized image analysis (ImageJ), and compared between groups. Student's t test was used for statistical analysis. RESULTS: Nestin-IR cells were found in granule cells layers of both controls and patients. Larger reactive somas (p < 0.01) were found in epileptic's sections but a significant reduction in the total number of nestin-IR cells per field and in the MGV was found in granular cells layers of patients with hippocampal sclerosis (p < 0.01). CONCLUSION: Reduced expression of nestin-IR in granular cells layers of epileptic's dentate gyrus may reflect changes in dentate gyrus neuroplasticity associated to chronic temporal epilepsy with hippocampal sclerosis. Further studies are required to determine the clinical implications on memory an emotional alterations such as depression.

Trastornos psiquiátricos y calidad de vida en crisis no epilépticas de origen psicógeno y epilepsia refractaria / Psychiatric disorders and quality of life in psychogenic non epileptic seizures and resistant epilepsy

INTRODUCCIÓN Actualmente dos tipos de crisis semiológicamente similares, pero etiológicamente diferentes, plantean en la clínica la realización de un diagnóstico diferencial: por un lado, las crisis epilépticas (CE); por el otro, las crisis no epilépticas de origen psicógeno (CNEP). Tanto la epilepsia refractaria (ER) como las CNEP presentan una alta comorbilidad con trastornos psiquiátricos. OBJETIVOS Determinar los diagnósticos psiquiátricos en ambos grupos de pacientes (ER y CNEP) y comparar la calidad de vida y el funcionamiento global en dichos grupos. MÉTODOS Se realizó una evaluación psiquiátrica semiestructurada y a través de escalas SCID I y II (escala semiestructurada para diagnósticos en eje I y II) para diagnósticos en DSM IV, QlesQ para calidad de vida y escala de Beck para severidad de la depresión. RESULTADOS Se hallaron diferencias significativas en las patologías psiquiátricas en el eje 1 (95% CNEP frente a 65% ER), con mayor frecuencia de depresión, ansiedad y trastorno de estrés postraumático en el grupo CNEP. Los trastornos psicóticos predominaron en el grupo ER. En el eje 2, el trastorno límite fue la diferencia significativa hallada, más frecuente en CNEP (54%). Un 71% de pacientes con CNEP y un 24% con ER consignaron que habían vivido situaciones traumáticas. La calidad de vida y el funcionamiento global fueron peores en el grupo CNEP. DISCUSIÓN Si bien las crisis epilépticas y CNEP se asemejan en su presentación, los perfiles psiquiátricos y antecedentes de ambos cuadros son diferentes. Su conocimiento permitirá acelerar la indicación de VEEG (video-electroencefalograma) ante la sospecha de CNEP para orientar el tratamiento adecuado.

Role of liposomal amphotericin B prophylaxis after liver transplantation compared with fluconazole for high-risk patients. impact on infections and mortality within one year.

BACKGROUND: Fungal infections are still one of the most important issue in liver transplant patients, contributing considerably to both morbidity and mortality. Few studies have been published comparing antifungal protocols for their impact on liver transplant (OLT) patients. The aim of this study was to evaluate the effects of liposomal amphotericin B compared with fluconazole prophylaxis on morbidity and mortality after liver transplantation. METHODS: We evaluated all 44 patients undergoing OLT from January 2006 to January 2009 who were enrolled and randomized to undergo treatment with Amphotericin B (3 mg/kg/d; group A = 25 patients) or fluconazole (800 mg Loading dose and thereafter 400 mg/d according to renal parameters and immunosuppressant trough levels; group B = 18 patients) for at least 7 to 14 days with 12 months follow-up after liver transplantation. A multivariate analysis assessed factors associated with infections and mortality. RESULTS: Neither antifungal prophylaxis was associated with a fungal episode; however, group A patients experienced fewer bacterial infectious episodes (Mann-Whitney U test P < .05). Furthermore, no renal impairment was observed in either groups. Nonetheless, patients undergoing fluconazole prophylaxis showed significant increases in immunosuppressive trough levels requiring dose adjustment. CONCLUSION: We observed comparable results of fluconazole and liposomal amphotericin B to prevent invasive fungal infections throughout 12 months after surgery. The latter drug was associated with fewer bacterial infections after liver transplantation.

Malformations of cortical development and epilepsy in adult patients.

OBJECTIVE: To describe clinical features of epilepsy secondary to Malformation of Cortical Development (MCD) in a series of adult patients. MATERIALS AND METHODS: We searched our database for all cases with confirmed epilepsy and MCD and included in the study only those with complete data. Mean age, sex, age at seizure onset (ASO), seizure types, abnormal neurological exam (ANE), mental retardation, family history, gestational or perinatal insults (G-PI), interictal EEG and response to treatment were analyzed. Cases were classified into the 3 main groups (G) according to the Barkovich classification (BC) and then compared: (G1) "malformations due to abnormal cell proliferation", (G2) "malformations due to abnormal migration" and (G3) "malformations due to abnormal cortical organization". RESULTS: We identified 152 (5.06%) patients with MCD from a total of 3000 with epilepsy. In total, 138 patients with complete medical data were included in this study. The mean age of patients was 36.2 years, 52.2% were female, the mean ASO was 12.3 years, 5.1% of cases had a positive family history and 21% had G-PI. An ANE was observed in 21% and mental retardation in 31.9%. Most of the patients (84.8%) had refractory epilepsy. The distribution of cases according to the BC was: 51.4% in G1, 28.9% in G2 and 19.6% in G3. Comparing the 3 groups, we found that an ANE was statistically more frequent in G3 and was present in 70.4% of cases. CONCLUSION: Our series of adult patients with epilepsy and MCD suggests that MCD are identified as commonly in a developing country as in previous "first world" series. Neurological deficits were more common in the subgroup of patients with polymicrogyria and schizencephaly (BC Group 3).

Light impurity in an equilibrium gas.

We investigate the evolution of a light impurity particle in a Lorentz gas where the background atoms are in thermal equilibrium. As in the standard Lorentz gas, we assume that the particle is negligibly light in comparison with the background atoms. The thermal motion of atoms causes the average particle speed to grow. In the case of the hard-sphere particle-atom interaction, the temporal growth is ballistic, while generally it is sublinear. For the particle-atom potential that diverges as r^{-λ} in the small separation limit, the average particle speed grows as t^{λ/[2(d-1)+λ]} in d dimensions. The particle displacement exhibits a universal growth, linear in time, and the average (thermal) speed of the atoms. Surprisingly, the asymptotic growth is independent of the gas density and the particle-atom interaction. The velocity and position distributions approach universal scaling forms which are non-Gaussian. We determine the velocity distribution in arbitrary dimension and for arbitrary interaction exponent λ. For the hard-sphere particle-atom interaction, we compute the position distribution and the joint velocity-position distribution.

[Analysis of psychotic disorders in patients with refractory partial epilepsy, psychiatric diagnoses and clinical aspects]. / Análisis de los trastornos psicóticos en pacientes con epilepsia parcialrefractaria, diagnóstico psiquiátrico y características clínicas.

INTRODUCTION: The association between psychotic disorders and epilepsy has been controversial. Different subtypes of psychotic disorders in epilepsy patients have been described according to temporal relationship with seizures-postictal (PIP), interictal (IIP) and bimodal (BP) psychoses are described in literature. OBJECTIVES: Determine clinical characteristics of patients with refractory partial epilepsy and psychoses and compare the results with a control group of patients with refractory partial epilepsy without psychoses. METHODS: A total of 57 patients with refractory partial epilepsy and psychotic disorders (psychotic group [PG]) and 56 patients with refractory partial epilepsy and without psychoses (control group, CG) were evaluated according to DSM-IV criteria and SCID-I. All patients underwent complete neurological, neuroimaging, neuropsychological, and psychiatric assessment. Clinical, demographic and neuroimaging data were compared between patients in CG and PG. RESULTS: In PG 15 patients (26 %) had criteria for PIP, 29 patients (51%) for IIP and 13 patients (23%) for BP. Epilepsy time duration and bilateral hippocampal sclerosis were significantly more frequent in patients with psichosis. PG patients had a longer evolution time of epilepsy and greater frequency of bilateral hippocampal sclerosis (p < 0.05). No differences were found between psychoses subtypes. CONCLUSIONS: Longer evolution of seizures and the presence of bilateral hippocampal sclerosis may increase propensity to develop psychoses in patients with refractory partial epilepsy.

Transformation of amyloid-like fibers, formed from an elastin-based biopolymer, into a hydrogel: an X-ray photoelectron spectroscopy and atomic force microscopy study.

Previous studies have revealed the propensity of elastin-based biopolymers to form amyloid-like fibers when dissolved in water. These are of interest when considered as "ancestral units" of elastin in which they represent the simplest sequences in the hydrophobic regions of the general type XxxGlyGlyZzzGly (Xxx, Zzz = Val, Leu). We normally refer to these biopolymers based on elastin or related to elastin units as "elastin-like polypeptides". The requirement of water for the formation of amyloids seems quite interesting and deserves investigation, the water representing the natural transport medium in human cells. As a matter of fact, the "natural" supramolecular organization of elastin is in the form of beaded-string-like filaments and not in the form of amyloids whose "in vivo" deposition is associated with some important human diseases. Our work is directed, therefore, to understanding the mechanism by which such hydrophobic sequences form amyloids and any conditions by which they might regress to a non-amyloid filament. The elastin-like sequence here under investigation is the ValGlyGlyValGly pentapeptide that has been previously analyzed both in its monomer and polymer form. In particular, we have focused our investigation on the apparent stability of amyloids formed from poly(ValGlyGlyValGly), and we have observed these fibers evolving to a hydrogel after prolonged aging in water. We will show how atomic force microscopy can be combined with X-ray photoelectron spectroscopy to gain an insight into the spontaneous organization of an elastin-like polypeptide driven by interfacial interactions. The results are discussed also in light of fractal-like assembly and their implications from a biomedical point of view.

Clinical-electroencephalogram patterns at seizure onset in patients with hippocampal sclerosis.

OBJECTIVE: The purpose of this study is to identify specific clinical-electroencephalogram (EEG) patterns at seizure onset in patients with hippocampal sclerosis (HS). METHODS: Sixty-six ictal video-EEG recordings corresponding to 26 patients with HS have been reviewed, focusing on the EEG features found during the first 30 ictal s. The EEG activity has been classified into the following groups: (A) according to spatial distribution: type 1: temporal electrodes on one side; type 2: temporal and adjacent frontal electrodes on one side; and type 3: non-lateralizing electrographic activity; and (B) according to morphology; subtype (a): regular 5-9 Hz rhythmic activity (RA); subtype (b): low-voltage rapid activity, followed by a 5-9 Hz RA; and subtype (c): irregular EEG sharp waves. We analyzed the clinical symptoms sequence and established the relationship with the ictal EEG patterns. RESULTS: Considering spatial distribution and morphology, the most frequent ictal EEG patterns were type 1 (57%), type 2 (37%), and subtype (a): 62%; subtype (b): 27%; and subtype (c): 11%. The sequence of clinical symptoms observed was: aura-->behavioral arrest-->oro-alimentary automatisms-->unilateral hand automatisms. All seizures with aura and including two or more symptoms of the clinical sequence (65%) were associated with a 1a, 1b, 2a or 2b EEG pattern. CONCLUSIONS: The identification of a specific clinical-EEG pattern provides a useful tool for the epileptogenic zone localization in non-invasive pre-surgical assessment of patients with hippocampal sclerosis. SIGNIFICANCE: The identification of a specific clinical-EEG pattern associated to neuroimaging findings and neuropsychological testing allows indicating surgery for the treatment of epilepsy in patients with hippocampal sclerosis, without performing any further complementary studies.

Integrating medical applications in an open architecture through generic and reusable components.

Allowing exchange of information and cooperation among network-wide distributed and heterogeneous applications is a major need of current health care information systems. It forces the development of open and modular integration architectures. Major issues in the development include defining a flexible and robust federation model, developing interaction and communication facilities as well as the mechanism insuring semantic interoperability. We developed generic and reusable software components to ease the construction of any integration platform. The Pilot and the Mediator Service components facilitate the execution of services and the meaningful transformation of information. They have been tested in the context of the SynEx European project to construct a multi-agents based integration architecture. The possibility of such architectures to take into account the issue of semantic interoperability is further discussed.

[Esquizofreniform psychosis after epilepsy surgery. A case of forced normalization fenomena]. / Psicosis esquizofreniforme tras cirugía de epilepsia. Un caso del fenómeno de normalización forzada.

The present case report is about the development of a eschizophreniform psychosis after epilepsy surgery (anterior temporal lobectomy). This adverse event was the novo, in a patient without a history of previous psychosis. This case have been studied pre and post-surgery, and have been used the DSM IV diagnosis criteria. The patient developed a subacute alucinatory-delusion syndrome, while seizures disappeared. This inverse relationship is an example of alternative psychosis or forced normalization after surgery treatment. This clinic example may us think about the controversial relationship between temporal epilepsy and psychosis.

Psicosis esquizofreniforme tras cirugía de epilepsia. Un caso del fenómeno de normalización forzada / Esquizofreniform psychosis after epilepsy surgey. A case of forced normalization fenomena

El presente trata acerca de un caso de desarrollo de psicosis como complicación de la cirugía de la epilepsia (lobectomía temporal anterior). Se realizaron evaluaciones psiquiátricas, pre y post cirugía, según criterios diagnóstico del DSM IV. La paciente desarrolló un cuadro alucinatoriodelirante de evolución subaguda, en forma simultánea a la curación de sus crisis epilépticas. Esta relación inversa entre ambas patologías constituye un ejemplo de psicosis alternativa o fenómeno de normalización forzada secundario al tratamiento quirúrgico. Este ejemplo clínico nos acerca a la tan controvertida relación existente entre la epilepsia del lóbulo temporal y la psicosis (AU)

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Clinical features and prognosis of nonepileptic seizures in a developing country.

PURPOSE: To determine the predictive value of clinical features and medical history in patients with nonepileptic seizures (NESs). METHODS: One hundred sixty-one consecutive ictal video-EEGs were reviewed, and 17 patients with 41 NESs identified. NES diagnosis was defined as paroxysmal behavioral changes suggestive of epileptic seizures recorded during video-EEC without any electrographic ictal activity. Clinical features, age, sex, coexisting epilepsy, associated psychiatric disorder, social and economic factors, delay in reaching the diagnosis of NES, previous treatment, and correlation with outcome on follow-up were examined. RESULTS: The study population included 70% female patients with a mean age of 33 years. Mean duration of NESs before diagnosis was 9 years. Forty-one percent had coexisting epilepsy. The most frequent NES clinical features were tonic-clonic mimicking movements and fear/anxiety/hyperventilation. The most common psychiatric diagnosis was conversion disorder and dependent and borderline personality disorder. Seventy-three percent of patients with pure NESs received antiepileptic drugs (AEDs), and 63.5% of this group received new AEDs. Fifty-nine percent of the patients received psychological/psychiatric therapy. At follow-up, 23.5% were free of NESs. CONCLUSIONS: All seizure-free patients had two good prognostic factors: having an independent lifestyle and the acceptance of the nonepileptic nature of the episodes. Video-EEG monitoring continues to be the diagnostic method to ensure accurate seizure classification. Establishing adequate health care programs to facilitate access to new technology in public hospitals as well as the implementation of continuous education programs for general practitioners and neurologists could eventually improve the diagnosis and treatment of patients with NESs.

Fractal aspects of elastin supramolecular organization.

The supramolecular organisation of elastin and its soluble derivative alpha-elastin were studied by scanning and transmission electron microscopy. It was found a variety of different structures including filaments, fibrils, fibres, networks and dendritic, leaf-like forms. Self-similar patterns, extending for at least three orders of magnitude, were revealed, strongly suggesting the presence of fractal objects. The fractal dimension D was determined by using the box counting method.

The influence of high blood levels of urea on the presence of Campylobacter pylori in the stomach: a clinical study.

In order to determine whether urea influences the presence of Campylobacter pylori (Cp) in the stomach, the incidence of this infection was determined in patients with chronic renal failure who received no treatment (group A) or underwent regular hemodialysis (group B). A third group was examined as control. Biopsies from the gastric antrum were taken for histological investigation and for Cp detection. No significant differences among the 3 groups of patients were found with regards to the incidence of Campylobacter pylori. Urea can be considered as a preferred metabolite but no proof that high levels influence the occurrence of the organism in the stomach was found.