Epilepsy for primary health care: a cost-effective Latin American E-learning initiative.

A lack of neurologists in Latin America forces primary health care providers to manage epilepsy. With the main goal of improving diagnostic and therapeutic management of patients with epilepsy through training of physicians in the primary health care level, the International League Against Epilepsy Education Commission (2013-2017) created a low-cost, regional, virtual course. The course, set-up in Moodle platform, was structured in eight modules, each lasting for a week. Teaching was based on written didactic material, videos, and interactive discussions, both in Spanish and Portuguese. Topics included epidemiology, diagnosis, classification, treatment, prognosis, social issues, and epilepsy policies. Each course was limited to 50 participants and priority was given to general practitioners. Certification was given to those approving the final examination. Since 2015, five courses have been developed, involving 143 participants from 17 countries and 21 tutors. Of the participants, 61% worked in primary health care services. A total of 129 participants (90%) completed the course, and 110 submitted the final examination with an approval rate of 95%. From 85 participants completing the course evaluation, 98% would recommend the course to other colleagues, and 99% showed interest in taking other similar courses. High self-confidence for the management of patients with epilepsy increased from 21% at baseline to 73% after the course. The online course on epilepsy for primary care physicians in Latin America was shown to be a cost-effective course, with good retention and excellent approval rates. Our current challenges include periodic updating, complete self-sustainability, and exploring different strategies to reach our target audience more effectively.

Protective Activity of Erythropoyetine in the Cognition of Patients with Parkinson's Disease.

Introduction: Treatment strategies in Parkinson's disease (PD) can improve a patient's quality of life but cannot stop the progression of PD. We are looking for different alternatives that modify the natural course of the disease and recent research has demonstrated the neuroprotective properties of erythropoietin. In Cuba, the Center for Molecular Immunology (CIM) is a cutting edge scientific center where the recombinant form (EPOrh) and recombinant human erythropoietin with low sialic acid (NeuroEPO) are produced. We performed two clinical trials to evaluate the safety and tolerability of these two drugs in PD patients. In this paper we want to show the positive results of the additional cognitive tests employed, as part of the comprehensive assessment. Materials and method: Two studies were conducted in PD patients from the outpatient clinic of CIREN, including n = 10 and n = 26 patients between 60 and 66 years of age, in stages 1 to 2 of the Hoehn and Yahr Scale. The first study employed recombinant human (rhEPO) and the second an intranasal formulation of neuroEPO. All patients were evaluated with a battery of neuropsychological scales composed to evaluate global cognitive functioning, executive function, and memory. Results: The general results in both studies showed a positive response to the cognitive functions in PD patients, who were undergoing pharmacological treatment with respect to the evaluation (p < 0.05) before the intervention. Conclusions: Erythropoietin has a discrete positive effect on the cognitive functions of patients with Parkinson's disease, which could be interpreted as an effect of the neuroprotective properties of this molecules. To confirm the results another clinical trial phase III with neuroEPO is in progress, also designed to discard any influence of a placebo effect on cognition.

Non-Invasive Brain Stimulation for Children with Autism Spectrum Disorders: A Short-Term Outcome Study.

Non-Invasive Brain Stimulation (NIBS) is a relatively new therapeutic approach that has shown beneficial effects in Autism Spectrum Disorder (ASD). One question to be answered is how enduring its neuromodulatory effect could be. Twenty-four patients with ASD (mean age: 12.2 years) received 20 sessions of NIBS over the left dorsolateral prefrontal cortex (L-DLPFC). They were randomized into two groups with two (G1) or three (G2) clinical evaluations before NIBS. Both groups had a complete follow-up at six months after the intervention, with the aim of determining the short-term outcome using the total score on the Autism Behavior Checklist, Autism Treatment Evaluation Checklist, and the Autism Diagnostic Interview. Transcranial Direct Current Stimulation (tDCS) was used in ASD patients aged <11 years, and repetitive Transcranial Magnetic Stimulation (rTMS) for 11-13-year-olds. Observation points were at one, three, and six months after completing all the sessions of NIBS. A significant reduction in the total score on the three clinical scales was observed and maintained during the first six months after treatment, with a slight and non-significant tendency to increase the scores in the last evaluation. Twenty sessions of NIBS over the L-DLPFC improves autistic symptoms in ASD children, with a lasting effect of six months.

Effectiveness of music therapy as an aid to neurorestoration of children with severe neurological disorders.

This study was a two-armed parallel group design aimed at testing real world effectiveness of a music therapy (MT) intervention for children with severe neurological disorders. The control group received only the standard neurorestoration program and the experimental group received an additional MT "Auditory Attention plus Communication protocol" just before the usual occupational and speech therapy. Multivariate Item Response Theory (MIRT) identified a neuropsychological status-latent variable manifested in all children and which exhibited highly significant changes only in the experimental group. Changes in brain plasticity also occurred in the experimental group, as evidenced using a Mismatch Event Related paradigm which revealed significant post intervention positive responses in the latency range between 308 and 400 ms in frontal regions. LORETA EEG source analysis identified prefrontal and midcingulate regions as differentially activated by the MT in the experimental group. Taken together, our results showing improved attention and communication as well as changes in brain plasticity in children with severe neurological impairments, confirm the importance of MT for the rehabilitation of patients across a wide range of dysfunctions.

[Evaluation of treatment of iron deficiency anemia in pregnancy]. / Evaluación del tratamiento a mujeres embarazadas con anemia ferropénica.

BACKGROUND: Pregnancy is a condition that predisposes women to anemia, a problem which is easily solved with the identification of susceptible patients and with proper treatment. OBJECTIVE: To determine the prevalence of anemia in the study group, the characteristics of the patients, and assess the impact of iron therapy in anemic pregnant women. MATERIAL AND METHODS: A retrospective study was done in 98 pregnant patients who attended a medical office in San Luis Potosi, S.L.P, between 2010 and 2011. The studied variables were: hemoglobin and hematocrit concentration for anemia diagnosis. Statistical analysis was performed using Epi Info-7 for the association between variables. RESULTS: The prevalence of anemia found in the study was 4.08% in the first weeks of gestation. 75% of those patients were overweight or obese, and as the pregnancy progressed prevalence increased to 16.32%. The patients whose anemia was detected between weeks 28-33 of gestation had 4.58 times the risk of having it than those who were detected in the first trimester (p < .05). While anemia was more frequent among women with overweight or obesity 5% (n = 3), no statistically significant difference with normal weight women was observed in early pregnancy. CONCLUSIONS: The prevalence of anemia increased as pregnancy progressed, therefore It is necessary that the physician requests the patient 3 or 4 blood studies to keep adequate prenatal care and have the opportunity for early detection of anemia.

Causas de desapego a tratamiento, dieta y seguimiento de pacientes con diabetes y posibles factores asociados con la enfermedad / Causes to detachment to treatment, diet and monitoring of patients with diabetes and possible factors associated with disease

Objetivo Analizar las causas de desapego a tratamiento y dieta de pacientes con diabetes y factores asociados con la enfermedad, como historia familiar de diabetes e hipertensión, en pacientes de un municipio de San Luis Potosí, México, y zonas aledañas. Métodos Estudio descriptivo de variables como edad, sexo, escolaridad, ocupación, historia familiar de diabetes e hipertensión, causas de desapego al tratamiento y dieta; estudio analítico por comparación de grupos en cuanto al riesgo de padecer diabetes de acuerdo a las variables socio demográficas y antecedentes familiares. Resultados De los 156 pacientes incluidos, las principales causas de desapego o abandono del tratamiento y/o dieta indicados fueron el olvido y la insistencia en el consumo de alimentos restringidos, además los pacientes con antecedentes familiares de hipertensión en ambos padres tuvieron 5,8 veces más riesgo de presentar Diabetes Mellitus, en comparación con aquellos sin éste antecedente (p<0,01). Aquellos pacientes con antecedentes maternos de diabetes presentaron 4,76 veces máyor riesgo de padecerla, comparados con aquellos que presentaban antecedentes paternos únicamente (p<0,001). En el caso de los pacientes con antecedentes de obesidad, estos presentaron 2,4 veces mayor riesgo de padecer diabetes, que los que no la tenían (p<0,05). Conclusiones Las principales causas, referidas por los pacientes, de desapego al tratamiento y dieta fueron el olvido y la insistencia en el consumo de alimentos restringidos. Además, el grado de asociación de Diabetes Mellitus con los antecedentes familiares de esta patología e hipertensión es de 2,4 a 5,8 veces, con una p<0,05.

Objectives Analyze the causes of detachment to diet and treatment of patients with diabetes and factors associated with disease such as family history of diabetes and hypertension, in patients from one municipality of San Luis Potosi, Mexico, and surrounding areas. Methods Descriptive study of variables such as age, sex, schooling level, occupation, family history of diabetes and hypertension, causes of detachment to diet and treatment; analytic for groups in terms of the risk of diabetes according to socio demographic and family history. Results Of the 156 patients included main causes of detachment or abandonment of the indicated treatment and/or were the oblivion and insistence on restricted food intake. Patients with a family history of hypertension in both parents had 5.8 times the risk of Diabetes Mellitus, compared to those without this history (p<0.01). Those patients with a maternal history of diabetes had 4.76 times the risk of suffering it too, compared to those with only paternal history (p<0.001). For patients with a history of obesity, they had 2.4 times higher risk of developing diabetes than those who had not (p<0.05). Conclusions Main causes, reported by patients, for detachment to treatment and diet were the oblivion and the insistence on restricted food intake, and the degree of association of Diabetes Mellitus with family history of this disease and hypertension is 2.4 to 5.8 times, with p<0.05.

[Causes of diabetic patients' indifference towards treatment, diet and monitoring and possible factors associated with such disease]. / Causas de desapego a tratamiento, dieta y seguimiento de pacientes con diabetes y posibles factores asociados con la enfermedad.

OBJECTIVES: Analyze the causes of detachment to diet and treatment of patients with diabetes and factors associated with disease such as family history of diabetes and hypertension, in patients from one municipality of San Luis Potosi, Mexico, and surrounding areas. METHODS: Descriptive study of variables such as age, sex, schooling level, occupation, family history of diabetes and hypertension, causes of detachment to diet and treatment; analytic for groups in terms of the risk of diabetes according to socio demographic and family history. RESULTS: Of the 156 patients included main causes of detachment or abandonment of the indicated treatment and/or were the oblivion and insistence on restricted food intake. Patients with a family history of hypertension in both parents had 5.8 times the risk of Diabetes Mellitus, compared to those without this history (p<0.01). Those patients with a maternal history of diabetes had 4.76 times the risk of suffering it too, compared to those with only paternal history (p<0.001). For patients with a history of obesity, they had 2.4 times higher risk of developing diabetes than those who had not (p<0.05). CONCLUSIONS: Main causes, reported by patients, for detachment to treatment and diet were the oblivion and the insistence on restricted food intake, and the degree of association of Diabetes Mellitus with family history of this disease and hypertension is 2.4 to 5.8 times, with p<0.05.

Use of Cuban recombinant human erythropoietin in Parkinson's disease treatment.

INTRODUCTION: Recombinant human erythropoietin is used primarily to treat anemia. There is evidence of its neuroprotective capacity from preclinical studies in Parkinson's disease and other neurodegenerative diseases. Recombinant human erythropoietin produced in Cuba (ior-EPOCIM) is registered and approved for use in humans in Cuba and in a number of other countries. OBJECTIVE: Assess safety and possible neuroprotective effect of ior-EPOCIM in a group of Parkinson's disease patients. METHODS: A three-phase exploratory study (proof of concept) was conducted from August 2008 to April 2009: preliminary assessment, treatment (weeks 1-5), and post-treatment (weeks 6-35). Participants were 10 Parkinson's disease patients (8 men, 2 women) from the outpatient clinic at the International Neurological Restoration Center, all at least one year post onset, aged 47-65 years. The ior-EPOCIM was administered subcutaneously in a once-weekly dose (60 IU/kg body weight) for five weeks. Therapy with patients' antiparkinsonian drugs was maintained throughout the study, except during motor examination, conducted following a 12-hour withdrawal (OFF condition). Safety was evaluated primarily by recording adverse events (by intensity and causality) from start of treatment until the study's completion. Hematological parameters and blood pressure were also measured because of their direct relationship to the medication's action. To evaluate possible neuroprotective activity, variables were included related to patients' motor function and cognitive and affective status, measured using internationally recognized scales. All variables were evaluated before, during and after treatment. Data were processed using a fixed-effects linear model, with a repeated-measures design (significance level p ≤ 0.05). RESULTS: Three patients experienced mild adverse events (precordial discomfort and hypertension in one; leg fatigue in another; renal colic in a third), with a possible causal relationship in the first two that was neither life threatening nor required hospitalization. Hemoglobin was the only hematological parameter that showed a growing and significant increase (p < 0.001), but without reaching pathological levels. The other variables presented clinically positive and statistically significant changes compared to pretreatment assessment: motor function (p < 0.001), cognitive status (p < 0.001) and mood (p = 0.013). CONCLUSIONS At the dosage used, ior-EPOCIM was safe and well tolerated in these Parkinson's disease patients. Further studies are needed to corroborate these results and evaluate the medication's possible neuroprotective effect. KEYWORDS Parkinson disease, erythropoietin, recombinant proteins, neuroprotective agents, clinical trial, safety, ior-EPOCIM, Cuba.

Impacto del Programa de Evaluación Externa de la Calidad en Química Clínica en México de 2004 a 2008 / Impact of the Program of External Quality Assessment in Clinical Chemistry in Mexico from 2004 to 2008 / Impacto do Programa de Avaliação Qualidade Externa em Química Clínica no México de 2004 a 2008

Se valoró el impacto del Programa de Evaluación Externa de la Calidad, aplicable a laboratorios clínicos en el área de Química Clínica, en México, con base en resultados obtenidos por los laboratorios durante el ciclo marzo 2008-febrero 2009 y el periodo 2004-2008, mediante un estudio analítico, longitudinal y retrospectivo de los resultados obtenidos por los laboratorios que participaron en el Programa de Evaluación Externa de la Calidad de la Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí. El análisis estadístico se realizó con los programas Microsoft® Office Excel y Epi Info T. El porcentaje de laboratorios clínicos con desempeño aceptable (excelente y bueno) por analito, durante el ciclo de evaluación marzo 2008-febrero 2009, fue del 75% al 82%, que aumentó cuando se utilizaron métodos automatizados y semiautomatizados. Para el periodo 2004-2008, los laboratorios en 2004 tuvieron 3,02 veces mayor riesgo de no calificar con desempeño aceptable (p<0,05) que en 2008. En conclusión, el Programa de Evaluación Externa de la Calidad de la Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, ha tenido un impacto favorable en el desempeño global de los laboratorios clínicos, que permite asegurar su calidad analítica.

The impact of the External Quality Assessment Program, applicable to clinical laboratories in the area of Clinical Chemistry in Mexico, was studied, based on laboratory results during the March 2008-February 2009 cycle and the 2004-2008 period, through analytical, longitudinal, retrospective analyses of the results obtained by the laboratories that participated in the External Quality Assessment Program of the School of Chemical Sciences of Universidad Autónoma de San Luis Potosí. Statistical analysis was performed with Microsoft® Office Excel and Epi Info T programs. The percentage of clínical laboratories with acceptable performance (excellent and good) by analyte during the evaluation cycle in March 2008-February 2009 was 75% to 82%, whích íncreased when automated and semíautomated methods were used. For the 2004-2008 period, the laboratories, in 2004, had 3.02 times greatet risk of not qualifying with acceptable performance (p<0.05) than in 2008. In conclusión, the External Qualíty Assessment of the School of Chemícal Sciences of Universidad Autónoma de San Luis Potosí has had a strong impact on the overall performance of clinical laboratories, whích ensures the latter's qualíty.

Evolución de la memoria episódica en pacientes epilépticos sometidos a lobectomía temporal / Evolution of episodic memory in epileptic patients submitted to temporal lobectomy

Introducción: La memoria episódica resulta vulnerable a la lobectomía temporal. Nuestro objetivo es describir los cambios que aparecen en este subsistema de memoria, en pacientes sometidos a lobectomía temporal realizada como estrategia para control de crisis. Pacientes y Métodos: La muestra está compuesta por 11 pacientes, los cuales fueron evaluados antes de realizar la lobectomía temporal y al año de ésta, utilizando una batería de pruebas neuropsicológicas. Resultados: Observamos disminución en el rendimiento mnésico, en la modalidad ipsilateral al hemisferio donde se realiza la lobectomía y aumento en la modalidad relacionada con el hemisferio contralateral a la intervención. Sin embargo estas diferencias en elrendimiento entre los dos momentos evaluativos no se manifiestan en igual magnitud en todas las variables evaluadas ni alcanzan valor estadístico significativo. Conclusiones: Asociado a la lobectomía temporal el perfil neuropsicológico de la memoria episódica muestra disminución del rendimiento en la modalidad ipsilateral a la cirugía y mejoría en la modalidad contralateral, evolución esta que refuerza el supuesto de lateralización funcional.

Introduction: Episodic memory is vulnerable to temporal lobectomy. Our objective is to describe the changes that appear in this memory sub-system in patients submitted to temporal lobectomy, as a strategy to crisis control. Patients and methods: The simple is composed of 11 patients who were evaluated before performing the temporal lobectomy and a year after, using neuropsychologic tests.Results: We observed a diminishing in the mnesic rendering, in the ipsilateral modality to the hemisphere where the lobectomy is performed and an increase in the modality related with the contralateral hemisphere to that of the intervention. But nevertheless, these differences as to the rendering of the evaluative moments that neither manifest themselves in thesame magnitude in all evaluated variables nor reach significant statistical value. Conclusions: The neuropsychologic profile of episodic memory associated to temporal lobectomy shows a diminishing in therendering of ipsilateral modality to surgery, but an improvement in the contralateral modality an evolution that reinforces the supposing of a functional lateralization.

Caracterización de aislados de Escherichia coli O157: H7 en canales de bovinos y porcinos mediante PCR / Charactertization of Escherichia ciki O157: H7 isolates obtained from bovine and porcine carcasses

Muchos de los brotes causados por Escherichia coli O157:H7 se han asociado al consumo de carne bovina mal cocida, pero también se ha reportado su presencia en la carne de otros animales domésticos. En México existe poca información sobre la presencia de este patógeno en canales de res y de cerdo. El objetivo de este estudio fue determinar la presencia de E. coli O157:H7 en canales de res y cerdo y su caracterización mediante PCR. De un total de 18 aislados, 12 fueron positivas por PCR para los genes rfbE y fliC que determinan el serotipo O157:H7. De estos 12, uno de canal de res y tres de canales de cerdo fueron positivos por PCR para los genes stx1, stx2 y eaeA, por lo que fueron considerados como enterohemorrágicos. Las diferencias encontradas en el número de canales positivas para los genes caracterizados no fueron estadísticamente significativas, y los resultados señalan que E. coli O157:H7 puede ser encontrada en ambos tipos de canal, representando un riesgo para la salud, por lo que se deben tomar medidas más estrictas de higiene y manejo para evitar que canales que no cumplan con el carácter de inocuidad lleguen a los consumidores finales.

Many Escherichia coli O157:H7 outbreaks have been associated to consumption of undercooked beef, but the presence has also been reported in the meat of other domestic animals. In Mexico, little information exists on the presence of this pathogen in bovine and pork carcasses. The objective of this study was to determine the presence and/or absence of E. coli serotype O157:H7 in bovine and pork carcasses and their characterization by means of PCR. Of 18 isolates, 12 were positive by PCR to rfbE and fliC genes, which determine O157:H7 serotype. Of these 12, one from bovine carcass and three of pork carcasses were positive by PCR to stx1, stx2 and eaeA genes, therefore, they were considered enterohemorrhagic strains. The differences found in the positive carcass number to any of the genes were not statistically significant. The results show that E. coli O157:H7 could be found in both carcasses types, representing a risk for the health, so strict hygienic and handling measures should be taken in order to avoid that carcasses which do not fulfill the food safety aspect might arrive to the final consumers.

A neurofunctional evaluation strategy for presurgical selection of temporal lobe epilepsy patients.

Introduction Temporal lobe epilepsy (TLE) is the prototype of a surgically correctable syndrome. Successful surgical outcomes depend on a thorough presurgical evaluation aimed primarily at identifying the epileptogenic zone. Objective Describe the noninvasive presurgical selection and evaluation strategy for TLE patients introduced at the International Neurological Restoration Center (CIREN) in Havana, Cuba, and evaluated between 2001 and 2006 for its accuracy in identifying candidates for non-lesional resection surgery. Methods Ictal onset electrographic patterns of 1,679 seizures in 72 patients with drug-resistant partial epilepsy, obtained through longterm scalp Video EEG (V-EEG) monitoring, were evaluated. The correlation between the V-EEG-defined epileptogenic zone and the dysfunction shown by single photon emission computed tomography (ictal and interictal brain SPECT) and nuclear magnetic resonance spectroscopy (MRS) was established. Results V-EEG monitoring determined that 44.4% of evaluated patients had complex partial temporal lobe seizures. Identification of patients with medial temporal epilepsy (MTE) increased as a result of lateralization and localization of the dominant mean ictal pattern frequency (5.56 ± 1.31 Hz) during the period of maximum spectral power VARETA localization of an ictal epileptiform activity source coincided with the epileptogenic zone in all TLE patients who subsequently underwent a successful temporal lobectomy. Semiquantitative analysis of ictal and interictal brain SPECT images, as well as metabolic ratios measured by MRS, combined with V-EEG findings, enabled localization/lateralization of the epileptogenic zone in TLE patients whose MRIs were normal or showed bilateral structural abnormalities. Conclusions Confirmation of correct localization/lateralization of the epileptogenic zone following successful surgical outcomes in selected TLE patients led CIREN to develop a surgical treatment strategy for patients in Cuba with drug-resistant temporal lobe epilepsy. This strategy offers an appropriate, cost-effective treatment alternative for developing countries like Cuba, with the benefit of significantly improving TLE patients' quality of life.

Evaluación del tratamiento de erradicación de Staphylococcus aureus meticilino resistentes de portadores asintomáticos / Evaluation of erradication treatment of Meticillin resistant staphylococcus aureus in asymptomatic carriers

Los Staphylococcus aureus meticilino resistente (SAMR) son microorganismos resistentes a una amplia gama de antibióticos beta lactamicos, que producen infecciones, en pacientes ambulatorios y hospitalizados, asociadas con el carácter de portador nasofaríngeo e incrementando la morbi-mortalidad en áreas críticas de atención a la salud, como cuidados intensivos y hemodiálisis.El objetivo es evaluar a un año la aplicación de un tratamiento a base de rifampicina y trimetoprim/sulfametoxasol para erradicar el carácter de portador nasofaríngeo de SAMR en pacientes de la unidad de hemodiálisis del HGZ-Nº1 del IMSS 2006-2008.Es un estudio descriptivo en cuanto a edad, sexo y enfermedad concomitante de pacientes portadores de estafilococos resistentes a la meticilina. Analítico en cuanto a la erradicación a corto y largo plazo del carácter de portador de esos microorganismos.En la evaluación a largo plazo, de la totalidad de pacientes que ingresaron con SAMR, la portación se erradicó en un 100%...

The MRSA are resistant microorganisms to a wide range of beta-lactam antibiotics, which produce infections of outpatients and hospitalized, associated with the character of nasopharyngeal carrier and increasing morbidity and mortality in critical areas of health-care, such as intensive care and hemodialysis

Evaluación del tratamiento de erradicación de Staphylococcus aureus meticilino resistentes de portadores asintomáticos / Evaluation of erradication treatment of Meticillin resistant staphylococcus aureus in asymptomatic carriers

Los Staphylococcus aureus meticilino resistente (SAMR) son microorganismos resistentes a una amplia gama de antibióticos beta lactamicos, que producen infecciones, en pacientes ambulatorios y hospitalizados, asociadas con el carácter de portador nasofaríngeo e incrementando la morbi-mortalidad en áreas críticas de atención a la salud, como cuidados intensivos y hemodiálisis.El objetivo es evaluar a un año la aplicación de un tratamiento a base de rifampicina y trimetoprim/sulfametoxasol para erradicar el carácter de portador nasofaríngeo de SAMR en pacientes de la unidad de hemodiálisis del HGZ-Nº1 del IMSS 2006-2008.Es un estudio descriptivo en cuanto a edad, sexo y enfermedad concomitante de pacientes portadores de estafilococos resistentes a la meticilina. Analítico en cuanto a la erradicación a corto y largo plazo del carácter de portador de e

The MRSA are resistant microorganisms to a wide range of beta-lactam antibiotics, which produce infections of outpatients and hospitalized, associated with the character of nasopharyngeal carrier and increasing morbidity and mortality in critical areas of health-care, such as intensive care and hemodialysisO (AU)

Oxidative stress markers in surgically treated patients with refractory epilepsy.

OBJECTIVES: This study examines the redox status of drug-resistant epileptic patients and how it is modified after surgical treatment. DESIGN AND METHODS: The activity of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase), and markers of damage to biomolecules (malondialdehyde and advanced oxidation protein products) were determined by spectrophotometric methods in the serum of 9 drug-resistant epileptic patients, before and at different times after surgery, and in 32 control subjects. RESULTS: Pre-surgery, epileptic patients presented increases in markers of oxidative damage and alterations in the activities of antioxidant enzymes. Additionally, patients showed a correlation between advanced oxidation protein products and the evolution time of the illness. After surgery, patients showed a trend to normalization in all the measured variables, except for the superoxide dismutase activity. CONCLUSIONS: Drug-resistant temporal lobe epilepsy is associated with an oxidative stress condition that is favourably modified by the surgical resection of the epileptic foci.