Typical absence status epilepticus in older people: syndromic delineation.

Objective We describe the clinical, electroencephalograph^ and neuroimaging findings of older patients with typical absence status epilepticus (ASE). Methods This investigation was a retrospective analysis of prospectively collected consecutive patients between January 2011 and October 2021. All patients ≥60 years with impairment of awareness and continuous generalized, rhythmic, synchronous and symmetric epileptiform discharges and normal background on video-electroencephalogram (vEEG) were included. Results Six patients were identified with a diagnosis of typical ASE. The mean age was 67 years. Five could be classified as idiopathic generalized epilepsy (IGE) though two had been erroneously categorized as cryptogenic focal epilepsy (FE). In one, the episode of ASE was thought to represent the beginning of late-onset IGE (de novo late-onset typical ASE). In all cases, ASE was controlled within the first 24 hours. Significance Typical ASE is a rare cause of confusion in the elderly population requiring urgent vEEG evaluation. It most frequently represents reactivation of a previous IGE, in effect related to patients with epilepsy with onset in childhood or adolescence, not previously diagnosed or treated, representing rather the debut of (de novo) late-onset IGE.

Enhancing the saccharification of pretreated chestnut burrs to produce bacteriocins.

The present study aims to valorize chestnut burrs, an important lignocellulosic waste, through a biorefinery concept. A solid residue rich in glucan (41.36 ± 0.59 %) and lignin (39.06 ± 0.01 %) obtained from a previous process of pre-hydrolysis was subjected to four treatments with water or NaOH to enhance enzymatic hydrolysis. Saccharification was performed using different ratios of commercial cellulases and ß-glucosidases and at controlled pH 4.8 or 6.0 (with citrate buffer) or uncontrolled pH. Carbohydrate-rich solutions with or without nutrients were used to produce bacteriocins by Lactobacillus plantarum CECT 211. The use of NaOH at high temperatures (120 and 130 °C) was the most suitable treatment to improve saccharification. Regarding the production of bacteriocins, the best result was obtained using the enzymatic solution obtained at controlled pH 6.0, supplemented with MRS broth nutrients (except glucose). Thus, the concentrations of bacteriocins obtained in this culture medium (9.21 BU/mL) was 1.22 and 1.98 times higher than those obtained in the nutrient supplemented medium buffered at pH 4.8 (7.56 BU/mL) and in the commercial MRS broth (4.65 BU/mL), respectively. These results highlight the feasibility of the technology developed in this work.

Valorization of exhausted olive pomace for the production of omega-3 fatty acids by Crypthecodinium cohnii.

Exhausted olive pomace (EOP) represents a potential candidate side stream to be utilized in biotechnological processes. EOP composition includes significant amounts of extractives and pectin, which are both usually discarded and are not utilized in the valorization process of the raw material. In this study, organosolv technology was optimized to remove the extractives and pectin using a Central Composite Rotatable Design. Optimal pretreatment conditions were predicted to be at 97.95 °C for 23.18 min, upon addition of 50% (v/v) EtOH in H2O, with 0.5% (w/v) of H2SO4 as catalyst. The composition analysis of liquid fraction revealed a high content of total sugars (17.58 g/L), galacturonic acid (7.05 g/L) and phenolic compounds (2.97 g/L). The liquid fraction was utilized as a carbon source by the heterotrophic marine microalgae Crypthecodinium cohnii, where it was shown to promote lipid accumulation up to 38.5% wt. of cell biomass, even without any additional detoxification step. This study is the first report that shows the use of galacturonic acid as carbon source for the growth of C. cohnii, while underpinning the use of EOP as a promising substrate for the development of zero-waste bioprocesses.

Ligninolytic Enzymes of Endospore-Forming Bacillus aryabhattai BA03.

In this work we investigated the enzymes produced by Bacillus aryabhattai BA03, particularly in those involved in ligninolytic activities such as laccases (Lac), lignin peroxidases (LiP) and Mn-dependent peroxidase (MnD-P). In this way, the maximal production of Lac (0.069 ± 0.000 U/mL) was obtained at pH 9, and 37 ºC after 72 h. LiP expressed the highest activity at 96 h in acid medium at 37 ºC (0.741 ± 0.029 U/mL). Meanwhile, the strain produced MnD-P (1.052 ± 0.001 U/mL) at the highest temperature assayed (44 ºC) and pH 7 at 72 h. In addition, this microorganism produced resistant endospores able to germinate after the sterilization program (121 ºC, 15 min) showing a high enzymatic activity. Using the heat-treated culture as inoculum, the percentage of decolorization of 150 mg/L of Coomassie Brillant Blue reached 89.42 ± 0.11% in only 24 h. These results open the use of these enzymes and endospores in bioremediation processes carried out under different temperatures and pH values.

Biotransformation of phenolic compounds by Bacillus aryabhattai.

Phenolic compounds could pose environmental problems if they are in excess, although they could be a renewable resource of substances with industrial interest. The novel strain Bacillus aryabhattai BA03 is able to produce high-added value metabolites from different phenolic compounds such as vanillin, 4-vinylguaiacol and 4-vinylphenol while inducing ligninolytic enzymes such as laccases (Lac) and lignin peroxidases (LiP). In comparison with the medium without inducers, the presence of 500 mg/L caffeic acid improved 9.1-fold times the expression of Lac (0.118 ± 0.004 U/mL) and 5.8-fold times the expression of LiP (2.300 ± 0.053 U/mL), just as these processes exhibited high global rates of biotransformation. When isoeugenol, ferulic acid or p-coumaric acid are in the media, the strain removed more than 90% of these compounds, secreting vanillin, 4-vinylguaiacol or 4-vinylphenol. Bacillus aryabhattai proved to be an appropriate tool for the removal of several phenolic compounds and the production of more valuable products.

Valorization of chestnut (Castanea sativa) residues: Characterization of different materials and optimization of the acid-hydrolysis of chestnut burrs for the elaboration of culture broths.

Four kinds of waste from the industrial processing of chestnuts (Castanea sativa), namely leaves, pruned material and burrs from chestnut tree plus chestnut shells, were characterized to determine their content in polymers and thus their potential use in biorefinery processes. Results revealed that chestnut burrs have the highest polysaccharide content being the most promising for carrying out the subsequent stages of acid hydrolysis. Treatment with diluted sulfuric acid (prehydrolysis) allowed the solubilization of xylose, glucose and arabinose, but also some toxic compounds such as furan derivatives, aliphatic acids and phenolic constituents. Xylose, the main component released in the hemicellulosic hydrolyzates, was maximized by using a 3**(2-0) full factorial design combined with desirability function. At optimum conditions set at 130 °C and 3% (w/v) H2SO4, this value was 22.6 g L-1 xylose. Three concentrations of activated charcoal (1, 2.5 and 5% w/v) were evaluated to remove certain unwanted byproducts, and it was found that under the highest dosage, 95.27 ±â€¯0.03% of the color was removed with an almost total reduction of furan derivatives, making this liquor an appropriate basis for the development of suitable culture media for lactic acid bacteria. To validate this hypothesis three lactic acid bacteria, namely Lactobacillus plantarum, Lactobacillus pentosus and Lactococcus lactis were positively tested finding lactic acid yields of 0.89, 0.92 and 0.83 g/L·h respectively.

Enzymatic hydrolysis of brewer's spent grain to obtain fermentable sugars.

Lignocellulosic biomass is a feedstock with the potential to be converted into value-added bioproducts. The use of enzymatic hydrolysis allows the cleavage of lignocellulose into their monomeric units, but there are some drawbacks that make its use in industrial biocatalysis unfeasible. In the present study, we describe the hydrolysis of brewer's spent grain (BSG) with an enzymatic cocktail produced by Aspergillus niger CECT 2700 and its comparison with commercial enzymes. In addition, it was determined whether pretreating the BSG (non-pressurized alkaline hydrolysis or treatment with cholinium glycinate ionic liquid) is necessary. Results show that both pretreatments enhanced xylose release (10.55 ±â€¯0.07 g/L and 8.14 ±â€¯0.13 g/L respectively), meanwhile the hydrolysis of raw BSG with the enzymatic cocktail produced solutions containing high levels of glucose (18.45 ±â€¯1.66 g/L) and xylose (6.38 ±â€¯0.26 g/L).

Biorefining brewery spent grain polysaccharides through biotuning of ionic liquids.

Brewery spent grain (BSG), a relevant waste from beer industry mainly composed of polysaccharides and lignin, is experiencing a surge in the production with its associated environmental impact. Thus, this manuscript bets in the application of aqueous solutions of a cholinium-based ionic liquid (IL) containing glycinate as anion ([N1112OH][Gly]) for an efficient delignification pretreatment. The operation at 90 °C yielded drastic lignin reduction (75.89%), greater than the levels attained when a traditional imidazolium-based IL (1-ethyl-3-methylimidazolium acetate, [C2C1im][C1COO]), was used (40.18%). The advantages of this pretreatment positively impacted the subsequent saccharification reaction, as the levels were increased up to about 1.5 times regarding the control (no IL) or the imidazolium-based pretreatment. ATR-FTIR spectrometry and scanning electron microscopy turned out to be useful tools to monitor the structural changes exerted. The results presented in this work make up the basis for a rational design of bio-ILs for delignification of lignocellulosic materials.

Fed-batch production of vanillin by Bacillus aryabhattai BA03.

Bacillus aryabhattai BA03, a strain isolated in our laboratory, has interesting properties related to the production of natural aromas and flavors. Specifically, we have found that it was able to produce vanillin from ferulic acid (FA). Furthermore, this strain produces high amounts of 4-vinylguaiacol in only 14h, this being the only intermediate metabolite observed in the process. FA is an inexpensive feedstock for the production of natural value-added compounds when extracted from lignocellulosic wastes. In this study, we optimized the operational conditions (temperature, pH and agitation), medium composition and bioconversion technology (batch or fed-batch) to produce vanillin. In a fed-batch process conducted with just one additional supplementation after 24h, the maximal concentration of vanillin (147.1±0.9mg/L) was observed after 216h (QV=0.681mg/Lh; YV/fFA=0.082mg/mg) after degrading 90.3% FA. In view of our data, we postulate that Bacillus aryabhattai BA03 carries out a decarboxylation of ferulic acid as a metabolic pathway.

Postanoxic alpha, theta or alpha-theta coma: Clinical setting and neurological outcome.

AIM: The aim of this study was to determine the prognosis of 26 consecutive adults with alpha coma (AC), theta coma (TC) or alpha-theta coma (ATC) following CRA and to describe the clinical setting and EEG features of these patients. METHODS: We retrospective analyzed a prospectively collected cohort of adult patients diagnosed as having AC, TC or ATC after CRA between January 2008 and June 2016. None of patients included in this analysis underwent therapeutic hypothermia (TH). Neurological outcome was expressed as the best score 6 months after CRA using the five-point Glasgow-Pisttsburgh Cerebral Performance Categories (CPC) RESULTS: Twenty-six patients were identified with a diagnosis of postanoxic AC, TC or ATC coma. There were 20 (77%) men and 6 (23%) women. The mean age was 63 ±â€¯16 years. The most frequent EEG pattern was TC (21 patients, 80%), followed by AC (3 patients, 12%) and ATC (2 patients, 8%). The cardiac rhythm as primary origin of the CRA was ventricular fibrillation (VF) in 16 patients (61.5%), asystole in 8 patients (34.6%) and ventricular tachycardia (VT) in one patient (3.8%). The presence of EEG reactivity was present in 8 patients (30%). The mortality rate was 85%. Of the 4 surviving patients, two (3.8%) had moderate disability (CPC 2), one (3.8%) had severe disability (CPC 3) and one (3.8%) reached a good recovery. The age was significantly lower in survivors 46.2 ±â€¯10.8 versus nonsurvivors 63.3 ±â€¯15.5 (p = 0.04). There was increased association of EEG reactivity with survival (p = 0.07). CONCLUSION: Hypoxic-ischemic AC, TC and ATC are associated with a poor prognosis and a high rate of mortality. In younger patients with AC, TC and ATC and incomplete forms showing reactivity on the EEG, there is a greater probability of clinical recovery.

De novo absence status epilepticus of late onset (DNASLO) precipitated by oral treatment with cefuroxime: description of an ambulatory case.

We describe the case of an elderly woman with an episode of ambulatory de novo absence status epilepticus of late onset (DNASLO) after oral treatment with cefuroxime. A high level of suspicion of DNASLO in cases of unexplained confusion in adults or elderly subjects taking cephalosporins is essential to prompt an emergency EEG and, in turn, rapidly achieve an appropriate diagnosis and enable optimal treatment.

Super-refractory nonconvulsive status epilepticus due to self-poisoning with metaldehyde.

INTRODUCTION: Metaldehyde self-poisoning in adults is uncommon and, to the best of our knowledge, an episode of super-refractory nonconvulsive status epilepticus (sr-NCSE) following an suicide attempt has not been previously demonstrated. CASE REPORT: A 68-year-old woman was admitted to our Intensive Care Unit (ICU) in coma. On neurologic examination, the pupils were reactive, brainstem reflexes were present and plantar responses were flexor bilaterally. Routine laboratory tests were unremarkable. Arterial blood gas analysis revealed a mixed acidosis. A computed tomography (CT) scan of the brain and angio-CT were normal. The family confirmed that the patient had had suicidal ideation, and they had discovered a bag of slug killer (metaldehyde 5%) in her room. Two hours after the admission at the ICU, her neurological state remained unchanged. Sedation with intravenous propofol and antiepileptic therapy with levetiracetam (1000 mg/24 h) were started. The next day, propofol infusion was stopped but the level of consciousness of the patient did not improve. A video-electroencephalograhy (v-EEG) showed continuous generalized paroxysms of spike-wave and sharp-slow wave complexes compatible with the diagnosis of generalized NCSE. On day 3, the episode of NCSE was controlled. Finally, 15 days after ICU admission she was discharged with a normal neurological examination. CONCLUSION: This clinical case highlights that in comatose patients as consequence of metaldehyde poisoning, a v-EEG evaluation should be perform in order to rule out the existence of NCSE.

Biological treatment of model dyes and textile wastewaters.

Previous works conducted in our laboratory, reveled that Bacillus aryabhattai DC100 produce ligninolytic enzymes such as laccases and/or peroxidases, opening new applications in different bioprocesses, including the treatment of disposal residues such as dyestuffs from textile processing industries. This work described the degradation of three commercial model dyes Coomassie Brilliant Blue G-250 (CBB), Indigo Carmine (IC) and Remazol Brilliant Blue R (RBBR) under different culture media and operational conditions. The process was optimized using a Central Composite Rotatable Design, and the desirability predicted complete decolorization of 150 mg/L CBB at 37 °C, 304.09 rpm and salt concentration of 19.204 g/L. The model was validated with concentrations up to 180 mg/L CBB and IC, not being able to remove high amount of RBBR. The procedure here developed also allowed Chemical Oxygen Demands (COD) reductions in CBB of about 42%, meanwhile tests on real effluents from a local textile industry involved COD reductions of 50% in a liquid wastewater and 14% in semi-liquid sludge. Thus, allow the authorized discharge of wastewater into the corresponding treatment plant. Decolorization efficiencies and COD reductions open on the potential application of B. aryabhattai DC100 on the bioremediation of real effluents from textile industries.

Bacillus aryabhattai BA03: a novel approach to the production of natural value-added compounds.

A strain designated as BA03, with the ability to transform ferulic acid into vanillin and 4-vinylguaiacol, was isolated from contaminated cryovials. The production of natural value-added compounds was dependent on the media employed. The morphological and physiological characteristics of this strain were compared with those of the typical vanillin-producer strain Amycolatopsis sp. ATCC 39116. According to a partial 16S rRNA sequence, we determined that BA03 belonged to Bacillus aryabhattai. In addition, analysis of the results showed that this strain exhibited interesting enzymatic activity, including cellulases, laccases, lipases and pectinases. In light of this, we propose new functions for this multitasking microorganism. We suggest that it may be used for converting lignocellulosic wastes into byproducts with industrial uses, and also for treating disposal residues such as dyes in the textile industry. Hence, the possibility for novel research with B. aryabhattai opens up in the fields of biodegradation and/or revalorization of wastes.

[The shuttle run test is not valid for the detection of asthma in school physical education programs]. / La prueba course-navette no es válida para detectar asma en programas de educación física escolar.

OBJECTIVE: Certain sporting activities may trigger asthma exacerbations of varying intensity in children. Such exacerbations may lead to limitations in and rejection of such activities. During school hours, teachers are in a good position to observe these phenomena. The aim of the present study was to evaluate the shuttle run, a test of physical fitness used in school physical education programs, as a way of detecting asthma. PATIENTS AND METHODS: We carried out a cross-sectional observational study of school children between the ages of 6 and 12 years using the asthma symptom questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), a shuttle run test, and a free running test at maximum effort in order to study bronchial hyperresponsiveness. The principal measure of bronchial hyperresponsiveness used in both physical fitness tests was peak expiratory flow rate as measured with a peak flow meter. In comparing the results of the shuttle run test with those of the free running test and the ISAAC questionnaire we used the chi(2) test to measure association and the Cohen kappa coefficient to measure agreement. RESULTS: We distributed the ISAAC questionnaire (n=919) to 460 (50.1%) boys and 459 (49.9%) girls between the ages of 6 and 12 years. All the tests were completed by 826 children. The level of agreement between the shuttle run test and free running test was positive but low for decreases in peak expiratory flow rate compared to baseline of 15% (chi(2)=5.6; P< .05; kappa=0.093; SE, 0.042) and of 20% (chi(2)=4.5; P< .05; kappa=0.08; SE, 0.046). For 10% decreases association was not significant and agreement was low (kappa=0.05; SE, 0.04). There was no agreement between the ISAAC questionnaire and the shuttle run test (kappa=0.095; SE, 0.63). CONCLUSIONS: The shuttle run test using peak expiratory flow rate as the principal measure of bronchial hyperresponsiveness is not valid for the detection of asthma in schoolchildren.

La prueba course-navette no es válida para detectar asma en programas de educación física escolar / The shuttle run test is not valid for the detection of asthma in school physical education programs

Objetivo: Determinadas actividades deportivas pueden desencadenar en el niño agudizaciones de asma de intensidad variable, limitaciones y rechazo de las actividades deportivas. Durante el horario escolar los profesores son observadores privilegiados de estos fenómenos. El objetivo del presente estudio ha sido evaluar la prueba course-navette ("carrera de ida y vuelta", PCN), prueba de rendimiento físico de los programas de educación física escolar, como medida para detectar asma. Pacientes y métodos: Se ha realizado un estudio observacional y transversal en escolares de 6 a 12 años de edad, mediante cuestionario de síntomas relacionados con el asma (ISAAC) y pruebas de rendimiento físico (PCN) y de carrera libre con esfuerzo máximo para estudiar la hiperrespuesta bronquial, utilizando en ambas como medida principal el flujo espiratorio máximo (FEM) determinado con medidor del ápice de flujo espiratorio. En la comparación de los resultados de la PCN con los del test de carrera libre y el cuestionario ISAAC se midió el grado de asociación (con la prueba de la χ²) y de acuerdo (estadístico kappa de Cohen). Resultados: Se distribuyó el cuestionario ISAAC (n = 919) a 460 niños (50,1%) y 459 niñas (49,9%) de 6 a 12 años de edad (mediana ± desviación estándar: 8 ± 1,87 años). Completaron todas las pruebas 826. Se observó una asociación con bajo acuerdo entre la PCN positiva y el test de carrera libre positivo para descensos del FEM, en relación con el basal, del 15% χ² = 5,6; p < 0,05; kappa = 0,093; error estándar [EE] = 0,042) y del 20% (χ² = 4,5; p < 0,05; kappa = 0,08; EE = 0,046). Para descensos del FEM del 10% la asociación no fue significativa y el acuerdo resultó débil (kappa = 0,05; EE = 0,04). No hubo acuerdo entre ISAAC y la PCN (kappa = 0,095; EE = 0,63). Conclusiones: La PCN con el FEM como medida principal del efecto no es válida para detectar asma en escolares

Objective: Certain sporting activities may trigger asthma exacerbations of varying intensity in children. Such exacerbations may lead to limitations in and rejection of such activities. During school hours, teachers are in a good position to observe these phenomena. The aim of the present study was to evaluate the shuttle run, a test of physical fitness used in school physical education programs, as a way of detecting asthma. Patients and methods: We carried out a cross-sectional observational study of school children between the ages of 6 and 12 years using the asthma symptom questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), a shuttle run test, and a free running test at maximum effort in order to study bronchial hyperresponsiveness. The principal measure of bronchial hyperresponsiveness used in both physical fitness tests was peak expiratory flow rate as measured with a peak flow meter. In comparing the results of the shuttle run test with those of the free running test and the ISAAC questionnaire we used the χ² test to measure association and the Cohen κ coefficient to measure agreement. Results: We distributed the ISAAC questionnaire (n=919) to 460 (50.1%) boys and 459 (49.9%) girls between the ages of 6 and 12 years. All the tests were completed by 826 children. The level of agreement between the shuttle run test and free running test was positive but low for decreases in peak expiratory flow rate compared to baseline of 15% (χ²=5.6; P<.05; κ=0.093; SE, 0.042) and of 20% (χ²=4.5; P<.05; κ=0.08; SE, 0.046). For 10% decreases association was not significant and agreement was low (κ=0.05; SE, 0.04). There was no agreement between the ISAAC questionnaire and the shuttle run test (κ=0.095; SE, 0.63). Conclusions: The shuttle run test using peak expiratory flow rate as the principal measure of bronchial hyperresponsiveness is not valid for the detection of asthma in schoolchildren