Levetiracetam as an alternative therapy for Tourette syndrome

Tourette syndrome is a common childhood-onset neuropsychiatric disorder characterized by chronic tics and frequent comorbid conditions such as attention deficit disorder. Most currently used tic-suppressing drugs are frequently associated with serious adverse events. Thus, alternative therapeutic agents with more favorable side-effect profiles are being evaluated. New hypotheses and recent studies involving GABAergic system in the pathophysiology of Tourette syndrome suppose a reason for the evaluation of GABAergic drugs. Levetiracetam is a drug with an atypical GABAergic mechanism of action that might be expected to improve tics. Although trials performed to evaluate the efficacy of levetiracetam in the treatment of Tourette syndrome have provided conflicting results, it may be useful in some patients. The established safe profile of levetiracetam makes this drug an alternative for treatment if intolerance to currently used drugs appears, but additional evaluation with larger and longer duration controlled studies are necessary to assess the real efficacy in patients with Tourette syndrome

Experiencia en el salvamento de extremidades en una unidad de tumores óseos

Los autores exponen su experiencia en el tratamiento quirúrgico de 26 casos de tumores malignos primarios de los huesos largos de las extremidades en estadio II.B. El diagnóstico era de osteosarcoma en 12 casos, sarcoma de Ewing en 3, condrosarcoma de bajo grado en 4, sarcomas osteogénicos paraostales en 3, mieloma en 1, adamantinoma en 1, y tumor de células gigantes (TCG) en otro caso. Se trataba de tumores controlados mediante la aplicación de protocolos de Quimioterapia como son el T-10 de Rosen para con el osteosarcoma y el T-9 para el sarcoma de Ewing, consiguiendo necrosis tumorales del orden entre el 75% y el 85%, con buena respuesta de compartimentación y de esclerosis. Todos los tumores se encontraban en estadio H-BNo,Mo, respetando los vasos de la extremidad, según el Divas practicado. En los 26 casos se han seguido los postulados de la ISOLS, para realizar las técnicas de salvamento de extremidad. Estas técnicas consistieron, entre otras, en el implante de prótesis o a medida (12 casos) o bien modulares. Se efectuaron tratamientos mixtos como aloinjertos criopreservados en Banco de Hueso + Endoprótesis en 10 casos. En 2 casos, se realizó artrodesis de rodilla con enclavado de Kunstcher femorotibial y aloinjerto. En otros 2 casos la Osteosíntesis endomedular y cortical fue el método de fijación del aloinjerto. Se hace una valoración crítica de cada caso, del tipo de resección, su resultado funcional, complicaciones, recidivas, metástasis, y el grado de satisfacción personal del pacienteThe experience on the surgical treatment of 26 patients with a Primary Malignant Bone Tumor of the long bones in stage II-B is reported. There weve 12 osteosarcomas, 3 Ewing's sarcoma, 4 low-grade chondrosarcoma, 3 paraosteal sarcoma, 1 myeloma, 1 Adamantinoma and 1 Giant-Cell tumor. Tumors were treated by chemotherapy protocols such as Rosen T-10 for osteosarcomas and T-9 for Ewing's sarcoma, with 75-80% of tumor necrosis disclosing a good response and sclerosis. All tumors were staged as II-BNoMo with vessels preservation according to the DIVAS test. Sugery for limb salvage was performed in all these patients based on ISOLS criteria. Costum-made or modular prosthetic implantation was the surgical technique in 12 cases. Mixed methods susch as cryopreserved allografts they Endoprosthesis was applied in 10 patients, two cases were treated by knee arthrodesis with a femorotibial endomedulary Kunstcher's nail and an allograft. Other 2 cases received endomedular and cortical osteosyntesis to stabilize the allograft. The paper describes the functional evaluation of each patient depending on the type of tumor, the size of the bone resection, complications, recurrences, metastases, surgical revisions and also level of subjective personal satisfaction of each patient

Regeneración de la superficie ocular: stem cells/células madre y técnicas reconstructivas Regeneration of the ocular

La córnea es un tejido transparente constituido microscópicamente por 5 capas bien diferenciadas. El epitelio corneal es esencial para la transparencia corneal y se encuentra en continua renovación a lo largo de la vida a partir de la población de células madre limbocorneales. La localización de estas células madre limbocorneales parece residir en las capas basales del epitelio limbocorneal, de vital importancia para mantener el microambiente de estas células madre limbocorneales, que depende de una variedad de factores intrínsecos y extrínsecos. La insuficiencia límbica se produce cuando ocurre una pérdida parcial o total de estas células madre limbocorneales. Este cuadro lleva a una opacificación corneal con la consiguiente pérdida de visión. En estos casos, el trasplante corneal supone únicamente un reemplazo temporal del epitelio corneal; es necesario llevar a cabo un tratamiento previo con trasplante de limbo autólogo o alogénico, que permita regenerar la población de células limbocorneales dañadas. Para disminuir el riesgo que supone el trasplante de limbo en el ojo donante, se han propuesto técnicas de cultivo de células limbocorneales a partir de pequeñas biopsias limbocorneales

Trasplante celular y terapia regenerativa con células madre

Uno de los campos de la medicina que más expectativas ha levantado en los últimos años es la terapia celular con células madre. El aislamiento de células embrionarias humanas, la aparente e inesperada potencialidad de las células madre adultas y el desarrollo de la terapia génica nos lleva a imaginar un futuro esperanzador para un importante número de enfermedades actualmente incurables. A lo largo de las siguientes páginas vamos a tratar de dibujar el panorama de la investigación con células madre, describiendo los principales logros en este campo así como algunas de las preguntas pendientes de responder. A pesar de las grandes expectativas, es fundamental que mantengamos un espíritu crítico y realista a la hora de analizar los avances científicos en este área

Noninferiority of Preservative-free Versus BAK-preserved Latanoprost-timolol Fixed Combination Eye Drops in Patients With Open-angle Glaucoma or Ocular Hypertension

Précis: Noninferiority of efficacy was demonstrated for a preservative-free latanoprost-timolol fixed combination compared with a BAK-containing formulation at 84 days after treatment in patients with open-angle glaucoma or ocular hypertension. Purpose: The purpose of this study was to compare the effect on intraocular pressure and safety of preservative-free latanoprost-timolol fixed combination (T2347) to benzalkonium chloride-preserved latanoprost-timolol fixed combination in patients with open-angle glaucoma or ocular hypertension. Methods: Phase III, randomized, parallel-group, investigator-masked study in 10 countries. A total of 242 patients aged 18 years or older with open-angle glaucoma or ocular hypertension in both eyes controlled with a preserved latanoprost-timolol fixed combination (15.7±2.4 mm Hg overall before inclusion) were randomized at day 0 with no washout period to receive the preservative-free alternative T2347 (N=127) or remain on the preserved comparator (N=115) for 84 days. Intraocular pressure changes from day 0 were measured at 9:00 am (±1 hour) on day 42 and day 84, and noninferiority of T2347 to the preserved comparator was analyzed statistically at day 84. Safety parameters were also reported. Results: The mean change in intraocular pressure from baseline to day 84 was -0.49±1.80 mm Hg for preservative-free T2347 and -0.49±2.25 mm Hg for the preserved comparator. These results met the noninferiority limits. Similar results were observed at day 42. There was no difference between groups in the incidence of adverse events or ocular signs. The total ocular symptoms score was better for T2347 than BPLT upon instillation at day 84 (45.9%/44.3%/9.8% of patients with improvement/no change/worsening vs. 33.6%/47.3%/19.1%; P=0.021), reflecting improvements in individual symptoms such as irritation/burning/stinging (P<0.001), and itching (P<0.01) on day 84. Conclusions: Preservative-free latanoprost-timolol fixed combination T2347 showed noninferior efficacy compared with the preserved comparator and was well tolerated

The Transiting Multi-planet System HD15337: Two Nearly Equal-mass Planets Straddling the Radius Gap

We report the discovery of a super-Earth and a sub-Neptune transiting the star HD 15337 (TOI-402, TIC 120896927), a bright (V = 9) K1 dwarf observed by the Transiting Exoplanet Survey Satellite (TESS) in Sectors 3 and 4. We combine the TESS photometry with archival High Accuracy Radial velocity Planet Searcher spectra to confirm the planetary nature of the transit signals and derive the masses of the two transiting planets. With an orbital period of 4.8 days, a mass of ${7.51}_{-1.01}^{+1.09}\,{M}_{\oplus }$ and a radius of 1.64 ± 0.06 R ⊕, HD 15337 b joins the growing group of short-period super-Earths known to have a rocky terrestrial composition. The sub-Neptune HD 15337 c has an orbital period of 17.2 days, a mass of ${8.11}_{-1.69}^{+1.82}\,{{\rm{M}}}_{\oplus }$, and a radius of 2.39 ± 0.12 R ⊕, suggesting that the planet might be surrounded by a thick atmospheric envelope. The two planets have similar masses and lie on opposite sides of the radius gap, and are thus an excellent testbed for planet formation and evolution theories. Assuming that HD 15337 c hosts a hydrogen-dominated envelope, we employ a recently developed planet atmospheric evolution algorithm in a Bayesian framework to estimate the history of the high-energy (extreme ultraviolet and X-ray) emission of the host star. We find that at an age of 150 Myr, the star possessed on average between 3.7 and 127 times the high-energy luminosity of the current Sun

K2-280 b - a low density warm sub-Saturn around a mildly evolved star

Stars and planetary system

Ab interno implantation of glaucoma drainage devices tubes in the posterior chamber

Background: Glaucoma drainage device (GDD) implantation in the anterior chamber are associated with corneal complications. We describe a novel technique to implant GDD tubes in the posterior chamber of pseudophakic eyes. Methods: Ten patients with glaucoma who required GDD tube implantation were included. Results: The new technique begins with the passage of one of two straight needles existing at each end of a 10–0 Polypropylene suture through the GDD tube. A 23-gauge needle then is inserted at an angle 180° away and passed from the anterior to the posterior chamber and finally through the sclera. The two suture straight needles from the 10–0 Polypropylene suture are positioned in the lumen of the 23-gauge needle. The 23-gauge needle is then extracted from the eye by passing the 2 needles through the lumen. The suture remains inside the posterior chamber, and the tube is inserted into the posterior chamber by pulling on the suture from the other side. No intra-operative complications were found such as bleeding, vitreous tube placement, bent tubes, etc. Conclusions: This surgical procedure to implant a tube into the posterior chamber of the pseudophakic eyes is uncomplicated and facilitates the insertion of the flexible tube into the posterior chamber. This eliminates the tendency of the tube to enter the vitreous as the tube is always placed in the posterior chamber away from the cornea