Registro ACESUR: atención de pacientes adultos con crisis epilépticas en servicios de urgencias: diferencias entre primer episodio y recurrencia

Objetivo. Describir las características y la atención recibida de pacientes adultos que consultan por crisis epiléptica (CE) en los servicios de urgencias hospitalarios (SUH), diferenciando entre primera crisis y recurrencia en epiléptico conocido. Método. ACESUR es un registro observacional de cohortes multipropósito, prospectivo y multicéntrico con un muestreo sistemático, los días pares de febrero y julio alternando con los impares de abril y octubre de 2017. Se incluyeron pacientes 18 años con diagnóstico de CE en los SUH. Se recogieron variables clínico-asistenciales de la visita índice de pacientes, distinguiendo entre primera CE y recurrencia en epiléptico. Resultados. El registro ACESUR recogió a 664 pacientes procedentes de 18 SUH españoles, 229 (34, 5%) con primera CE y 435 (65, 5%) con CE recurrentes. Los pacientes con primera CE fueron de mayor edad (p < 0, 001), presentaron motivos de consulta distintos (p < 0, 001) y requirieron más traslados en ambulancia (p < 0, 001). La atención recibida en el SUH fue diferente, en pacientes con primera CE se solicitó con mayor probabilidad una prueba complementaria específica (OR ajustada = 13, 94; IC95%:7, 29-26, 7; p < 0, 001) y se necesitó mayor hospitalización o estancia prolongada en el SUH (OR ajustada = 1, 69; IC95%:1, 11-2, 58; p = 0, 015). No hubo diferencias en cuanto al tratamiento farmacológico en fase aguda ni preventivo (OR ajustada = 1, 40; IC95%:0, 94-2, 09; p = 0, 096). Se inició tratamiento con fármacos antiepiépticos (FAE) en 100 pacientes (43, 7%) tras primera CE y se reinició o modificó añadiendo nuevo FAE en 142 pacientes (32, 6%) con CE recurrentes. Conclusiones. Las características clínicas y la atención recibida de pacientes adultos con primera CE en SUH en España difieren de las recurrencias en epiléptico conocido. Objective. To describe the characteristics of care received by patients who come to the emergency department with a first epileptic seizure versus a recurrent seizure in a patient with diagnosed epilepsy. Methods. ACESUR (Acute Epileptic Seizures in the Emergency Department) is a prospective multicenter, multipurpose registry of cases obtained by systematic sampling on even days in February and July 2017 and on odd days in April and October 2017. Patients were aged 18 years or older and had an emergency department diagnosis of epileptic seizure. We recorded clinical variables and details related to care given during each patient''s visit, including whether the event was a first or recurrent seizure. Results. A total of 664 patients attended by 18 Spanish emergency departments were entered into the ACESUR registry. Two hundred twenty-nine (34.5%) were first seizures and 435 (65.5%) were recurrences. Patients who were attended for first seizures were older, consulted for a wider variety of reasons, and were transported in ambulances (P<.001, all comparisons). Care received differed between patients with first seizures versus recurrent seizures. Specific complementary testing was more likely in patients with first seizures (adjusted odds ratio [aOR], 13.94; 95% CI, 29-26.7; P<.001), and they were more often hospitalized or stayed longer in the emergency department, (aOR, 1.69; 95% CI, 1.11-2.58; P=.015). Pharmacologic treatment did not differ between the groups, either in the acute phase or for prevention (aOR, 1.40; 95% CI, 0.94-2.09; P=.096). Antiepileptic drugs were given to 100 patients (43.7%) after a first seizure and were restarted or changed in 142 patients with recurrent seizure (32.6%). Conclusions. The clinical characteristics of adults attended for a first epileptic seizure differ from those of patients with diagnosed epilepsy who were attended for recurrent seizures in Spain. The care received also differs

Effect of small doses of naloxone on sexual exhaustion in White New Zealand male rabbits

The objective of the present study was to determine the effect of small doses of naloxone on sexual exhaustion in White New Zealand male rabbits. Twelve young and 12 adult male rabbits 6-12 months old and 14-20 months of age, respectively, were selected from a commercial farm. Each male rabbit was housed individually in galvanized cages (90 cm x 60 cm x 40 cm). The rabbits were housed in an open shed exposed to natural photoperiod (12 L 12 D, 19°N). Daily temperature fluctuated through the year from 28 to 16°C. Humidity was 45 ± 5%. Water and food (rabbit chow PMI) was supplied ad libitum. After sexual behaviour for each studied group was established, the males were given a 6-day rest, and 3 days before next trial, six males of each group (treated) received a subcutaneous implant of 8 mg of naloxone in a crystalline nitrocellulose pellet formulated to be completely absorbed in 15 days. The remaining six males were sham-treated (control). At the end of the resting period as previously described, the sexual behavior of each group was studied and compared using a Mann-Whitney statistical U-test. The effect of naloxone on sexual behavior was analyzed with a Wilcoxon test for correlated samples. With regard to sexual activity between young and adult rabbits, it was observed that there was a significant difference between groups (P = 0.00275, Z = 2.8823, adjusted Z = 2.99.43) showing that younger rabbits mounted/ejaculated from 9 to 10 females compared with 6 to 8 mounted/ejaculated by older rabbits. When naloxone was administered to both groups, there was a significant difference when comparing sexual behavior before and after administration of naloxone (table first and second trial). Young rabbits treated with naloxone mounted/ejaculated 11-12 females while older rabbits mounted nine females before reaching sexual exhaustion. A significant difference was observed when comparing the number of estrous females that were mounted/ejaculated between groups. Environmental photoperiod and temperature changes were not considered. It was concluded that endogenous opioids are important modulators of behavioral and hormonal interactions related to sexual behavior. © 2005 Elsevier B.V. All rights reserved

Effect of small doses of naloxone on the pulsatile secretion of prolactin in the crossbreed ewe during the non-breeding season

The objective of this work was to study the effect of small doses of naloxone (Nx) on the pulsatile secretion of prolactin (Pr). For this purpose 12 crossbreed ewes were selected and allocated to three groups of four. Group 1 was treated with two injections (at 7 and 19 h) of 40 ?g of GnRH. Group 2 was treated with two i.m. injections (at 7 and 19 h) of 0.5 mg of naloxone. And the control group 3 was sham treated with injections of 3 ml saline. Blood samples were taken at 20 min intervals during six consecutive hours after injections. When ewes were treated at 7 h no significant changes were observed in concentrations of prolactin following treatment with GnRH. Values fluctuated between 200 and 210 ng/ml. In group 2 treated with naloxone there was no change in plasma Pr concentrations during the first 100 min of sampling, however 60 min after Nx treatment Pr decreased significantly (p < 0.01) and thereafter Pr plasma levels were consistently less (p < 0.001) than control and GnRH treated ewes for the duration of the experiment. The response of the three groups after the second injection (19 h): After the injection of GnRH plasma Pr levels followed much the same pattern observed after the initial treatment, Pr concentrations were similar to those of control ewes. Ewes treated with a second small dose of naloxone (0.5 mg i.m.) however, showed a decrease in plasma Pr 60 min after the administration of the endogenous opioid antagonist. Thereafter Nx treated ewes had lesser (p < 0.001) plasma Pr levels until the termination of the experiment. It was concluded that Nx an opioid antagonist administered in small intermittent doses can alter Pr plasma concentrations in the ewe, showing that endogenous opioids are important modulators of endocrine function and that the administration of small intermittent doses of opioid antagonists produce significant endocrine changes in ewes. � 2006 Elsevier B.V. All rights reserved

Effect of perinatal asphyxia and carbamazepine treatment on cortical dopamine and DOPAC levels

The objective of the present study was to determine the effect of small doses of naloxone on sexual exhaustion in White New Zealand male rabbits. Twelve young and 12 adult male rabbits 6-12 months old and 14-20 months of age, respectively, were selected from a commercial farm. Each male rabbit was housed individually in galvanized cages (90 cm x 60 cm x 40 cm). The rabbits were housed in an open shed exposed to natural photoperiod (12 L 12 D, 19 N). Daily temperature fluctuated through the year from 28 to 16°C. Humidity was 45 5%. Water and food (rabbit chow PMI) was supplied ad libitum. After sexual behaviour for each studied group was established, the males were given a 6-day rest, and 3 days before next trial, six males of each group (treated) received a subcutaneous implant of 8 mg of naloxone in a crystalline nitrocellulose pellet formulated to be completely absorbed in 15 days. The remaining six males were sham-treated (control). At the end of the resting period as previously described, the sexual behavior of each group was studied and compared using a Mann-Whitney statistical U-test. The effect of naloxone on sexual behavior was analyzed with a Wilcoxon test for correlated samples. With regard to sexual activity between young and adult rabbits, it was observed that there was a significant difference between groups (P = 0.00275, Z = 2.8823, adjusted Z = 2.99.43) showing that younger rabbits mounted/ejaculated from 9 to 10 females compared with 6 to 8 mounted/ejaculated by older rabbits. When naloxone was administered to both groups, there was a significant difference when comparing sexual behavior before and after administration of naloxone (table first and second trial). Young rabbits treated with naloxone mounted/ejaculated 11-12 females while older rabbits mounted nine females before reaching sexual exhaustion. A significant difference was observed when comparing the number of estrous females that were mounted/ejaculated between groups. Environmental photoperiod and temperature changes were not considered. It was concluded that endogenous opioids are important modulators of behavioral and hormonal interactions related to sexual behavior. " 2005 Elsevier B.V. All rights reserved.",,,,,,"10.1016/j.anireprosci.2005.02.006",,,"http://hdl.handle.net/20.500.12104/41003","http://www.scopus.com/inward/record.url?eid=2-s2.0-27744465846&partnerID=40&md5=7d67bb4da0e435bc9b35739411611e6

The dendritic tress of purkinje cells: A computer assisted analysis of HRP labeled neurons in organotypic cultures of kitten cerebellum

From a commercial flock, 15 prepuberal does of the Alpine breed were selected, body weight and age averaged 35.8 kg and 8 months, respectively. The experiment was carried out during the months of May and June when anoestrus is more incipient in this latitude (19 13'N). Feeding and handling was conventional with water ad libitum. In groups of 5 chosen at random, they were treated as follows: Group A was used as control, group B received an implant of 15 mg naloxone. And group C received an i.m. injection of 0.5 mg naloxone i.m. at 12 h intervals for 15 days. To observe the effect of this experimental treatment on the pattern of secretion of LH, on day 0 a blood sample (2 mL) was obtained through a cannulae implanted in the jugular vein every 20 min for 7 h continuous. Blood samples were allowed to coagulate at room temperature and thereafter, centrifuged at 2.500 rpm for 15 min; plasma was decanted into small plastic vials and stored frozen until LH assay was carried out. Blood samples were obtained on day 0, 5, 10, 15 and 20. Plasma concentration of LH was determined by RIA as previously reported. And the statistical analysis of LH concentrations was studied using a descriptive method followed by an inferential screening and a variance analysis. It was observed that the plasmatic concentrations of LH changed through time in all groups, changes were more pronounced in the naloxone treated animals as compared with the control group. It was observed that there was no significance on the interaction between treatment and the sampling day. An influence of time upon the plasmatic levels of LH was observed, showing a high degree of significance (f = 12.58 (4.44) p = 0.0000005). There was tendency of an increase in LH secretion through time observed in all groups. A large difference was detected when comparing plasma LH from the first 2 samples with samples obtained in days 10, 15 and 20 of the experiment. It was observed that the effect of naloxone through time did not show significant differences until after the second week of treatment. This results give further support of the important role that endogenous opioids on the control of reproduction of sheep. " Medwell Journals, 2009.",,,,,,,,,"http://hdl.handle.net/20.500.12104/45079","http://www.scopus.com/inward/record.url?eid=2-s2.0-67650641136&partnerID=40&md5=951c150ecaff0f36c69d53c9694641f9",,,,,,"4",,"Journal of Animal and Veterinary Advances",,"68

Sexual behavior of male New Zealand white rabbits in an intensive production unit.

Sexual behavior in the male white New Zealand rabbit in intensive production units is not fully documented. Therefore, the objective of this work was to provide further information about the sexual behavior of this species in intensive production systems. Fourteen 6- to 12-month-old rabbits were studied for 6 months (July/December) when housed individually under natural photoperiod (19 degrees latitude north). They were mated once a week. When mated they were exposed at 6-min intervals to five oestrous females. The number of mounts, time between mounts, time and number of ejaculations, time between ejaculations, and also enuresis, grasping and kicking were recorded. Mounts (n=222) were observed and recorded. Males mated one to five times during each evaluative session. Enuresis was present only in one observation. Sexual aggressiveness such as grasping and kicking was present during 142 and 133 matings. Time for mounting and ejaculation in accumulated means (minutes, seconds, tenths) from the first to the fifth mount were noted and an accumulative average of 4.20 min for the fifth mounting was noted. Minimum times for ejaculation and next mating was 00:17:00 min and maximum was 05:33:03 min. It was concluded that sexual behavior in white New Zealand male rabbits remained unchanged through the duration of the period of study

Sexual exhaustion in White New Zealand male rabbits of different ages

Sexual exhaustion was studied in hybrid White New Zealand rabbits of different ages, for this purpose six young rabbits from 6 to 12 months of age, and six adult rabbits of 14-20 months of age were selected. Sexually receptive females were taken to the male's cage, for a period of 4 min, if copulation was not performed, the observation was then considered finished. If the male mounted within this period of time, the mounted female was immediately replaced by another female and 4 min of exposure time to the male were reinitiated, and repetitions were conducted until the male that was being studied refused to mount a new female at which time the male was considered to be sexually exhausted. Young rabbits mounted and ejaculated 9-10 times before sexual exhaustion. Adult rabbits showed a fluctuation of between 6 and 8 mounts per ejaculations before refusing another mount. The statistical analysis with a Mann-Whitney U-test, showed that the Rank sum for group A was 57, while for group B was 21. The U-value was 0.0 and the adjusted Z -2.9943. A significant difference was observed between groups with a value of P = 0.00275. In the present study it was demonstrated that there is an influence of age on sexual behavior of rabbits. � 2002 Elsevier Science B.V. All rights reserved

Sexual behavior of male New Zealand white rabbits in an intensive production unit.

Sexual behavior in the male white New Zealand rabbit in intensive production units is not fully documented. Therefore, the objective of this work was to provide further information about the sexual behavior of this species in intensive production systems. Fourteen 6- to 12-month-old rabbits were studied for 6 months (July/December) when housed individually under natural photoperiod (19 degrees latitude north). They were mated once a week. When mated they were exposed at 6-min intervals to five oestrous females. The number of mounts, time between mounts, time and number of ejaculations, time between ejaculations, and also enuresis, grasping and kicking were recorded. Mounts (n=222) were observed and recorded. Males mated one to five times during each evaluative session. Enuresis was present only in one observation. Sexual aggressiveness such as grasping and kicking was present during 142 and 133 matings. Time for mounting and ejaculation in accumulated means (minutes, seconds, tenths) from the first to the fifth mount were noted and an accumulative average of 4.20 min for the fifth mounting was noted. Minimum times for ejaculation and next mating was 00:17:00 min and maximum was 05:33:03 min. It was concluded that sexual behavior in white New Zealand male rabbits remained unchanged through the duration of the period of study