Predisposition To Metabolic Acidosis Induced By Topiramate.

Metabolic acidosis induced by topiramate is a well documented but infrequent adverse event. The objective was to demonstrate the lowering of carbon dioxide serum levels, which is usually asymptomatic but may facilitate the occurrence of metabolic acidosis in patients using topiramate. We evaluated, prospectively, the carbon dioxide serum levels of 18 patients seen at the epilepsy clinic of our university hospital, before and 3 months after introducing topiramate. Five patients were female and 13 were male, age ranging from 2 to 16 years old (mean=9. 3). Carbon dioxide mean serum levels were 25 and 21.2 mmol/L (normal = 22 to 30), before and 3 months after introducing topiramate, respectively. Dose ranged from 2.08 to 11.76 mg/kg/day (mean=6. 7mg/kg/day). Adverse events were anorexia, nausea and somnolence. We conclude that the lowering of carbon dioxide serum levels induced by topiramate is mostly asymptomatic, but may facilitate the occurrence of metabolic acidosis. Since patients in use of topiramate have refractory epilepsy, they may need epilepsy surgery, and must be carefully monitored for the risk of metabolic acidosis during surgery.581021-

La régulation des plateformes dans le secteur du transport de passagers au Portugal et en Espagne: Stratégies différentes, coalitions différentes

Digital Platform Work (DPW) is part of a new phase of capitalism, in which monopolistic digital platforms use algorithms to mediate labour supply and demand. As DPW grows, the share of atypical workers in the labour market increases and European Union states are pressed to regulate it, but the strategies adopted are different. This is the case with the regulation of DPW in the passenger transport sector approved by the governments of Portugal and Spain. This paper makes a comparative analysis of these case studies based on parliamentary debates and media reports. We argue that the centre-left parties which led the governments in both countries, adopted a distinct regulation strategy because they each have specific conceptions of solidarity.info:eu-repo/semantics/publishedVersio

Public Awareness And Attitudes Toward Epilepsy In Different Social Segments In Brazil.

To assess public awareness and attitudes toward epilepsy in Brazilians of different cultural and socioeconomic backgrounds. Several studies have examined public awareness and attitudes toward epilepsy in various countries but there are no equivalent data for Brazil or South America. We have applied the survey proposed by Caveness and Gallup, with some modifications and adaptations to four groups (I-IV) of subjects: I--105 individuals accompanying patients to the Ophthalmologic outpatient clinic of the Hospital das Clínicas of the State University of Campinas (UNICAMP); II--93 students recently admitted to medical and nursing school; III--101 senior non-medical students; and IV--69 senior medical students. Group II, III, and IV were students at UNICAMP. Individuals with a low socioeconomic standing had a poor profile of familiarity, knowledge and attitudes toward epilepsy. The pre-university and university students had a relatively good profile when compared to the published international polls. Senior medical students had an excellent level of familiarity and knowledge, but showed no change in their objection to having a son or a daughter marry an epileptic person. Our data suggest that there is a clear-cut relationship between the level of education and the individual's familiarity and attitudes toward epilepsy. Effective elimination of the prejudice toward epilepsy requires specific training and not just general, superficial information about the condition.5632-

Late Onset Temporal Lobe Epilepsy With Mri Evidence Of Mesial Temporal Sclerosis Following Acute Neurocysticercosis: Case Report.

The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with albendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T2 signal in this patient has not, to date, been associated with a poor seizure control. This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE.59255-

Peripartum Cardiomyopathy. Post Partum Cardiorespiratory Arrest Complicated by Placental Accretism

Peripartum cardiomiopathy is a rare and life-threatening cardiac disease that affects young women previously healthy, during the peripartum period. It is a form of dilated cardiomyopathy with left-sided systolic dysfunction, which may lead to symptoms and signs of congestive heart failure. The exclusion diagnosis is based essentially on clinical presentation and initial symptoms may mimic physiologic alterations of pregnancy. The authors present a case of a 34 week multiple gestation with a growth restriction of one of the fetus and with a suspicion of a mild pre-eclampsia, motive by which we decided labour induction. During placental expulsion, in which we noticed difficulty in finding placental cleavage, the patient presented an assistoly, recovering after cardiorespiratory reanimation. However, the profuse bleeding after labour leaded to a life saving hysterectomy. Histological examination revealed placenta accreta. The echocardiography performed post-operatively diagnosed a dilated cardiomyopathy

Coccolithophore fluxes in the open tropical North Atlantic: influence of thermocline depth, Amazon water, and Saharan dust

Coccolithophores are calcifying phytoplankton and major contributors to both the organic and inorganic oceanic carbon pumps. Their export fluxes, species composition, and seasonal patterns were determined in two sediment trap moorings (M4 at 12 degrees N, 49 degrees W and M2 at 14 degrees N, 37 degrees W) collecting settling particles synchronously from October 2012 to November 2013 at 1200 m of water depth in the open equatorial North Atlantic. The two trap locations showed a similar seasonal pattern in total coccolith export fluxes and a predominantly tropical coccolithophore settling assemblage. Species fluxes were dominated throughout the year by lower photic zone (LPZ) taxa (Florisphaera profunda, Gladiolithus flabellatus) but also included upper photic zone (UPZ) taxa (Umbellosphaera spp., Rhabdosphaera spp., Umbilicosphaera spp., Helicosphaera spp.). The LPZ flora was most abundant during fall 2012, whereas the UPZ flora was more important during summer. In spite of these similarities, the western part of the study area produced persistently higher fluxes, averaging 241 x 10(7) +/- 76 x 10(7) coccoliths m(-2) d(-1) at station M4 compared to only 66 x 10(7) +/- 31 x 10(7) coccoliths m(-2) d(-1) at station M2. Higher fluxes at M4 were mainly produced by the LPZ species, favoured by the westward deepening of the thermocline and nutricline. Still, most UPZ species also contributed to higher fluxes, reflecting enhanced productivity in the western equatorial North Atlantic. Such was the case of two marked flux peaks of the more opportunistic species Gephyrocapsa muellerae and Emiliania huxleyi in January and April 2013 at M4, indicating a fast response to the nutrient enrichment of the UPZ, probably by wind-forced mixing. Later, increased fluxes of G. oceanica and E. huxleyi in October-November 2013 coincided with the occurrence of Amazon-River-affected surface waters. Since the spring and fall events of 2013 were also accompanied by two dust flux peaks, we propose a scenario in which atmospheric dust also provided fertilizing nutrients to this area. Enhanced surface buoyancy associated with the river plume indicates that the Amazon acted not only as a nutrient source, but also as a surface density retainer for nutrients supplied from the atmosphere. Nevertheless, lower total coccolith fluxes during these events compared to the maxima recorded in November 2012 and July 2013 indicate that transient productivity by opportunistic species was less important than "background" tropical productivity in the equatorial North Atlantic. This study illustrates how two apparently similar sites in the tropical open ocean actually differ greatly in ecological and oceanographic terms. The results presented here provide valuable insights into the processes governing the ecological dynamics and the downward export of coccolithophores in the tropical North Atlantic.Netherlands Organization for Scientific Research (NWO) [822.01.008]; European Research Council (ERC) [311152]; University of Bremen; European Union [600411]info:eu-repo/semantics/publishedVersio

De Novo Psychogenic Seizures After Epilepsy Surgery: Case Report.

The occurrence of de novo psychogenic seizures after epilepsy surgery is rare, and is estimated in 1.8% to 3.6%. Seizures after epilepsy surgery should be carefully evaluated, and de novo psychogenic seizures should be considered especially when there is a change in the ictal semiology. We report a patient with de novo psychogenic seizures after anterior temporal lobe removal for refractory temporal lobe epilepsy. Once psychogenic seizures were diagnosed and psychiatric treatment was started, seizures stopped.58535-

Sexual Dysfunction In Epilepsy: Identifying The Psychological Variables.

In order to evaluate the psychological variables that affect sexual dysfunction (SD) in epilepsy, where compared 60 epileptics (Group 1) with 60 healthy individuals (Group 2), through the State-Trait Anxiety Inventory (Spielberger et al., 1970), Beck Depression Inventory (Beck, 1974) and Sexual Behavior Interview (Souza, 1995). Sexual dysfunction (SD), anxiety and depression were found more frequently in Group 1 than in Group 2 and were not related to sex. Variables such as the onset duration and frequency of seizures as well as the use to medication were not associated with SD. Temporal lobe epilepsy was related to SD (p = 0.035) but not to anxiety or depression. Anxiety and depression were related to SD in both groups. Perception in controlling the seizures was closely related to anxiety (p = 0) and depression (p = 0.009). We conclude that psychological factors play an important role in the alteration of sexual behavior in epileptics and that suitable attention must be given to the control of these variables.58214-2

Dark matter from cosmic defects on galactic scales?

We discuss the possible dynamical role of extended cosmic defects on galactic scales, specifically focusing on the possibility that they may provide the dark matter suggested by the classical problem of galactic rotation curves. We emphasize that the more standard defects (such as Goto-Nambu strings) are unsuitable for this task, but show that more general models (such as transonic wiggly strings) could in principle have a better chance. In any case, we show that observational data severely restricts any such scenarios.Comment: Submitted to Phys. Rev. D (Brief Reports). v2: Reference added and some typos corrected, matches published versio