Disfunción sinusal transitoria secundaria a tratamiento con lacosamida

The case of an 84-year-old female patient is presented, with a history of high blood pressure, dyslipidemia, chronic venous failure and osteoarthritis, which –due to trigeminal neuralgia– had received treatment with several drugs, without achieving neuropathic pain control; that was why the treatment with lacosamide was started in monotherapy, with an increase in dose until the therapeutic objective was achieved; but the patient presented clinical manifestations and electrocardiographic alterations compatible with sinus dysfunction, which were solved after reducing the dose of the drug.Se presenta el caso de una paciente de 84 años de edad, con antecedentes de hipertensión arterial, dislipemia, insuficiencia venosa crónica y osteoartrosis, que –debido a una neuralgia del trigémino– había recibido tratamiento con varios fármacos, sin lograr control del dolor neuropático, por lo que se inició tratamiento con lacosamida en monoterapia, con incremento de dosis hasta lograr el objetivo terapéutico; pero la paciente presentó manifestaciones clínicas y alteraciones electrocardiográficas compatibles con disfunción sinusal, que se resolvieron tras la reducción de la dosis del fármaco

Drug-resistant epilepsy in a patient with frontal oligodendroglioma and history of varicella encephalitis

INTRODUCTION: Drug-resistant epilepsy is considered when two tolerated antiepileptic drugs trials, appropriately chosen and adequately employed have failed, to achieve a sustained absence of seizures. This situation is more significant in patients with focal onset seizures and in seizures due to acquired causes.CLINICAL CASE: A male who was hospitalized at five years old for a clinical profile of fever, cephalea, vomiting, instability to the gait and difficulty standing, after suffering from a varicella rash seven days ago. Varicella zoster virus IgM was positive in serum. He was diagnosed with acute varicella encephalitis, and the evolution was favorable with an acyclovir treatment. Given this medical history, the patient began suffering from seizures at fourteen and a half years old. He was treated with several antiepileptics, for one and a half years until it was concluded that the epilepsy was drug-resistant. A cerebral MRI showed a 17 mm in diameter hyperintense lesion, irregular in shape, at the level of the right parasagittal frontal cortico-subcortical region, and was reported as compatible with varicella zoster residual glyosis. Since the patient was still having seizures, he was considered as a candidate for epilepsy surgery. The video electroencephalogram showed recruiting rhythms, which seemed to originate in the right frontal region. The lesionectomy was performed, and the anatomopathological piece was reported as NOS oligodendroglioma. At present, and after one year post surgery, the patient has been seizures free and is following a discontinuous pattern of antiepileptic treatment.CONCLUSION: The cause of the epilepsy was diagnosed in this patient, at first, with regard to the history of varicella zoster virus encephalitis, which can produce seizures as a consequence. Nevertheless in epilepsy, from clinical data, an electroencephalogram, a cerebral MRI and evolution, it must always make a differential diagnosis with other causes, among them long term evolution neoplasm.INTRODUCCIÓN: La epilepsia farmacorresistente se plantea cuando han fracasado dos ensayos de fármacos antiepilépticos tolerados, apropiadamente elegidos y empleados de forma adecuada, para conseguir la ausencia mantenida de crisis. Dicha situación es más significativa en las crisis de inicio focal y por causas adquiridas.CASO CLÍNICO: Varón que a los cinco años fue hospitalizado por fiebre, cefalea, vómitos, inestabilidad de la marcha y dificultad para la bipedestación, tras haber presentado erupción varicelosa hacía siete días. La serología en suero fue positiva para la IgM del virus varicela zóster. Se diagnosticó encefalitis aguda varicelosa y la evolución fue favorable con el tratamiento de aciclovir. Con este antecedente, a los catorce años se presentan crisis epilépticas. Se indicó tratamiento con diferentes antiepilépticos durante un año y medio hasta concluirlo como una epilepsia farmacorresistente. En el informe de las imágenes de resonancia magnética (IRM) cerebral se describió una lesión hiperintensa en la secuencia T2 a nivel frontal parasagital derecha cortico-subcortical de forma irregular de 17 mm de diámetro, informada como compatible con gliosis residual de encefalitis por varicela. Se consideró al paciente candidato a cirugía de epilepsia, solicitándosele vídeo-EEG que mostraba ritmos reclutantes que parecían originarse en la región frontal derecha. Se intervino quirúrgicamente realizándose lesionectomía y la pieza anatomo-patológica fue informada como oligodendroglioma NOS. El paciente está libre de crisis desde hace un año, y en pauta de lenta discontinuación del tratamiento antiepiléptico.CONCLUSIÓN: Este paciente al principio se diagnosticó la causa de la epilepsia en relación al antecedente de encefalitis viral por varicela, que puede producir como secuela crisis epilépticas. Sin embargo, en la epilepsia a partir de los datos clínicos, del EEG, las IRM de cerebro y la evolución se debe siempre realizar el diagnóstico diferencial con otras causas, y especialmente las neoplásicas de evolución lenta

Search for Bc+→π+μ+μ−B_c^+\to\pi^+\mu^+\mu^- decays and measurement of the branching fraction ratio B(Bc+→ψ(2S)π+)/B(Bc+→J/ψπ+){\cal B}(B_c^+\to\psi(2S)\pi^+)/{\cal B}(B_c^+\to J/\psi \pi^+)

International audienceThe first search for nonresonant $B_c^+\to\pi^+\mu^+\mu^-$ decays is reported. The analysis uses proton-proton collision data collected with the LHCb detector between 2011 and 2018, corresponding to an integrated luminosity of 9 fb$^{-1}$. No evidence for an excess of signal events over background is observed and an upper limit is set on the branching fraction ratio ${\cal B}(B_c^+\to\pi^+\mu^+\mu^-)/{\cal B}(B_c^+\to J/\psi \pi^+) < 2.1\times 10^{-4}$ at $90\%$ confidence level. Additionally, an updated measurement of the ratio of the $B_c^+\to\psi(2S)\pi^+$ and $B_c^+\to J/\psi \pi^+$ branching fractions is reported. The ratio ${\cal B}(B_c^+\to\psi(2S)\pi^+)/{\cal B}(B_c^+\to J/\psi \pi^+)$ is measured to be $0.254\pm 0.018 \pm 0.003 \pm 0.005$, where the first uncertainty is statistical, the second systematic, and the third is due to the uncertainties on the branching fractions of the leptonic $J/\psi$ and $\psi(2S)$ decays. This measurement is the most precise to date and is consistent with previous LHCb results

Studies of η\eta and η′\eta' production in pppp and ppPb collisions

The production of $\eta$ and $\eta'$ mesons is studied in proton-proton and proton-lead collisions collected with the LHCb detector. Proton-proton collisions are studied at center-of-mass energies of $5.02$ and $13~{\rm TeV}$, and proton-lead collisions are studied at a center-of-mass energy per nucleon of $8.16~{\rm TeV}$. The studies are performed in center-of-mass rapidity regions $2.5 < y_{c.m.} < 3.5$ (forward rapidity) and $-4.0 < y_{c.m.}<-3.0$ (backward rapidity) defined relative to the proton beam direction. The $\eta$ and $\eta'$ production cross sections are measured differentially as a function of transverse momentum for $1.5 < p_{T}<10~{\rm GeV}$ and $3 < p_{T}<10~{\rm GeV}$, respectively. The differential cross sections are used to calculate nuclear modification factors. The nuclear modification factors for $\eta$ and $\eta'$ mesons agree at both forward and backward rapidity, showing no significant evidence of mass dependence. The differential cross sections of $\eta$ mesons are also used to calculate $\eta/\pi^0$ cross section ratios, which show evidence of a deviation from the world average. These studies offer new constraints on mass-dependent nuclear effects in heavy-ion collisions, as well as $\eta$ and $\eta'$ meson fragmentation.The production of $\eta$ and $\eta'$ mesons is studied in proton-proton and proton-lead collisions collected with the LHCb detector. Proton-proton collisions are studied at center-of-mass energies of $5.02$ and $13~{\rm TeV}$, and proton-lead collisions are studied at a center-of-mass energy per nucleon of $8.16~{\rm TeV}$. The studies are performed in center-of-mass rapidity regions $2.5<y_{\rm c.m.}<3.5$ (forward rapidity) and $-4.0<y_{\rm c.m.}<-3.0$ (backward rapidity) defined relative to the proton beam direction. The $\eta$ and $\eta'$ production cross sections are measured differentially as a function of transverse momentum for $1.5<p_{\rm T}<10~{\rm GeV}$ and $3<p_{\rm T}<10~{\rm GeV}$, respectively. The differential cross sections are used to calculate nuclear modification factors. The nuclear modification factors for $\eta$ and $\eta'$ mesons agree at both forward and backward rapidity, showing no significant evidence of mass dependence. The differential cross sections of $\eta$ mesons are also used to calculate $\eta/\pi^0$ cross section ratios, which show evidence of a deviation from the world average. These studies offer new constraints on mass-dependent nuclear effects in heavy-ion collisions, as well as $\eta$ and $\eta'$ meson fragmentation

Measurement of the Branching Fraction of B0→J/ψπ0B^{0} \rightarrow J/\psi \pi^{0} Decays

International audienceThe ratio of branching fractions between $B^{0} \rightarrow J/\psi \pi^{0}$ and $B^{+} \rightarrow J/\psi K^{*+}$ decays is measured with proton-proton collision data collected by the LHCb experiment, corresponding to an integrated luminosity of 9 fb$^{-1}$. The measured value is $\frac{\mathcal{B}_{B^{0} \rightarrow J/\psi \pi^{0}}}{\mathcal{B}_{B^{+} \rightarrow J/\psi K^{*+}}} = (1.153 \pm 0.053 \pm 0.048 ) \times 10^{-2}$, where the first uncertainty is statistical and the second is systematic. The branching fraction for $B^{0} \rightarrow J/\psi \pi^{0}$ decays is determined using the branching fraction of the normalisation channel, resulting in $\mathcal{B}_{B^{0} \rightarrow J/\psi \pi^{0}} = (1.670 \pm 0.077 \pm 0.069 \pm 0.095) \times 10^{-5}$, where the last uncertainty corresponds to that of the external input. This result is consistent with the current world average value and competitive with the most precise single measurement to date

Amplitude analysis and branching fraction measurement of B+→D∗−Ds+π+B^{+}\to D^{*-}D^{+}_{s}\pi^{+} decays

International audienceThe decays of the $B^{+}$ meson to the final state $D^{*-}D^{+}_{s}\pi^{+}$ are studied in proton-proton collision data collected with the LHCb detector at centre-of-mass energies of 7, 8, and 13 TeV, corresponding to a total integrated luminosity of 9 fb$^{-1}$. The ratio of branching fractions of the $B^{+}\to D^{*-}D^{+}_{s}\pi^{+}$ and $B^{0}\to D^{*-}D^{+}_{s}$ decays is measured to be $0.173\pm 0.006\pm 0.010$, where the first uncertainty is statistical and the second is systematic. Using partially reconstructed $D^{*+}_{s}\to D^{+}_{s}\gamma$ and $D^{+}_{s}\pi^{0}$ decays, the ratio of branching fractions between the $B^{+}\to D^{*-}D^{*+}_{s}\pi^{+}$ and $B^{+}\to D^{*-}D^{+}_{s}\pi^{+}$ decays is determined as $1.31\pm 0.07\pm 0.14$. An amplitude analysis of the $B^{+}\to D^{*-}D^{+}_{s}\pi^{+}$ decay is performed for the first time, revealing dominant contributions from known excited charm resonances decaying to the $D^{*-}\pi^{+}$ final state. No significant evidence of exotic contributions in the $D^{+}_{s}\pi^{+}$ or $D^{*-}D^{+}_{s}$ channels is found. The fit fraction of the scalar state $T_{c\bar{s} 0}^{\ast}(2900)^{++}$ observed in the $B^{+}\to D^{-}D^{+}_{s}\pi^{+}$ decay is determined to be less than 2.3% at a 90% confidence level

Helium identification with LHCb

International audienceThe identification of helium nuclei at LHCb is achieved using a method based on measurements of ionisation losses in the silicon sensors and timing measurements in the Outer Tracker drift tubes. The background from photon conversions is reduced using the RICH detectors and an isolation requirement. The method is developed using $pp$ collision data at $\sqrt{s}=13\,{\rm TeV}$ recorded by the LHCb experiment in the years 2016 to 2018, corresponding to an integrated luminosity of $5.5\,{\rm fb}^{-1}$. A total of around $10^5$ helium and antihelium candidates are identified with negligible background contamination. The helium identification efficiency is estimated to be approximately $50\%$ with a corresponding background rejection rate of up to $\mathcal O(10^{12})$. These results demonstrate the feasibility of a rich programme of measurements of QCD and astrophysics interest involving light nuclei

Enhanced production of Λb0\Lambda_{b}^{0} baryons in high-multiplicity pppp collisions at s=13\sqrt{s} = 13 TeV

International audienceThe production rate of $\Lambda_{b}^{0}$ baryons relative to $B^{0}$ mesons in $pp$ collisions at a center-of-mass energy $\sqrt{s} = 13$ TeV is measured by the LHCb experiment. The ratio of $\Lambda_{b}^{0}$ to $B^{0}$ production cross-sections shows a significant dependence on both the transverse momentum and the measured charged-particle multiplicity. At low multiplicity, the ratio measured at LHCb is consistent with the value measured in $e^{+}e^{-}$ collisions, and increases by a factor of $\sim2$ with increasing multiplicity. At relatively low transverse momentum, the ratio of $\Lambda_{b}^{0}$ to $B^{0}$ cross-sections is higher than what is measured in $e^{+}e^{-}$ collisions, but converges with the $e^{+}e^{-}$ ratio as the momentum increases. These results imply that the evolution of heavy $b$ quarks into final-state hadrons is influenced by the density of the hadronic environment produced in the collision. Comparisons with a statistical hadronization model and implications for the mechanisms enforcing quark confinement are discussed

Charge-dependent curvature-bias corrections using a pseudomass method

International audienceMomentum measurements for very high momentum charged particles, such as muons from electroweak vector boson decays, are particularly susceptible to charge-dependent curvature biases that arise from misalignments of tracking detectors. Low momentum charged particles used in alignment procedures have limited sensitivity to coherent displacements of such detectors, and therefore are unable to fully constrain these misalignments to the precision necessary for studies of electroweak physics. Additional approaches are therefore required to understand and correct for these effects. In this paper the curvature biases present at the LHCb detector are studied using the pseudomass method in proton-proton collision data recorded at centre of mass energy $\sqrt{s}=13$ TeV during 2016, 2017 and 2018. The biases are determined using $Z\to\mu^+\mu^-$ decays in intervals defined by the data-taking period, magnet polarity and muon direction. Correcting for these biases, which are typically at the $10^{-4}$ GeV$^{-1}$ level, improves the $Z\to\mu^+\mu^-$ mass resolution by roughly 20% and eliminates several pathological trends in the kinematic-dependence of the mean dimuon invariant mass