Prenatal Stress and Risk of Febrile Seizures in Children: A Nationwide Longitudinal Study in Denmark

We aimed to examine whether exposure to prenatal stress following maternal bereavement is associated with an increased risk of febrile seizures. In a longitudinal population-based cohort study, we followed 1,431,175 children born in Denmark. A total of 34,777 children were born to women who lost a close relative during pregnancy or within 1 year before the pregnancy and they were included in the exposed group. The exposed children had a risk of febrile seizures similar to that of the unexposed children (hazard ratio (HR) 1.00, 95% CI 0.94–1.06). The HRs did not differ according to the nature or timing of bereavement. Our data do not suggest any causal link between exposure to prenatal stress and febrile seizures in childhood

The Staphylococcus aureus Protein Sbi Acts as a Complement Inhibitor and Forms a Tripartite Complex with Host Complement Factor H and C3b

The Gram-positive bacterium Staphylococcus aureus, similar to other pathogens, binds human complement regulators Factor H and Factor H related protein 1 (FHR-1) from human serum. Here we identify the secreted protein Sbi (Staphylococcus aureus binder of IgG) as a ligand that interacts with Factor H by a—to our knowledge—new type of interaction. Factor H binds to Sbi in combination with C3b or C3d, and forms tripartite Sbi∶C3∶Factor H complexes. Apparently, the type of C3 influences the stability of the complex; surface plasmon resonance studies revealed a higher stability of C3d complexed to Sbi, as compared to C3b or C3. As part of this tripartite complex, Factor H is functionally active and displays complement regulatory activity. Sbi, by recruiting Factor H and C3b, acts as a potent complement inhibitor, and inhibits alternative pathway-mediated lyses of rabbit erythrocytes by human serum and sera of other species. Thus, Sbi is a multifunctional bacterial protein, which binds host complement components Factor H and C3 as well as IgG and β2-glycoprotein I and interferes with innate immune recognition

High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo

Background: An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. The objective of this study was to determine the prevalence of epilepsy in onchocerciasis endemic areas in the Democratic Republic of the Congo (DRC) and investigate whether a higher annual intake of Ivermectin was associated with a lower prevalence of epilepsy. Methodology/Principle findings: Between July 2014 and February 2016, house-to-house epilepsy prevalence surveys were carried out in areas with a high level of onchocerciasis endemicity: 3 localities in the Bas-Uele, 24 in the Tshopo and 21 in the Ituri province. Ivermectin uptake was recorded for every household member. This database allowed a matched case-control pair subset to be created that enabled putative risk factors for epilepsy to be tested using univariate logistic regression models. Risk factors relating to onchocerciasis were tested using a multivariate random effects model. To identify presence of clusters of epilepsy cases, the Kulldorff's scan statistic was used. Of 12, 408 people examined in the different health areas 407 (3.3%) were found to have a history of epilepsy. A high prevalence of epilepsy was observed in health areas in the 3 provinces: 6.8–8.5% in Bas-Uele, 0.8–7.4% in Tshopo and 3.6–6.2% in Ituri. Median age of epilepsy onset was 9 years, and the modal age 12 years. The case control analysis demonstrated that before the appearance of epilepsy, compared to the same life period in controls, persons with epilepsy were around two times less likely (OR: 0.52; 95%CI: (0.28, 0.98)) to have taken Ivermectin than controls. After the appearance of epilepsy, there was no difference of Ivermectin intake between cases and controls. Only in Ituri, a significant cluster (p-value = 0.0001) was identified located around the Draju sample site area. Conclusions: The prevalence of epilepsy in health areas in onchocerciasis endemic regions in the DRC was 2–10 times higher than in non-onchocerciasis endemic regions in Africa. Our data suggests that Ivermectin protects against epilepsy in an onchocerciasis endemic region. However, a prospective population based intervention study is needed to confirm this

Eficácia da fonoterapia em disfagia neurogênica usando a escala funcional de ingestão por via oral (FOIS) como marcador Efficacy of speech therapy in neurogenic dysphagia using functional oral intake scale (FOIS) as a parameter

OBJETIVO: avaliar a eficácia da fonoterapia e a interferência dos fatores de risco para disfagia no atendimento de pacientes adultos internados com doença neurológica e sintoma de disfagia, tendo a escala funcional de ingestão por via oral como marcador da progressão segura da dieta por via oral. MÉTODOS: foi realizado estudo retrospectivo de 49 prontuários de pacientes com disfagia neurogênica, atendidos em fonoterapia no leito hospitalar e comparada a escala de ingestão de alimentação por via oral antes e depois da terapia - FOIS, (mede a quantidade e tipo de alimento que o paciente consegue ingerir por via oral de forma segura). Foram estudados também possíveis fatores de interferência na melhora via ingestão oral na fonoterapia como: doença de base, idade, condições respiratórias, condições clínicas, estado de consciência, tempo de terapia e número de sessões. RESULTADOS: dos 49 pacientes, 36 apresentaram melhora na FOIS após a fonoterapia. Quanto aos possíveis fatores de interferência nessa melhora, foram constatados: a piora clínica do doente, as intercorrências clínicas e o rebaixamento do nível de consciência, como estatisticamente significantes para a não evolução em fonoterapia visando à ingestão de alimentos por via oral. Os outros fatores analisados como: doença de base, idade, condições respiratórias, tempo e numero de sessões não demonstraram significância estatística, sugerindo não interferir na melhora ou piora do paciente. CONCLUSÃO: observa-se melhora efetiva da ingestão de alimentos por via oral nos pacientes com disfagia neurogênica atendidos em ambiente hospitalar em fonoterapia, salvo se apresentarem intercorrências clínicas e rebaixamento do nível de consciência durante o processo.<br>PURPOSE: to evaluate efficacy of speech therapy treatments and the interference of risk factors in adult patients admitted to the wards with neurological diseases and symptoms of dysphagia, using the functional oral intake scale as parameter of safe progression for oral feeding. METHODS: We carried out a retrospective study on forty-nine patients with neurogenic dysphagia under speech therapy sessions while in the wards and a comparison between the results of the functional oral intake scale before and after the therapy sessions(measuring the amount and type of orally-taken food in a safe manner by the patients). Possible factors affecting the therapy such as etiology of the neurologic disease, age, respiratory and clinical conditions, alertness, time and duration of the therapy sessions were studied. RESULTS: over the 49 studied patients, 36 showed improvement in the FOIS after speech therapy sessions. Regarding possible factors affecting the therapy, statistical analysis showed that deterioration of clinical condition, clinical intercurrences and decreased level of alertness were significant factors for the lack of progress to oral feeding during the speech therapy sessions. The other factors, etiology of disease, age, respiratory condition, time and number of sessions, did not demonstrate statistical significance. However, they did not interfere in improving or worsening the patients' clinical condition. CONCLUSION: there is an effective improvement in feeding by oral intake in patients with neurogenic dysphagia being treated by speech therapy sessions in the hospital wards. However, it cannot be achieved if the patient shows clinical intercurrences and decreased alertness level