Sudden unexpected death in an adolescent with epilepsy: All roads lead to the heart?

The incidence of sudden unexpected death in epilepsy (SUDEP) has been estimated from 0.5-1.4/1,000 person-years in people with treated epilepsy, and 9/1,000 person-years in candidates for epilepsy surgery. Potential risk factors for SUDEP include: age, early onset of epilepsy, duration of epilepsy, uncontrolled seizures, seizure type and winter temperatures. The arrythmogenic side-effect of antiepileptic drugs and seizures may increase the risk of SUDEP. In this report, we describe a patient with prolonged post-ictal tachycardia in EEG video recordings with a typical case of SUDEP: a 16-year-old boy with medically intractable complex partial seizures. Magnetic resonance imaging revealed left mesial temporal sclerosis. During non-invasive video-EEG monitoring, the patient presented a post-ictal heart rate increased for five hours. Two months after video-EEG, he died from SUDEP during a tonic-clonic secondary generalized seizure. The possibility of cardiac involvement in the pathogenesis of SUDEP has been suggested by many studies. Evaluation of this patient with EEG-video monitoring, including measurement of heart rate, contributed to an identification of ictal tachycardia that may have played a role in the SUDEP. Premature mortality seems to be increased in patients with epilepsy, and cardiac abnormalities may be a possible cause of SUDEP. (Cardiol J 2011; 18, 2: 194-196

Antimicrobial activity of per acetic acid for trans-operative disinfection of endodontic files

Reducing the accumulation of microorganisms on an endodontic file during endodontic treatment is important to limit recontamination of the root canal and increase likelihood of successful treatment outcome. Objective: To compare the antimicrobial activity of peracetic acid (PA), isopropyl alcohol and acetone against a range of bacteria and also for disinfection of contaminated endodontic K-files. Material and Methods: Antimicrobial activities of PA, isopropyl alcohol and acetone were compared against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, vancomycin resistant E. faecalis (VRE) and meticillin resistant S. aureus (MRSA), using minimum bactericidal concentration (MBC) and time-kill assays. Test solutions at different exposure times (15 s and 30 s) were assessed for treatment of endodontic files acting as carriers of E. faecalis-contaminated dental debris. Results: All bacteria were susceptible to PA (MBC range 0.25-1%), acetone (MBC range 50-60%) and isopropyl alcohol (30-40%). Using a time-kill assay of the antimicrobials at the determined MBC, all test microorganisms, with the exception of E. faecalis (VRE) 7766 were killed after 15 s exposure. In the case of E. faecalis 7766, viable cells remained detectable after 120 s exposure to acetone. Testing disinfection of endodontic K-files, previously coated with dental debris containing E. faecalis, it was found that PA (2%) completely killed E. faecalis after 15 s exposure. However, even after 30 s exposure, isopropyl alcohol (80%) and acetone (80%) had limited disinfecting activity. Conclusion: Extrapolation of these results to clinical practice would suggest that PA would be the most effective agent for trans-operative disinfection of endodontic K-files during treatment of a single patient

Confirmation of the utility of the International Staging System and identification of a unique pattern of disease in Brazilian patients with multiple myeloma

Santa Casa São Paulo, São Paulo, BrazilUniv Fed Rio de Janeiro, Rio de Janeiro, BrazilUniv São Paulo, São Paulo, BrazilHEMOPE, Recife, PE, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniv Fed Bahia, BR-41170290 Salvador, BA, BrazilHosp Brigadeiro São Paulo, São Paulo, BrazilUniv Fed Rio Grande do Sul, BR-90046900 Porto Alegre, RS, BrazilSch Med, Ribeirao Preto, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilUniv Fed Parana, BR-80060000 Curitiba, Parana, BrazilUniv Estadual Campinas, BR-13081970 Campinas, SP, BrazilInst Nacl Canc Rio Janeiro, Rio de Janeiro, BrazilCanc Res & Biostat, Seattle, WA USACedars Sinai Outpatient Canc Ctr, Aptium Oncol Inc, Los Angeles, CA USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Alternatives for the treatment of schistosomiasis: physico-chemical characterization of an inclusion complex between praziquantel and hydroxypropyl-β-cyclodextrin

O praziquantel (PZQ) é o fármaco de escolha no tratamento da esquistossomose. Porém, ele apresenta baixa solubilidade aquosa, o que pode limitar a sua biodisponibilidade no organismo. Para contornar estas características foi feita a inclusão da molécula do PZQ em hidroxipropil-beta-ciclodextrina (HP-β-CD). Desta forma, o objetivo deste trabalho foi preparar e caracterizar o complexo de inclusão PZQ/HP-β-CD. Estudos morfológicos, espectroscópicos e de calorimetria diferencial de varredura, demonstraram os primeiros indícios da interação hóspede/hospedeiro. Analisando a cinética de incorporação da molécula de PZQ na cavidade da HP-β-CD, pode-se determinar a constante cinética, além do tempo para equilíbrio do sistema. Utilizando-se isoterma de solubilidade foi possível observar que a interação com HP-β-CD aumentou a solubilidade aquosa do PZQ em 2,4 vezes. Ensaios de citotoxicidade in vitro, utilizando fibroblastos, demonstraram não haver indícios de toxicidade para estas células, nas concentrações testadas. Os resultados indicam que há um potencial favorável da aplicação deste fármaco na forma complexada em HP-β-CD.Colegio de Farmacéuticos de la Provincia de Buenos Aire

MALDI-TOF MS Enables the Rapid Identification of the Major Molecular Types within the Cryptococcus neoformans/C. gattii Species Complex

BACKGROUND: The Cryptococcus neoformans/C. gattii species complex comprises two sibling species that are divided into eight major molecular types, C. neoformans VNI to VNIV and C. gattii VGI to VGIV. These genotypes differ in host range, epidemiology, virulence, antifungal susceptibility and geographic distribution. The currently used phenotypic and molecular identification methods for the species/molecular types are time consuming and expensive. As Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF MS) offers an effective alternative for the rapid identification of microorganisms, the objective of this study was to examine its potential for the identification of C. neoformans and C. gattii strains at the intra- and inter-species level. METHODOLOGY: Protein extracts obtained via the formic acid extraction method of 164 C. neoformans/C. gattii isolates, including four inter-species hybrids, were studied. RESULTS: The obtained mass spectra correctly identified 100% of all studied isolates, grouped each isolate according to the currently recognized species, C. neoformans and C. gattii, and detected potential hybrids. In addition, all isolates were clearly separated according to their major molecular type, generating greater spectral differences among the C. neoformans molecular types than the C. gattii molecular types, most likely reflecting a closer phylogenetic relationship between the latter. The number of colonies used and the incubation length did not affect the results. No spectra were obtained from intact yeast cells. An extended validated spectral library containing spectra of all eight major molecular types was established. CONCLUSIONS: MALDI-TOF MS is a rapid identification tool for the correct recognition of the two currently recognized human pathogenic Cryptococcus species and offers a simple method for the separation of the eight major molecular types and the detection of hybrid strains within this species complex in the clinical laboratory. The obtained mass spectra provide further evidence that the major molecular types warrant variety or even species status

Relationship between functional fitness, medication costs and mood in elderly people

Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt

Functional markers for gene mapping and genetic diversity studies in sugarcane

<p>Abstract</p> <p>Background</p> <p>The database of sugarcane expressed sequence tags (EST) offers a great opportunity for developing molecular markers that are directly associated with important agronomic traits. The development of new EST-SSR markers represents an important tool for genetic analysis. In sugarcane breeding programs, functional markers can be used to accelerate the process and select important agronomic traits, especially in the mapping of quantitative traits loci (QTL) and plant resistant pathogens or qualitative resistance loci (QRL). The aim of this work was to develop new simple sequence repeat (SSR) markers in sugarcane using the sugarcane expressed sequence tag (SUCEST database).</p> <p>Findings</p> <p>A total of 365 EST-SSR molecular markers with trinucleotide motifs were developed and evaluated in a collection of 18 genotypes of sugarcane (15 varieties and 3 species). In total, 287 of the EST-SSRs markers amplified fragments of the expected size and were polymorphic in the analyzed sugarcane varieties. The number of alleles ranged from 2-18, with an average of 6 alleles per locus, while polymorphism information content values ranged from 0.21-0.92, with an average of 0.69. The discrimination power was high for the majority of the EST-SSRs, with an average value of 0.80. Among the markers characterized in this study some have particular interest, those that are related to bacterial defense responses, generation of precursor metabolites and energy and those involved in carbohydrate metabolic process.</p> <p>Conclusions</p> <p>These EST-SSR markers presented in this work can be efficiently used for genetic mapping studies of segregating sugarcane populations. The high Polymorphism Information Content (PIC) and Discriminant Power (DP) presented facilitate the QTL identification and marker-assisted selection due the association with functional regions of the genome became an important tool for the sugarcane breeding program.</p