Cysticidal Therapy: Impact On Seizure Control In Epilepsy Associated With Neurocysticercosis

Objective: To evaluate the clinical features and seizure control of epilepsy related to neurocysticercosis. Method: 18 patients with partial epilepsy and neurocysticercosis were treated with albendazol or praziquantel and followed from 3 months to 12 years. We analyzed results from the CSF exam, interietal electroencephalogram (EEG), head computerized tomography and/or magnetic resonance imaging. Results: The patients' mean age was 36.4 years. The mean duration of epilepsy was 16 years. 83% patients had simple partial seizures ; 17% had complex partial seizures. All patients underwent routine EEGs: 62% had abnormalities and 38% were normal. A relationship was observed between focal EEG abnormality and the location of cyst in 28% of the patients. The CSF exams showed pleocytosis in 33% of the patients, and 28% had elevated protein levels. Only 22% of patients had positive titer for cysticercosis in the CSF. In all patients who had somatosensory and special sensory seizures there was a relationship between location of the cysts and seizure semiology (n=11). After cysticidal therapy, 83% patients had a significant improvement in controlling seizures. Conclusion: In this group, we found a predominance of simple partial seizures and a relationship between somatosensory and special sensory seizures and the location of the cysts. Cysticidal therapy was effective in controlling seizures in these patients and should be considered for patients with partial seizures and semiology related to cyst location.58410141020Carpio, A., Escobar, A., Hauser, W.A., Cysticercosis and epilepsy: A critical review (1998) Epilepsia, 39, pp. 1025-1040Pal, D.K., Carpio, A., Sander, J.W., Neurocysticercosis and epilepsy in developing countries (2000) J Neurol Neurosurg Psychiatry, 68, pp. 137-143Del Brutto, O.H., Prognostic factors for seizure recurrence after withdrawal of antiepileptic drugs in patients with neurocysticercosis (1994) Neurology, 44, pp. 1706-1709Spina-França, A., Livramento, J.A., Machado, L.R., Cysticercosis of the central nervous system and cerebrospinal fluid: Immunodiagnosis of 1573 patients in 63 years (1993) Arq Neuropsiquiatr, 51, pp. 16-20Monteiro, L., Nunes, B., Mendonça, D., Lopes, J., Spectrum of epilepsy in neurocysticercosis: A long-term follow-up of 143 patients (1995) Acta Neurol Scand, 92, pp. 33-40Carpio, A., Santillán, F., León, P., Aspectos clinicos de la cisticercosis (1990) Rev Inst Cienc Salud (Ecuador), 5, pp. 1-40Palacio, L.G., Jiménez, I., Garcia, H.H., Neurocysticercosis in persons with epilepsy in Medellín, Colombia (1998) Epilepsia, 39, pp. 1334-1339Garcia, H.H., Gilman, R., Martinéz, M., Cysticercosis as a major cause of epilepsy in Peru (1993) Lancet, 341, pp. 197-200Medina, M.T., Rosas, E., Rubio-Donnadieu, F., Sotelo, J., Neurocysticercosis as the main cause of late-onset epilepsy in Mexico (1990) Arch Intern Med, 150, pp. 323-325Sotelo, J., Escobedo, F., Rodriguez-Carbajal, J., Rubio-Donnadieu, F., Therapy of parenchymal brain cysticercosis with praziquantel (1984) N Engl J Med., 310, pp. 1001-1007Shawhney, I.M.S., Lekhra, O.P., Shashi, J.S., Evaluation of epilepsy management in a developing country: A prospective study of 407 patients (1996) Acta Neurol Scand, 94, pp. 19-23Proposal for revised classification of epilepsies and epileptic seizures (1989) Epilepsia, 30, pp. 389-399Takayanagui, O.M., Jardim, E., Therapy for neurocysticercosis: Comparison between albendazole and praziquantel (1992) Arch Neurol, 49, pp. 290-294Carpio, A., Santillán, F., León, P., Is the course of neurocysticercosis modified by treatment with antibelminthic agents? (1995) Arch Intern Med, 155, pp. 1982-1988Kramer, L.D., Medical Treatment of cysticercosis-ineffective (1995) Arch Neurol, 52, pp. 101-102Hachinski, V., Medical treatment of cysticercosis (1995) Arch Neurol, 52, p. 104Krammer, L.D., Locke, G.E., Byrd, S.E., Daryabagi, J., Cerebral cysticercosis: Documentation of natural history with CT (1989) Radiology, 171, pp. 459-462Cukiert, A., Pugli, P., Scapolan, H.B., Congruence of the topography of intracranial calcifications and epileptic foci (1994) Arq Neuropsiquiatr, 52, pp. 289-294Escobedo, F., Penagos, P., Rodríguez, J., Sotelo, J., Albendazole therapy for neurocysticercosis (1987) Arch Intern Med, 147, pp. 738-741Murthy, J.M.K., Reddy, Y.V.S., Prognosis of epilepsy associated with single CT enhancing lesion: A long term follow up study (1998) J Neurol Sci, 159, pp. 151-155Bittencourt, P., Adamolekum, B., Bharucha, N., Epilepsy in the tropics: II. Clinical presentations, pathophysiology, immunologic diagnosis, economics and therapy (1996) Epilepsia, 37, pp. 1121-1127Del Brutto, O.H., Santibañez, R., Noboa, C.A., Epilepsy due to neurocysticercosis: Analysis of 203 patients (1992) Neurology, 42, pp. 389-392Narata, A.P., Arruda, W.O., Uemura, E., Neurocisticercose: Diagnósfico tomográfico em pacientes neurológicos (1998) Arq Neuropsiquiatr, 56 (2), pp. 245-249Minguetti, G., Ferreira, M., Computed tomography in neurocysticercosis (1983) J Neurol Neurossurg Psychiatry, 46, pp. 926-942Chequer, R.S., Vieira, V.L., Neurocisticercose no Estado do Espírito Santo (1990) Arq Neuropsiquiatr, 48, pp. 431-440Daras, M., Tuchman, A.J., Strobos, R.J., Computed tomography in adult onset epileptic seizures in a city hospital population (1987) Epilepsia, 28, pp. 519-522Singh, G., Neurocysticercosis in South-Central America and the Indian Subcontinent: A comparative evaluation (1997) Arq Neuropsiquiatr, 55, pp. 349-356Sethi, P.K., Kuar, B.R., Madan, V.S., Appearing and disappearing CT scan abnormalities and seizures (1985) J Neurol Neurossurg Psychiatry, 48, pp. 866-869Chandy, M.J., Rajshekhar, V., Ghosh, S., Single small enhancing CT lesions in Indian patients with epilepsy: Clinical, radiological and pathological considerations (1991) J Neurol Neurossurg Psychiatry, 54, pp. 702-705Rajsheklar, V., Albendazole theraphy for persistent solitary cysticercus granuloma in patient with seizures (1993) Neurology, 43, pp. 1238-1240Vazquez, V., Sotelo, J., The course of seizures after treatment for cerebral cysticercosis (1992) N Engl J Med, 327, pp. 696-701Alarcón, F., Escalante, L., Dueñas, G., Neurocysticercosis: Short course of treatment with albendazole (1989) Arch Neurol, 46, pp. 1231-123

Environmental heterogeneity caused by anthropogenic disturbance drives forest structure and dynamics in Brazilian Atlantic Forest

We evaluated how tree community floristic composition, forest structure and dynamics varied over a period of 13 years across a topographic gradient of ravines created by anthropic disturbance in Brazilian Atlantic Forest. The study area is located within a fragment of Atlantic Forest (21° 09' S, 44° 54' W), in Minas Gerais state, Brazil. This work was based on data of tree diameter at 1.3 m from the soil, collected in four inventories. Each individual was recorded as being in one of three stratified topographic classes: hilltop, slope and bottom. We used direct gradient analysis to evaluate floristic compositional changes, phytosociological analysis to evaluate structural variations, and assessed demographic and biomass changes over time through analysis of rates of forest dynamics. The results did not reflect modifications in the patterns of floristic composition and species diversity along the topographic gradient, while differences in forest structural attributes and dynamics may be detected at these smaller spatial scales. Thus, the same species group may employ different strategies against different restrictive environmental factors. Finally, we suggest that floristic composition and species diversity may be less sensitive parameters for post-disturbance responses than forest dynamics and structure

Síndrome De Transfusão Feto-fetal: Neurodesenvolvimento De Lactentes Tratados Com Cirurgia A Laser

To assess the neurodevelopmental functions of survivors of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser coagulation (FLC), during the first year of life, comparing them to a control group; and to verify the influence of specific variables on neurodevelopment. Method: This was a prospective, longitudinal study. The sample comprised 33 monochorionic diamniotic twins who underwent FLC for treatment of TTTS and 22 full-term infants of single-fetus pregnancies. Bayley Scales of Infant and Toddler Development Screening Test were used for evaluation. Prenatal, perinatal and postnatal information were obtained. Results: There was an increased frequency of infants in the TTTS group with inadequate performance compared to the control group. The identified variables (fetal donor, low economic income and cardiorespiratory disease) negatively impacted expressive communication and fine motor skills. Conclusion: Although through follow-up is recommended in all TTTS survivors, particular attention is required for the high-risk group as defined in this study. © 2016, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.74430731

Heat stress and ACTH administration on cortisol and insulin-like growth factor I (IGF-I) levels in lactating Holstein cows

Physiological and productive responses were studied in five Holstein cows in thermal comfort (T1), stress by exogenous adrenocorticotropic hormone (ACTH) administration (T2) and heat stress (T3) to compare acute and punctual stress (ACTH) and prolonged stress (heat stress). During T1 and T2, cows were housed in a climatic-free stall barn. In T3, the animals were kept in a climatic room (air temperature of 37°C from 08:00 to 13:00 h, and of 26°C from 14:00 to 07:00 h) for 7 days. Milk yield, rectal temperature (RT), respiratory rate (RR) and blood samples were obtained before, during and after all treatments. In T1 at 08:00 h, RT and RR were below the upper critical limit. Simultaneously, cortisol and insulin growth-factor I (IGF-I) were within the normal limits. After ACTH administration (T2), cortisol significantly increased, reaching maximum levels at 60 min and returning to basal levels at 300 min. However, IGF-I was not affected. During T3, Holstein cows did not effectively dissipate their body temperature and RT, RR and cortisol significantly increased. There was a 26.6% reduction in milk production after heat stress (P < .05). Prolonged heat stress was more stressful and cows had higher levels of CORT in T3 than in T2 even before the increase in body temperature. Although the total amount of cortisol and IGF-I presented a negative and significant Pearson correlation (r = −0.79), IGF-I was not significantly influenced by heat stress or ACTH administration, and the relationship between IGF-I and heat stress remains controversial

Total parasite biomass but not peripheral parasitaemia is associated with endothelial and haematological perturbations in Plasmodium vivax patients

Plasmodium vivax is the major cause of human malaria in the Americas. How P. vivax infection can lead to poor clinical outcomes, despite low peripheral parasitaemia remains a matter of intense debate. Estimation of total P. vivax biomass based on circulating markers indicates existence of a predominant parasite population outside of circulation. In this study we investigate associations between both peripheral and total parasite biomass and host response in vivax malaria. We analysed parasite and host signatures in a cohort of uncomplicated vivax malaria patients from Manaus, Brazil, combining clinical and parasite parameters, multiplexed analysis of host responses and ex vivo assays. Patterns of clinical features, parasite burden and host signatures measured in plasma across the patient cohort were highly heterogenous. Further data deconvolution revealed two patient clusters, here termed Vivaxlow and Vivaxhigh. These patient subgroups were defined based on differences in total parasite biomass but not peripheral parasitaemia. Overall Vivaxlow patients clustered with healthy donors and Vivaxhigh patients showed more profound alterations in haematological parameters, endothelial cell (EC) activation and glycocalyx breakdown and levels of cytokines regulating different haematopoiesis pathways compared to Vivaxlow. Vivaxhigh patients presented more severe thrombocytopenia and lymphopenia, along with enrichment of neutrophils in the peripheral blood and increased neutrophil-to-lymphocyte ratio (NLCR). When patients' signatures were combined, high association of total parasite biomass with a subset of markers of EC activation, thrombocytopenia and lymphopenia severity was observed. Finally, machine learning models defined a combination of host parameters measured in the circulation that could predict the extent of parasite infection outside of circulation. Altogether, our data show that total parasite biomass is a better predictor of perturbations in host homeostasis in P. vivax patients than peripheral parasitaemia. This supports the emerging paradigm of a P. vivax tissue reservoir, in particular in the hematopoietic niche of bone marrow and spleen

Limits to the sensitivity of a low noise compact atomic gravimeter

A detailed analysis of the most relevant sources of phase noise in an atomic interferometer is carried out, both theoretically and experimentally. Even a short interrogation time of 100 ms allows our cold atom gravimeter to reach an excellent short term sensitivity to acceleration of $1.4\times 10^{-8}$g at 1s. This result relies on the combination of a low phase noise laser system, efficient detection scheme and good shielding from vibrations. In particular, we describe a simple and robust technique of vibration compensation, which is based on correcting the interferometer signal by using the AC acceleration signal measured by a low noise seismometer.Comment: 30 pages, 14 figure

Capillary filling with pseudo-potential binary Lattice-Boltzmann model

We present a systematic study of capillary filling for a binary fluid by using a mesoscopic lattice Boltzmann model for immiscible fluids describing a diffusive interface moving at a given contact angle with respect to the walls. The phenomenological way to impose a given contact angle is analysed. Particular attention is given to the case of complete wetting, that is contact angle equal to zero. Numerical results yield quantitative agreement with the theoretical Washburn law, provided that the correct ratio of the dynamic viscosities between the two fluids is used. Finally, the presence of precursor films is experienced and it is shown that these films advance in time with a square-root law but with a different prefactor with respect to the bulk interface.Comment: 13 pages, 8 figures, accepted for publication on The European journal of physics