Cefalea racimos en una niña de 3 años

Summary. Introduction. Cluster headache is a rare disorder in childhood. We identified, in the literature, 64 cases of cluster headache starting at or before 18 years (only 17 of them began before 10 years old). All patients met the criteria of the International Headache Society. Russell et al demonstrated recently that the cluster headache is an inherited disorder in some families. They conclude that the gene is present in 3 to 4% of males and 7 to 10% of females with cluster headache and that it has an autossomal dominant transmission. Clinical case. The authors report the clinical case of a five-year-old child with cluster headache starting at three years. This paper reviews the differential diagnosis and the treatment of cluster headach

Bispectral index is a topographically dependent variable in patients receiving propofol anaesthesia

Background. As very strong agreement has been reported between bispectral index (BIS) values measured from the occipital and frontal skull areas, we compared BIS values measured from central and parietal areas with those from frontal area to investigate whether BIS is really a topographically dependent or topographically independent variable. Methods. Twenty patients, ASA I-II, non-obese, aged 18-62 yr and with no neurological disorders were enrolled. Based on the 10-20 international landmarks, five silver dome electrodes were positioned: F7, C3, P7, Cz (common reference) and Fp1 (ground). Using frontal (F7-Cz), central (C3-Cz) and parietal (P7-Cz) electrode montages, the corresponding BIS values were simultaneously recorded with an Aspect A-1000 monitor (software v3.12). The BIS values were recorded at the propofol concentration allowing laryngeal mask insertion, which was maintained during the 10 min data collection period in absence of additional external stimuli. Data were analysed using the Kruskall-Wallis, Wilcoxon paired sign with Bonferroni correction, Bland-Altman and linear correlation tests. Results. At the predicted effect target propofol concentration 4-8 μg ml−1, the 10 min mean BIS (median [min-max]) were 32 [20-44], 46 [28-68] and 58 [41-72] for the frontal, central and parietal leads, respectively. Differences between these BIS recordings were statistically significant (P<0.0001, Kruskall-Wallis; P<0.005, Wilcoxon paired sign test). Conclusions. The present results provide evidence that BIS index is a topographically dependent variable in patients receiving propofol anaesthesi

The long-term effect of complex regional pain syndrome type 1 on disability and quality of life after foot injury

PURPOSE: To study the long-term evolution of patients with lower-limb Complex Regional Pain Syndrome (CRPS), focusing on functional and proprioceptive aspects and quality of life. METHODS: In 20 patients suffering from chronic distal lower-limb CRPS diagnosed using Budapest criteria, we assessed joint position sense and strength of the knee muscles at the CRPS and unaffected leg, functional exercise capacity, pain, CRPS severity score, quality of life and kinesiophobia. Similar assessments were performed in 20 age-matched controls. RESULTS: The joint position performance (at 45°) was significantly lower for the CRPS leg as compared to controls. The knee extensor strength of the CRPS leg was significantly reduced as compared to the unaffected leg (−27%) and controls (−42%). CRPS patients showed significantly reduced performance at the 6 min-walk test as compared to their age group predicted value and controls. Patients suffering from CRPS for 3.8 years in average still exhibit high pain, severity and kinesiophobia scores. CONCLUSIONS: Long-term deficits in strength and proprioceptive impairments are observed at the knee joint of the CRPS leg. This persistent functional disability has significant repercussions on the quality of life. We highlight the importance of including strength and proprioceptive exercises in the therapeutic approaches for CPRS patients

Fragmentation of small carbon clusters, a review

An overview of the works devoted to fragmentation of small carbon clusters is given in a first part. Fragmentation of swift neutral and (multi) charged carbon clusters studied with the AGAT spectrometer is presented and discussed in a second part

An inverted-sandwich diuranium μ-η5:η5-cyclo-P5 complex supported by U-P5 δ-bonding

Reaction of [U(TrenTIPS)] [1, TrenTIPS=N(CH2CH2NSiiPr3)3] with 0.25 equivalents of P4 reproducibly affords the unprecedented actinide inverted sandwich cyclo-P5 complex [{U(TrenTIPS)}2(μ-η5:η5-cyclo-P5)] (2). All prior examples of cyclo-P5 are stabilized by d-block metals, so 2 shows that cyclo-P5 does not require d-block ions to be prepared. Although cyclo-P5 is isolobal to cyclopentadienyl, which usually bonds to metals via σ- and π-interactions with minimal δ-bonding, theoretical calculations suggest the principal bonding in the U(P5)U unit is polarized δ-bonding. Surprisingly, the characterization data are overall consistent with charge transfer from uranium to the cyclo-P5 unit to give a cyclo-P5 charge state that approximates to a dianionic formulation. This is ascribed to the larger size and superior acceptor character of cyclo-P5 compared to cyclopentadienyl, the strongly reducing nature of uranium(III), and the availability of uranium δ-symmetry 5f orbitals

Synthesis and characterization of an f‑block terminal parent imido [U=NH] complex: a masked uranium(IV) nitride

Deprotonation of [U(TrenTIPS)(NH2)] (1) [TrenTIPS = N(CH2CH2NSiPri3)3] with organoalkali metal reagents MR (M = Li, R = But; M = Na−Cs, R = CH2C6H5) afforded the imido-bridged dimers [{U-(TrenTIPS)(μ-N[H]M)}2] [M = L −Cs (2a−e)]. Treatmentof 2c (M = K) with 2 equiv of 15 crown-5 ether (15C5) afforded the uranium terminal parent imido complex [U(TrenTIPS)(NH)][K(15C5)2] (3c), which can also be viewed as a masked uranium(IV) nitride. The uranium−imido linkage was found to be essentially linear, and theoretical calculations suggested σ2π4 polarized U−N multiple bonding. Attempts to oxidize 3c to afford the neutral uranium terminal parent imido complex [U(TrenTIPS)(NH)] (4) resulted in spontaneous disproportionation to give 1 and the uranium−nitride complex [U(TrenTIPS)(N)] (5); this reaction is a new way to prepare the terminal uranium−nitride linkage and was calculated to be exothermic by −3.25 kcal mol−1

Estimation of 3D electron density in the Ionosphere by using fusion of GPS satellite-receiver network measurements and IRI-Plas model

GPS systems can give a good approximation of the Slant Total Electron Content in a cylindrical path between the GPS satellite and the receiver. International Reference Ionosphere extended to Plasmasphere (IRI-Plas) model can also give an estimation of the vertical electron density profile in the ionosphere for any given location and time, in the altitude range from about 50 km to 20000 km. This information can be utilized to obtain total electron content between any given receiver and satellite locations based on the IRI-Plas model. This paper explains how the fusion of measurements obtained from a GPS satellite-receiver network can be utilized together with the IRI-Plas model in order to obtain a robust 3D electron density model of the ionosphere. © 2013 ISIF ( Intl Society of Information Fusi

A possible case of spontaneous Loa loa encephalopathy associated with a glomerulopathy

It is well known that renal and neurological complications may occur after antifilarial treatment of patients infected with Loa loa. Conversely, spontaneous cases of visceral complications of loiasis have been rarely reported. A 31-year-old Congolese male patient who had not received any antifilarial drug developed oedema of the lower limbs, and then transient swellings of upper limbs. Two months after, he developed troubles of consciousness within several hours. At hospital, the patient was comatose with mild signs of localization. Laboratory tests and an abdominal echography revealed a chronic renal failure due to a glomerulopathy. Three weeks after admission, Loa microfilariae were found in the cerebrospinal fluid, and a calibrated blood smear revealed a Loa microfilaraemia of 74,200 microfilariae per ml. The level of consciousness of the patient improved spontaneously, without any specific treatment, but several days after becoming completely lucid, the patient died suddenly, from an undetermined cause. Unfortunately, no biopsy or autopsy could be performed. The role of Loa loa in the development of the renal and neurological troubles of this patient is questionable. But the fact that such troubles, which are known complications of Loa infection, were found concomitantly in a person harbouring a very high microfilarial load suggests that they might have been caused by the filarial parasite. In areas endemic for loiasis, examinations for a Loa infection should be systematically performed in patients presenting an encephalopathy or a glomerulopathy