Borderline personality features possibly related to cingulate and orbitofrontal cortices dysfunction due to schizencephaly.

Prefrontal cortex dysfunction has been associated with a series of behavioral symptoms, such as impulsivity and affective instability, which are the defining features of several personality disorders, notably, borderline personality disorder. We report on a 27-year-old patient with schizencephaly in the right frontal lobe (cingulate cortex lesion and secondary orbitofrontal cortex dysfunction) presenting with prominent borderline features and compromise of executive functions, decision-making and attention. We hypothesize that the personality disorder of our patient could be related to cingulate cortex lesion and secondary orbitofrontal cortex dysfunction associated with schizencephaly

Post-sepsis cognitive impairment and associated risk factors : a systematic review.

Introduction: Post-sepsis cognitive impairment is one of the major sequelae observed in survivors ofsepsis. This cognitive impairment can be global or may affect specific domains. A better understandingof these deficits and associated risk factors could influence the care of patients with sepsis.Objective: To perform a systematic review to investigate the presence of cognitive impairment and itsassociated risk factors among patients who survived sepsis.Methods: The search was conducted in MEDLINE (1966 to March 2017) and EMBASE (1988 to March 2017).We included studies with individuals who were 18 years or older with post-sepsis cognitive impairment.Results: We analysed 577 articles. Sixteen studies met the inclusion criteria. More than 74,000,000patients were evaluated in the selected studies. Significant variation was observed in the definitionof sepsis and cognitive impairment. Twelve studies used ACCP/SCCM criteria for sepsis, while cogni-tive impairment was defined per test used. Post-sepsis cognitive impairment was observed in 12.5 to21% of survivors of sepsis. Attention, cognitive flexibility, processing speed, associative learning, visualperception, work memory, verbal memory, and semantic memory were the specific domains affected.Depressive symptoms, central nervous system infection, length of hospitalisation due to infection, andtemporal proximity to the last period of infection were associated with cognitive impairment.Conclusion: The studies are heterogeneous, and there is urgent need for a common language, includ-ing definitions and neuropsychological tests, for the investigation of post-sepsis cognitive impairment.Despite this, there is mounting evidence for the clinical relevance of post-sepsis cognitive impairment

Effects of vaccination against the H1N1 virus on BDNF and TNF-? plasma levels in pregnant women.

Background: Vaccination is a widespread strategy to protect women and their children during fetal development. However, there is a lack of knowledge about potential effects of H1N1 vaccination on concentration of cytokines that are important to mother?s central nervous system functions and fetal neurodevelopment. Objective: The main purpose of the present study was to evaluate such interaction. The specific goals were to study the effects of vaccination against the H1N1 virus on plasma levels of the Brain Derived Neurotrophic Factor(BDNF), Tumor Necrosis Factor- (TNF-) and TNF- Receptors 1 and 2 (sTNFR1; sTNFR2), in different periods of gestation. Methods: Data were obtained during the period of 6 months in 2010, from a sample of 94 pregnant women who were using the health care service of Concei??o do Mato Dentro, a rural area in the state of Minas Gerais, Brazil. Seventeen women were in the first trimester of pregnancy, forty were in the second trimester and 37 were in the third trimester. Each of these groups was divided into two subgroups as follows: immunized against the H1N1 virus (I) and non-immunized (NI). Plasma concentrations of BDNF, TNF-, sTNFR1 and sTNFR2 were measured using the sandwich ELISA. Results: There was no difference in cytokine or neurotrophic factor levels evaluated between groups I and NI in any trimesters. Conclusion: These results show that the recommendation of vaccination against the H1N1 virus for all pregnant women as a public health measure could be considered safe, regarding aspects related to the role playe

Plasmodium berghei NK65 induces cerebral leukocyte recruitment in vivo : an intravital microscopic study.

Malaria is second only to tuberculosis as the leading cause of morbidity and mortality as a consequence of a single infectious agent. Much of the pathology of malaria arises from the inappropriate or excessive immune response mounted by the host in an attempt to eliminate the parasite. We here report the inflammatory changes observed in the cerebral microvasculature of C57BL/6 and BALB/c mice that had been inoculated with Plasmodium berghei NK65, a lethal strain of rodent malaria. Although no neurological signs were observed in experimentally infected mice, inflammation of the cerebral microvasculature was clearly evident. Histopathological analysis demonstrated that alterations in cerebral tissue were more intense in infected C57Bl/6 mice than in infected BALB/c animals. Intravital microscopic examination of the cerebral microvasculature revealed increased leukocyte rolling and adhesion in pial venules of infected mice compared with non-infected animals. The extravasation of Evans blue dye into the cerebral parenchyma was also elevated in infected mice in comparison with their non-infected counterparts. Additionally, protein levels of TNF-_, MIG/CXCL9, MCP-1/CCL2, MIP-1_/CCL3 and RANTES/CCL5 were up-regulated in brain samples derived from infected C57Bl/6 mice. Taken together, the data reported here illustrate the complex strain-dependent relationships between leukocyte recruitment, blood brain barrier permeability and chemokine production

High-through identification of T cell-specific phage-exposed mimotopes using PBMCs from tegumentary leishmaniasis patients and their use as vaccine candidates against Leishmania amazonensis infection.

In the current study, phage-exposed mimotopes as targets against tegumentary leishmaniasis (TL) were selected by means of bio-panning cycles employing sera of TL patients and healthy subjects, besides the immune stimulation of peripheral blood mononuclear cells (PBMCs) collected from untreated and treated TL patients and healthy subjects. The clones were evaluated regarding their specific interferon-? (IFN-?) and interleukin-4 (IL-4) production in the in vitro cultures, and selectivity and specificity values were calculated, and those presenting the best results were selected for the in vivo experiments. Two clones, namely A4 and A8, were identified and used in immunization protocols from BALB/c mice to protect against Leishmania amazonensis infection. Results showed a polarized Th1 response generated after vaccination, being based on significantly higher levels of IFN-?, IL-2, IL-12, tumour necrosis factor-? (TNF-?) and granulocyte-macrophage colony-stimulating factor (GM-CSF); which were associated with lower production of specific IL-4, IL-10 and immunoglobulin G1 (IgG1) antibodies. Vaccinated mice presented significant reductions in the parasite load in the infected tissue and distinct organs, when compared with controls. In conclusion, we presented a strategy to identify new mimotopes able to induce Th1 response in PBMCs from TL patients and healthy subjects, and that were successfully used to protect against L. amazonensis infectio

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc