Proteomic Analysis of the Hippocampus in Mouse Models of Trigeminal Neuralgia and Inescapable Shock-Induced Depression / 神经科学通报·英文版

To investigate the behavioral and biomolecular similarity between neuralgia and depression, a trigeminal neuralgia (TN) mouse model was established by constriction of the infraorbital nerve (CION) to mimic clinical trigeminal neuropathic pain. A mouse learned helplessness (LH) model was developed to investigate inescapable foot-shock-induced psychiatric disorders like depression in humans. Mass spectrometry was used to assess changes in the biomolecules and signaling pathways in the hippocampus from TN or LH mice. TN mice developed not only significant mechanical allodynia but also depressive-like behaviors (mainly behavioral despair) at 2 weeks after CION, similar to LH mice. MS analysis demonstrated common and distinctive protein changes in the hippocampus between groups. Many protein function families (such as cell-to-cell signaling and interaction, and cell assembly and organization,) and signaling pathways (e.g., the Huntington's disease pathway) were involved in chronic neuralgia and depression. Together, these results demonstrated that the LH and TN models both develop depressive-like behaviors, and revealed the involvement of many psychiatric disorder-related biomolecules/pathways in the pathogenesis of TN and LH.

In silico screening and evaluation of the anticonvulsant activity of docosahexaenoic acid-like molecules in experimental models of seizures

Background: Resistance to antiepileptic drugs and the intolerability in 20-30% of the patients raises demand for developing new drugs with improved efficacy and safety. Acceptable anticonvulsant activity, good tolerability, and inexpensiveness of docosahexaenoic acid [DHA] make it as a good candidate for designing and development of the new anticonvulsant medications

Methods: Ten DHA-based molecules were screened based on in silico screening of DHA-like molecules by root-mean-square deviation of atomic positions, the biological activity score of Professional Association for SQL Server, and structural requirements suggested by pharmacophore design. Anticonvulsant activity was tested against clonic seizures induced by pentylenetetrazole [PTZ, 60 mg/kg, i.p.] and tonic seizures induced by maximal electroshock [MES, 50 mA, 50 Hz, 1 ms duration] by intracerebroventricular [i.c.v.] injection of the screened compounds to mice

Results: Among screened compounds, 4-Phenylbutyric acid, 4-Biphenylacetic acid, phenylacetic acid, and 2-Phenylbutyric acid showed significant protective activity in pentylenetetrazole test with ED[50] values of 4, 5, 78, and 70 mM, respectively. In MES test, shikimic acid and 4-tert-Butylcyclo-hexanecarboxylic acid showed significant activity with ED[50] values 29 and 637 mM, respectively. Effective compounds had no mortality in mice up to the maximum i.c.v. injectable dose of 1 mM

Conclusion: Common electrochemical features and three-dimensional spatial structures of the effective compounds suggest the involvement of the anticonvulsant mechanisms similar to the parent compound DHA

Trauma Eléctrico / Electrical trauma

El trauma eléctrico puede ocurrir por contacto con un cable eléctricamente activo o con un rayo, clasificándose elmismo en lesiones por bajo voltaje para aquellas de menos de 1000V y lesiones por alto voltaje para aquellas demás de 1000V. Posee una incidencia poco despreciable siendo una causa frecuente de lesión por un fenómenonatural. Diferentes factores entre ellos el tipo de corriente, la resistencia de los tejidos, la duración del contacto,el voltaje, y los factores ambientales definen la gravedad y extensión de las lesiones que produce. Los tejidosafectados con mayor frecuencia son los nervios, vasos, hueso, músculo y piel siendo prevalentes las quemaduras,arritmias, parestesias y otros daños a los sistemas nervioso y cardiovascular. A pesar de tener una mortalidadbaja, la lesión difusa causada por el trauma eléctrico deriva en una importante cantidad de secuelas a cortoy largo plazo que se presenta en un alto porcentaje de los sobrevivientes y que, debido a su sintomatologíainespecífica podría resultar difícil de identificar y diagnosticar.

Electric trauma can occur by contact with an active electric wire or a lightning, being classified in low-voltage injuriesfor those under 1000V and high- voltage injuries for those over 1000V. It has a little despicable incidence beinga frequent cause of injury from a natural phenomenon. Different factors including the type of current, resistanceof the tissues, duration of contact, voltage, and environmental factors determine the severity and extent of theinjuries that it produces. The tissues most commonly affected are the nerves, vessels, bones, muscle and skin beingprevalent the burns, arrhythmias, paresthesia, and other damages to the nervous and cardiovascular systems.Despite having a low mortality, diffuse injury caused by electric trauma results in an important amount of short andlong-term sequelae that occurs in a high percentage of the survivors, and because of its non-specific symptoms maybe difficult to identify and diagnose.

Elevación transitoria del segmento st en paciente victima de trauma eléctrico en el Hospital San Rafael de Alajuela / Transient ST-segment elevation victim of electric trauma patient in the hospital alajuela

El trauma eléctrico ocurre cuando un organismo vivo participa de un circuito eléctrico. Esto produce un síndrome traumático que involucra daño térmico y alteraciones eléctricas en el cuerpo. Para entenderlo mejor es necesario conocer la física de la electricidad. En este articulo se revisara un caso que se presento en el hospital San Rafael en el cual fue posible observar anormalidades electrocardiografícas en un paciente expuesto a traumas eléctrico leve.

Electrical injuries happen when a living organism takes part in an electrical circuit through the tissues of that organism.Because of this, the result is trauma syndrome that involves termal damage an electrical disturbances into the body.For a better understanding, is necessary to know about the physics of electricity.We`ll rewiew a clinical case happened in Hospital San Rafael, in which was possible to see electrocardiograma anormalities in pacient exposed to low electrical trauma.

Padronização do tratamento cirúrgico do trauma elétrico na fase aguda / Standardization of surgical treatment of acute electrical trauma

INTRODUÇÃO: As queimaduras elétricas correspondem de 5 a 15% dos casos de acidentes com queimaduras. A maioria está associada a acidentes do trabalho, nos quais predominam as lesões com alta voltagem (acima de 1.000 Volts), em pacientes do sexo masculino. As taxas de mortalidade variam de 2 a 15%, nos mais diversos centros de queimados. O objetivo é revisar padronização das etapas cirúrgicas na fase aguda de desbridamento (primeiros 15 dias) pela comparação de dosagem de creatofosfoquinase, hidratação venosa e fotografias para a aplicação de uma rotina de etapas cirúrgicas. MÉTODOS: Trata-se de um estudo quantitativo, prospectivo, realizado em um hospital público da cidade de Fortaleza, CE, entre julho de 2013 a dezembro de 2015. A população foi composta por adultos jovens, entre 15 e 50 anos, de ambos os sexos, vítimas de queimaduras por choque elétrico, com lesão de terceiro grau, no mínimo muscular. RESULTADOS: Foram realizados 12 procedimentos cirúrgicos de amputações nos 15 pacientes do estudo (60%). Seis pacientes não sofreram amputação (40%). Um paciente sofreu três procedimentos de amputação no mesmo membro (pododáctilo, pé e coxa esquerdos) e outro, duas amputações em membros superiores distintos. CONCLUSÃO: O tratamento na fase aguda do choque elétrico deve incluir uma imediata e adequada reposição líquida venosa, associada com procedimentos cirúrgicos de desbridamentos e de amputações, o mais precoce possível, em etapas com intervalos de 48 a 72 horas.

INTRODUCTION: Electrical burns are responsible for 5% to 15% of cases of burn accidents. The majority is associated with workplace accidents, in which high-voltage injuries (>1,000 V) predominate in male patients. The mortality rates vary from 2% to 15% in different burn centers. The objective is to review the standardization of surgical steps in the acute phase of debridement (the first 15 days) by comparison of creatine phosphokinase levels, intravenous hydration, and photographs to implement routine surgical stages. METHODS: This was a quantitative, prospective study performed in a public hospital in the city of Fortaleza, Brazil, between July 2013 and December 2015. The population was composed of young adults between 15 and 50 years, of both sexes, who experienced electrical burns, with third-degree injuries and muscle involvement. RESULTS: Of the 15 patients in the study, 9 (60%) patients underwent 13 surgical amputation procedures and 6 (40%) patients did not undergo amputation. One patient underwent three amputation procedures in the same limb (toe, foot, and thigh) and another patient underwent two amputations in the upper limbs. CONCLUSION: Treatment in the acute phase of electrical shock must include immediate and adequate intravenous fluid replacement, along with surgical procedures of debridement and amputations, as early as possible, in steps with intervals of 48 to 72 hours.

Fisiopatología, manifestaciones sistémicas y secuelas de la fulguración en seres humanos / Pathophysiology systemic manifestations and sequelae of electrocution in humans

Un rayo es un impulso masivo de corriente unidireccional creado por un gradiente de electrones entre dos nubes o una nube y la tierra. El trauma eléctrico por lo general no es mortal, sin embargo se asocia a una serie de complicaciones médicas de importancia. Las secuelas están determinadas tanto por la intensidad de la corriente como por la duración de la aplicación energética. Las lesiones por electrofulguración ocurren por distintos mecanismos: golpe directo, lesión de contacto, “side splash”, corriente por tierra y trauma contuso. La electricidad atmosférica causa diferentes tipos de lesiones a nivel de la piel, como es el caso de las quemaduras lineales, punteadas, térmicas y en plumaje. Las figuras de Lichtenberg son patognomónicas de la electrofulguración. Además del efecto sobre el sistema tegumentario, se documentan lesiones cardiovasculares, respiratorias, gastrointestinales, oculares, auditivas y neurológicas. Cuando se presenta una muerte por electrofulguración, como pocas veces es presenciada y ocurre en espacios abiertos, se debe realizar un estudio exhaustivo del cadáver y del lugar del suceso para descartar otras causas de muerte natural o violenta. En Costa Rica en el año 2011 se presentaron 7 muertes por electrofulguración, principalmente durante la juventud y adultez temprana y a nivel de la zona rural, siendo el principal mecanismo de lesión el golpe directo.

Lightning is a massive unidirectional current that depends of an electron gradient; this electric flow travels from one cloud to another or to the ground. Electric trauma generally is not lethal, however, it is associated to several complications. Sequelae are determined both by the current strength and by the duration of the exposure. Lightning damage occurs by different mechanisms: direct strike, contact injury, side splash, ground current, and blunt trauma. Atmospheric electricity causes different skin lesions such as linear, punctate, thermal, and plumage burns. Lichtenberg figures are pathognomonic for lightning. Besides the effect on the integumentary system, respiratory, gastrointestinal, ocular, auditory, cardiovascular, and neurological injuries are documented as well. When lightning causes death, it usually happens in open places without witnesses. An exhaustive study of the cadaver and the setting of the event should be accomplished in order to exclude natural or violent causes of death. In Costa Rica in 2011, there were seven deaths related to lightning; young adults predominated and most took place in rural areas, being direct strike the main mechanism of damage.

Preconditioning with mono and polyunsaturated fatty acids and low-intensity electrical stimulation. Effects on skin repair in rats

PURPOSE: To evaluate the effects of preconditioning with oils mixes containing ω3/ω6/ω9 associated with micro-currents on skin repair in rats. METHODS: One-hundred and eight Wistar rats randomized into G-1, G-2 and G-3 groups were treated with saline (0.9%), mix 1 (corn+soybean oils) and mix 2 (olive+canola+flaxseed oils), respectively, in a single dose (0.01ml/g) by gavage. Next, each group was subdivided into sham and stimulated subgroups. Pulsed-wave microcurrents (0.5 µA, 0.5 Hz) were applied to stimulated subgroups for 20 min. One hour later anesthetized rats were subjected to surgery. A dorsal incision (6 cm long) was carried out and closed with interrupted nylon sutures. Samples (1cm2 ) were harvested from the mid-portion of the incision on the 7, 14, 21 post-operative (P.O.) days. Variables were analyzed using Mann-Whitney/Dunn tests Significance level was set to 5 % (p<0.05). RESULTS: Micro-currents promoted increase of exudate and reduction of epithelialization on day 7 in G1 rats. Mixes 1/2 reduced vascularization on 7/14th days P.O. Both 1/2 mixes reduced fibrosis on day 14. Preconditioning with mix 1 led to increased expression of NF-kB on the 7th day. CONCLUSION: Preconditioning with microcurrents has pro-inflammatory effects while oil mixes 1 and 2 decrease fibrosis and vascularization in the proliferative phase of cicatrization.

Synthesis and anticonvulsant activity evaluation of 3-alkoxy-4-[4- [hexyloxy/heptyloxy]phenyl]-4H-1,2,4 -triazole

A series of 3-alkoxy-4-[4-[hexyloxy/heptyloxy] phenyl]-4H-1,2,4-triazole was synthesized. The anticonvulsant effect and neurotoxicity of the compounds were calculated with maximal electroshock [MES] test and rotarod tests with intraperitoneally injected mice. Among the synthesized compounds, compound 3-heptyloxy-4-[4-[hexyloxy] phenyl]-4H-1,2,4-triazole [5f] was the most active one and also had the lowest toxicity. In the anti-MES potency test, it showed median effective dose [ED[50]] of 37.3 mg/Kg, median toxicity dose [TD[50]] of 422.5 mg/Kg, and the protective index [PI] of 11.3 which is much greater than the reference drug carbamazepine with PI value of 6.4. As well as demonstrating the anti-MES efficacy of compound 5f, its potency against seizures induced by pentylenetetrazole, 3-mercaptopropionic acid, and bicuculline were also established, with the results suggesting that GABA-mediated mechanisms might be involved in its anticonvulsant activity, such as enhancing of GABAergic neurotransmission or activity, activate GAD or inhibit GABA-T, and GABA[A]-mediated mechanisms

Propofol can Protect Against the Impairment of Learning-memory Induced by Electroconvulsive Shock via Tau Protein Hyperphosphorylation in Depressed Rats / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the possible neurophysiologic mechanisms of propofol and N-methyl-D- aspartate (NMDA) receptor antagonist against learning-memory impairment of depressed rats without olfactory bulbs.</p><p><b>METHODS</b>Models of depressed rats without olfactory bulbs were established. For the factorial design in analysis of variance, two intervention factors were included: electroconvulsive shock groups (with and without a course of electroconvulsive shock) and drug intervention groups [intraperotoneal (ip) injection of saline, NMDA receptor antagonist MK-801 and propofol. A total of 60 adult depressed rats without olfactory bulbs were randomly divided into 6 experimental groups (n=10 per group): ip injection of 5 ml saline; ip injection of 5 ml of 10 mg/kg MK-801; ip injection of 5 ml of 10 mg/kg MK-801 and a course of electroconvulsive shock; ip injection of 5 ml of 200 mg/kg propofol; ip injection of 5 ml of 200 mg/kg propofol and a course of electroconvulsive shock; and ip injection of 5 ml saline and a course of electroconvulsive shock. The learning-memory abilities of the rats was evaluated by the Morris water maze test. The content of glutamic acid in the hippocampus was detected by high-performance liquid chromatography. The expressions of p-AT8Ser202 in the hippocampus were determined by Western blot analysis.</p><p><b>RESULTS</b>Propofol, MK-801 or electroconvulsive shock alone induced learning-memory impairment in depressed rats, as proven by extended evasive latency time and shortened space probe time. Glutamic acid content in the hippocampus of depressed rats was significantly up-regulated by electroconvulsive shock and down-regulated by propofol, but MK-801 had no significant effect on glutamic acid content. Levels of phosphorylated Tau protein p-AT8Ser202 in the hippocampus was up-regulated by electroconvulsive shock but was reduced by propofol and MK-801 alone. Propofol prevented learning-memory impairment and reduced glutamic acid content and p-AT8Ser202 levels induced by electroconvulsive shock.</p><p><b>CONCLUSION</b>Electroconvulsive shock might reduce learning-memory impairment caused by protein Tau hyperphosphorylation in depressed rats by down-regulating glutamate content.</p>

Alteration of neural oscillations in hippocampal CA3 area in the fast avoidance response rat before and after electric shock avoidance training / 生理学报

The purpose of the present study is to explore the relationship of spatial learning ability and specific electrical activities of neural oscillations in the rat. The fast and general avoidance response groups were selected on the basis of the animals' responses to the electric shock in Y type maze, and their local field potentials (LFPs) of hippocampal CA3 area were recorded by wireless telemetry before and after shock avoidance training, respectively. The components of neural oscillations related to spatial identifying and learning ability were analyzed. The results showed that, compared with the general avoidance response group, the fast avoidance response group did not show any differences of LFPs in hippocampal CA3 area before electric shock avoidance trial, but showed significantly increased percentages of 0-10 Hz and 30-40 Hz rhythm in right hippocampal CA3 area after the shock avoidance training (P < 0.01 or P < 0.05). Fast Fourier transform showed that percentage increase of 0-10 Hz band occurred mainly in θ (3-7 Hz) frequency, and 30-40 Hz frequency change was equivalent to the γ1 band. Furthermore, compared with those before training, only the percentages of β, β2 (20-30 Hz) and γ1 rhythm increased (P < 0.01 or P < 0.05) in fast avoidance response rats after training, while the θ rhythm percentage remained unchanged. In contrast, θ rhythm percentage and the large amplitude (intensity: +2.5 - -2.5 db) θ waves in right CA3 area of general avoidance response rats were significantly reduced after training (P < 0.01). These results suggest that the increased percentages of β2 and γ1 rhythm and high-level (unchanged) percentage of θ rhythm in the right hippocampus CA3 area might be related to strong spatial cognition ability of fast avoidance response rats.

The Anticonvulsant Effect of Eupatorium Birmanicum DC Leave Extract Alone and in Combination with Phenytoin Against MES Seizure in Albino Mice.

To evaluate the anticonvulsant activity of aqueous extract of Eupatorium birmanicum DC leave (EB) alone and in combination with phenytoin against MES seizure in albino mice. Method: Aqueous extract of EB was prepared using Soxhlet apparatus. The anticonvulsant effect of the extract was tested on prescreened albino mice at 3 doses (200, 400 & 800 mg/kg). After 1 hr of oral administration of EB the animals were subjected to MES seizures by convulsiometer with a current of 45 mA for 0.2 sec via transauricular electrodes and the duration of the THLE was recorded. Sub-anticonvulsant dose of phenytoin was also determined and the effect of its combination with the most effective dose of EB tested. Results: EB aqueous extract exhibited significant anticonvulsant activity in the MES model at doses 400 mg/ kg (p<0.01) & 800 mg/kg (p<0.001). This reduction in the duration of THLE at 800mg/kg of EB was further reduced significantly (p<0.001) when combined with subanticonvulsant doses of phenytoin (10mg/kg). Conclusion: The aqueous extract of E. birmanicum leaves showed significant anticonvulsant activity in MES seizure model in albino mice and it significantly increased the anticonvulsant effect of phenytoin in the same animal model.

Anticonvulsant profile of 2-ethylthio-7-methyl-4-(4-methylphenyl)pyrazolo[1, 5-a][1, 3, 5]triazine

This work evaluates the central nervous effects in ICR strain mice of 2-ethylthio-7-methyl-4-(4-methylphenyl)pyrazolo[1,5-a][1,3,5]triazine (MH4b1), a compound obtained by an efficient one-step reaction of S,S-diethyl 4-methylbenzoylimidodithiocarbonate with 5-amino-3-methyl-1H-pyrazole, in order to assess its neuro-pharmacological profile. The tests applied were: maximal electroshock seizure (MES), pentylenetetrazole (PTZ) seizures, forced swimming, plus maze, marble burying, sleeping time, rota-rod and catalepsy. In addition, MH4b1 binding to the benzodiazepine site of the GABA-A receptor and MH4b1 inhibition of monoamine oxidase (MAO) subtypes A and B were evaluated. MH4b1 showed anticonvulsant effects in a dose dependent manner (30-300 mg/kg, p.o.) against MES and inhibition of MAO-B (IC50: 24.5 µM) without activity at the benzodiazepine site. These data suggest that MH4b1 has anticonvulsant properties related to MAO-B inhibition.

Este trabalho avalia o efeito do 2-etiltio-7-metil-4-(4-metilfenil)pirazol[1,5-a][1,3,5]triazina (MH4b1) no sistema nervoso central de camundongos ICR. O MH4b1 foi obtido por a reação de 4-metilbenzoilimidoditiocarbonato de S,S-dietil e 5-amino-3-metil-1H-pirazol em uma única etapa. O perfil neurofarmacológico foi realizado por testes de convulsão induzida por eletrochoque (MES) e pentilenotetrazol (PTZ) e por testes de nado forçado, labirinto em cruz, esconder as esferas, sono barbitúrico, rota-rod e catalepsia. Também foi avaliada a união do MH4b1 ao o local de ligação de benzodiazepínicos do receptor GABA-A e a capacidade inibitória do MH4b1 sobre a monoaminoxidase (MAO) A e B. O MH4b1 mostrou efeito anticonvulsivante dependente da dose (30-300 mg) no teste do MES e apresentou atividade inibitória da MAO-B (CI50: 24.5 µM) sem interagir com o local de ligação de benzodiazepínicos do receptor. Os resultados sugerem que o MH4b1 tem atividade anticonvulsivante relacionada com a inibição da MAO-B.

Anticonvulsant activity of capsicum annum [red pepper] fruit extract using pentylentetrazole and maximum electroshock induced seizure tests in rats

Epilepsy is a disorder of brain function characterized by periodic and unpredictable occurrence of seizures that refers to as a transient alteration of behavior due to disordered, synchronous and rhythmic firing of populations of brain neurons. Modern drug therapy of epilepsy is complicated by side effects and inability to control seizures in some patients. The present study was conducted to test the anticonvulsant activity of Capsicum annum fruit extract in rat models. The methanolic extract of Capsicum annum fruit was tested for its potential anticonvulsant activity using pentylentetrazole [PTZ] and maximum electroshock [MES] induced seizure models in rats. The simple activity meter was used to determine the sedative activity of Capsicum annum fruit extract. Thereafter, the protective index was calculated. Results obtained showed that the extract at concentrations of 5, 9, 10, 20 and 40 mg/kg produced dose dependent anticonvulsant activity. Capsicum annum [40 mg/kg, i.p.] caused 100% protection from seizure induced by PTZ and sedation in 50% of rats [TD[50]]. Fifty percent anticonvulsant activity was produced by 9mg/kg Capsicum annum. Moreover, the protective index was calculated to be more than four. When tested on seizure induced by MES, Capsicum annum extract at doses of 10, 20 and 40 mg/kg showed no seizure protection. It could be concluded that Capsicum annum fruit could be a source for potential antiepileptic agent[s]. Further studies are needed to determine the active constituents responsible for the anticonvulsant activity as well as to elucidate their mechanism[s] of action

Effects of propofol, ginsenoside Rg-1, protein phosphatase-2a, and lithium on the learning and memory in rats and the content of glutamic acid in hippocampus after the electroconvulsive therapy / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore and compare the effects of propofol, ginsenoside Rg-1, protein phosphatae-2A, and lithium on the learning and memory and the concentration of glutamic acid in hippocampus after the electroconvulsive therapy (ECT) in the model of depressed rats induced after the removal of olfactory bulb.</p><p><b>METHODS</b>The depressed rats were randomized into ECT intervention (two levels:no disposition and a course of electroconvulsive shock) and drug intervention (five levels:microinjection of saline injection, propofol, ginsenoside Rg-1, protein phosphatae-2A, and lithium, 20 g/L). Learning and memory were evaluated using the Morris water maze test within 24 h after the course of ECT. Glutamate contents in the hippocampus of rats were examined using high-performance liquid chromatography.</p><p><b>RESULTS</b>Both propofol alone and ECT alone induced the impairment of learning and memory in depressed rats, but their combination alleviated the such impairment caused by ECT. Ginsenoside Rg-1, protein phosphatae-2A ,and lithium had no obvious effect on the leaning and improved the learning and memory when in combination with ECT. There was a synergic effect between ECT intervention and drug intervention. ECT remarkably increased the glutamate content in the hippocampus of depressed rats, which could be reduced by both propofol and ginsenoside Rg-1. Protein phosphatae-2A and lithium did not affect glutamate content in the hippocampus of depressed rats before and after ECT.</p><p><b>CONCLUSIONS</b>ECT can increase the content of glutamate in hippocampus and thus cause the impairment of learning and memory in depressed rats. Propofol and ginsenoside Rg-1 can ameliorate the impairment by reducing the content of glutamate in hippocampus. Protein phosphatae-2A and lithium may also improve the learning and memory in depressed rats.</p>

Effect of Acute and Chronic Electroconvulsive Shock on 5-Hydroxytrypamine 6 Receptor Immunoreactivity in Rat Hippocampus

Electroconvulsive shock (ECS) induces not only an antidepressant effect but also adverse effects such as amnesia. One potential mechanism underlying both the antidepressant and amnesia effect of ECS may involve the regulation of serotonin (5-hydroxytryptamine) 6 (5-HT6) receptor, but less is known about the effects of acute ECS on the changes in 5-HT6 receptor expression in the hippocampus. In addition, as regulation of 5-HT receptor expression is influenced by the number of ECS treatment and by interval between ECS treatment and sacrifice, it is probable that magnitude and time-dependent changes in 5-HT6 receptor expression could be influenced by repeated ECS exposure. To explore this possibility, we observed and compared the changes of 5-HT6 receptor immunoreactivity (5-HT6 IR) in rat hippocampus at 1, 8, 24, or 72 h after the treatment with either a single ECS (acute ECS) or daily ECS for 10 days (chronic ECS). We found that acute ECS increased 5-HT6 IR in the CA1, CA3, and granule cell layer of hippocampus, reaching peak levels at 8 h and returning to basal levels 72 h later. The magnitude and time-dependent changes in 5-HT6 IR observed after acute ECS were not affected by chronic ECS. These results demonstrate that both acute and chronic ECS transiently increase the 5-HT6 IR in rat hippocampus, and suggest that the magnitude and time-dependent changes in 5-HT6 IR in the hippocampus appear not to be influenced by repeated ECS treatment.

Aspectos bioéticos del tratamiento de trastornos mentales con electroshock / Bioethical aspects of the treatment of mental disorders electroshock

Introducción: En el presente estudio presentamos los resultados obtenidos en relación a los aspectos bióeticos del tratamiento de pacientes internados en el Hospital Victor Larco Herrera, declarados inimputables y que son refractarios a tratamiento. Objetivo: Determinar los aspectos bioéticos del tratamiento con y el nivel de coordinación entre el ámbito judicial y sanitario. Material y método: Se basó en la revisión de las historias clínicas de los pabellones del Departamento de Hospitalización del Hospital Victor Larco Herrera. Población: En salas para 120 pacientes comunes con sintomatología aguda se encuentran 23 pacientes declarados inimputables. Resultados: En las salas para pacientes comunes con trastornos mentales se encontró 28 pacientes más declarados inimputables que presenta el 23,3% adicionales de camas para pacientes comunes, ocupadas por población con medidas de internacion de acuerdo a los delitos cometidos, que si fueran a la cárcel no se estaria cumpliendo con el principio de beneficiencia y de justicia. Los pacientes declarados inimputables; el mayor porcentaje tienen diagnostico de esquizofrenia y son refractarios a medicación anti psicótica clásica por lo que es necesaria la terapia electro convulsiva aún considerando los efectos adversos, pero que son beneficiosos para su pronta recuperación lo que se confronta el principio de no maleficiencia. Así mismo, el consentimiento informado que es un derechos el paciente a acceder o no a un tratamiento riesgoso, lo hacemos en resguardo de preservar el principio de autonomía del paciente. Conclusión: El presente trabajo nos permite concluir que se cumple con los principios bióeticos con el tratamiento con electroshock y existen dificultades de coordinación del poder Judicial y el ámbito sanitario.

Introduction: In this study we present the results obtained in relation to bioethical aspects of inpatient treatment in Victor Larco Herrera Hospital, declared not criminally responsible and who are refractory to treatment. Objective: Determining bioethical aspects electroshok treatment, and the level of coordination between the judicial and healthcare. Material and methods: The methodology used for this study was based on a review of the medical records of the ward of the Hospital Department Victor Larco Herrera Hospital. Population: 120 rooms common in patients with acute symptoms are declared not criminally responsible 23 patients (representing 38,33%) Results: In rooms for patients with common mental disorders over 28 declared not criminally responsible patients representing 23,3% of additional beds for public patients, occupied population interned measures according to the offenses, was found, on the contrary would to jail would not comply with the principle of beneficence and justice. Patients held criminally responsible, have the highest percentage of Schizophrenic diagnosis and who are refractory to classical anti psychotic medication is necessary electroconvulsive therapy even considering the adverse effects but that are beneficial for a speddy recovery to the principle of non - maleficence is confronted. Also reported Consent is a patient’s right to access or not a risky treatment, we do in defence of preserving the principle of patient autonomy. Conclusion: This Work allows us to conclude that it meets the bioethical principles electroshok trearment and there are difficulties in coordination of the judiciary and the health field.

Embarazo y depresión / Pregnancy and depression

La situación clínica que representa la coexistencia de un episodio depresivo en el transcurso de un embarazo en la vida de una mujer, reviste una gran complejidad y obliga al psiquiatra a evaluar múltiples variables. La alta prevalencia de depresión en las mujeres y la coincidencia temporal con la edad fértil, hace que dicha eventualidad no sea una rareza, sino más bien un escenario posible y frecuente. En este capítulo se describen las características clínicas de la depresión antenatal, se dan pautas de tratamiento teniendo en consideración los cambios farmacocinéticos del embarazo, se discute el dilema clínico sobre el uso de la medicación psicofarmacológica en la gestación y su posible impacto en el desarrollo obstétrico y en el neonato, y se dimensionan las consecuencias de la patología psiquiátrica no tratada. Se propone un abordaje racional sobre la correcta evaluación de los riesgos de la conducta a adoptar; es decir, la valoración del riesgo de la medicación en el embarazo, el riesgo de no medicar a una embarazada cuando la depresión lo amerita y el impacto de la patología psiquiátrica sobre la mujer, el embarazo en sí y el recién nacido.

The clinical situation representing the co-existence of a depressive episode during the course of a pregnancy in a woman's life is very complex and obliges the Psychiatrist to evaluate multiple variables. The high prevalence of depression among women, and the temporal coincidence with childbearing age makes this eventuality not strange, but rather a possible and frequent scenario. In this chapter, the author describes the clinical characteristics of antenatal depression, provides the treatment guidelines taking into consideration the pharmacokinetic changes of pregnancy, discusses the clinical dilemma on the use of psychopharmacological medication during conception and its possible impact on the obstetric development and the newly born, and measures the consequences of untreated psychiatric pathoogy. The author proposes a rational approach to the correct evaluation of the risks of the behavior to be adopted; that is to say, the assessment of the risk of the medication in pregnancy, the risk of not medicating a pregnant woman when depression calls for it, and the impact of the psychiatric pathology on the woman, the pregnancy itself and the newly born.

Hipotermia y corazón / Hypothermia and heart

Las ondas J o de Osborn son deflexiones positivas al final del complejo QRS, que han sido descritas en electrocardiogramas de pacientes con hipotermia. Se presenta el caso de un paciente masculino de 62 años de edad con hipotermia, cuyo electrocardiograma mostró bradicardia sinusal y ondas de OSBORN...

Ejercicio físico y depresión en adultos mayores: una revisión sistemática / Physical Exercise and Depression in the Elderly: A Systematic Review

Antecedentes: La literatura avala los beneficios del ejercicio para personas con trastornos depresivos; sin embargo, hay controversia sobre estos beneficios para personas adultas mayores deprimidas. Objetivo: Determinar el efecto de diferentes tipos de ejercicio en la depresión de adultos mayores mediante una revisión sistemática de ensayos clínicos. Fuentes de los datos: The Cochrane Library; PubMed-MEDLINE (1966-diciembre de 2010); EMBASE (1980-diciembre de 2010); LILACS (1986-diciembre de 2010); SCIELO (1998-diciembre de 2010), y Register of Controlled Trials; búsqueda manual en otros orígenes. Métodos: Se incluyeron ensayos clínicos con personas de edad > 60 años con diagnóstico de depresión, sin restricción por a ño de publicación, idioma y sexo, con intervenciones estructuradas de ejercicio y controlados con el cuidado usual (medicamentos, psicoterapia, terapia de electrochoque), placebo o sin intervención. Tres evaluadores realizaron la búsqueda, aplicaron los criterios de inclusión y exclusión, evaluaron la calidad metodológica y extrajeron los datos de manera independiente; las discrepancias se resolvieron por consenso. El desenlace primario fue la puntuación de los síntomas depresivos. Resultados: Se identificaron 11 estudios (n = 7.195). En general, el ejercicio produce mejoría de la depresión en adultos mayores, con mayor evidencia a corto plazo (3 meses) y con trabajos de fuerza a alta intensidad. Conclusiones: El ejercicio es benéfico para las personas adultas mayores con depresión; sin embargo, los estudios que lo respaldan son de baja calidad metodológica y heterogéneos, lo que hace necesario realizar ensayos clínicos que clarifiquen la magnitud del efecto y las dosis a las cuales es benéfico.

Background: The literature supports the benefits of exercise in people with depressive disorders, but there is controversy over these benefits in depressed elderly. Objective: To determine the effect of different types of exercise on depression in older adults using a systematic review of clinical trials. Data sources: The Cochrane Library; PubMed-MEDLINE (1966-dic 2010); EMBASE (1980-dic 2010); LILACS (1986-dic 2010); SCIELO (1998-dic 2010); Register of Controlled Trials; manual search in other sources. Methods: Clinical trials with people >60 years with diagnosis of depression were included, without restriction by year of publication, language and sex, with exercise intervention structures, controlled with usual care (medication, psychotherapy, electric shock therapy), placebo or non-intervention. Three independent reviewers conducted the search, applied inclusion and exclusion criteria, assessed methodological quality and extracted data; discrepancies were resolved by consensus. The primary outcome was the score for depressive symptoms. Results: A total of 11 studies (n =7195) were identified. In general, exercise produces an improvement in depression in older adults with more evidence in the short-term (3 months) and strength training at high intensity. Conclusions: Exercise is beneficial for older persons with depression, but studies that support this are of low methodological quality and heterogeneous, which makes it necessary to develop clinical trials to clarify the magnitude of the effect and the levels at which it is beneficial.

Relación del aporte de oxígeno y la supervivencia del paciente con shock en UCI / Relation of the constribution of oxygen and the survival of the patient with shock in UCI

Introducción: establecer la repercusión en la supervivencia del pacientecríticamente enfermo con diagnóstico de shock y el diagnóstico del equilibrioácido-base presentes en los gases sanguíneos de ingreso a la Unidad de Cuidados Intensivos.Métodos: estudio tipo cohorte concurrente. Ámbito: una Unidad de Cuidados Intensivos general. Pacientes: pacientes con diagnóstico de shock a los que se les toma gases sanguíneos al ingreso de la Unidad y se monitorean los gases a través del tiempo hasta el egreso del paciente. Variables de interés: el desenlace se definió como la supervivencia de los pacientes en función del tiempo. También se monitorizaron en función del tiempo variables del equilibrio ácido-base, función respiratoria, función ventilatoria y electrolitos en sangre.Resultados: el modelo de regresión de Cox mostró que los pacientes hombres que ingresan a la unidad con diagnóstico de shock tienen un riesgo 2.78 veces mayor de fallecer que las mujeres. Las variables FiO2 y THbc funcionan como predictivas de mortalidad y las variables PAO2, PCO2 y PO2 son factores protectores de mortalidad.Conclusión: el oportuno diagnóstico del equilibrio ácido-base en un pacientecon shock que ingresa a una UCI, y la intervención inmediata de las variables de porte de oxígeno (PAO2, FiO2, THBc, PCO2 y PO2) cambiarán favorablemente el pronóstico y la supervivencia de los pacientes.