¿Anestesia halogenada o anestesia total endovenosa en neurocirugía? / Volatile or total intravenous anesthesia for neurosurgery?

Total intravenous anesthesia (TIVA) with propofol/remifentanil appears in the literatura as a good option for neurosurgical patients who have increased intracranial pressure (ICP),risk of postoperative nausea and vomiting (PONV), need for neuromonitoring, and in those with impaired brain self-regulation. On the other hand, in patients with normal neurological status, normal ICP, a technique with volatile (halogenated) agents plus an opiiid can be used. This review describes two anesthetic techniques available for use in neurosurgery, highlighting the neurophysiological changes, advantages and disadvantages of each technique. MATERIAL AND METHOD: PubMed search engine was used for bibliographic search. DISCUSSION: The search for an ideal anesthetic in neurosurgery is still a matter of debate. There are numerous investigations aimed at finding an optimal agent that ensure the coupling between cerebral flow (CBF) and metabolism, keeping self-regulation intact without increasing the CBF and intracerebral pressure (ICP). CONCLUSIONS: Both anesthetic techniques, TIVA and volatile agents (halogenated), can be used in neurosurgical procedures and should provide neuroprotection, brain relaxation and a rapid awakening.

La anestesia total endovenosa (TIVA) con propofol/remifentanilo aparece en la literatura como una buena opción para pacientes neuroquirúrgicos que tienen aumento de la presión intracraneana (PIC), riesgo de náuseas y vómitos posoperatorios (NVPO), necesidad de neuromonitoreo, y en aquellos con alteración de la autorregulación cerebral. Por otra parte, en pacientes con estado neurológico normal, PIC normal puede usarse una técnica con agentes volátiles (halogenados) más un opioide. Esta revisión describe dos técnicas anestésicas disponibles para su uso en neurocirugía, destaca los cambios neurofisiológicos, ventajas y desventajas de cada técnica. MATERIAL Y MÉTODO: Para búsqueda bibliográfica se usó buscador PubMed. DISCUSIÓN: La búsqueda de un anestésico ideal en neurocirugía sigue siendo tema de debate. Existen numerosas investigaciones destinadas a buscar un agente óptimo que asegure el acoplamiento entre flujo sanguíneo cerebral (FSC) y metabolismo, manteniendo la autorregulación intacta sin aumentar el FSC y presión intracerebral (PIC). CONCLUSIONES: Ambas técnicas anestésicas, TIVA y agentes volátiles (halogenados), pueden ser usadas en procedimientos neuroquirúrgicos y deben brindar neuroprotección, relajación cerebral y un despertar rápido.

Topography of the medullary cone of the feline night monkey: Clinical implications in epidural anesthesia / Topografia do cone medular do macaco-da-noite: auxiliando a abordagem peridural

Feline night monkey (Aotus azarae infulatus) is an arboreal primate that sleeps during the day hidden among branches of trees, leaving its hideout after nightfall. Little is known about the morphology of these animals, which leads to some difficulty in clinical and surgical approaches, as there has been substantial growth in the veterinarian’s role in maintaining the health and well-being of wildlife. Thus, we sought to investigate the topography and morphometry of the medullary cone, a small portion of the nervous system of the feline night monkey, which is of paramount importance in approaches for epidural anesthesia. Specimens from five young females were used, each with eight lumbar vertebrae, three sacral vertebrae, and a medullary cone with an average length of 7.5 cm, located between L5 and S3. Based on this finding, we suggest that a probable site for the application of epidural anesthesia is the space between S3 and Cc1.

O macaco-da-noite (Aotus azarae infulatus) é um animal arborícola que dorme durante o dia escondido entre os ramos, saindo do esconderijo após o anoitecer. Pouco se sabe sobre a morfologia destes animais, o que gera certa dificuldade nas abordagens clínico-cirúrgicas, uma vez que cresce substancialmente o papel do médico veterinário nas questões de saúde e bem-estar de animais selvagens. Visando contribuir com esses profissionais, buscou-se investigar a topografia e morfometria de uma pequena porção do sistema nervoso do macaco-da-noite, o cone medular, que é de suma importância nas abordagens quanto à anestesia peridural. Foram utilizados cinco espécimes fêmeas, jovens, de macaco-da-noite, que apresentavam oito vértebras lombares e três vértebras sacrais, e cone medular possuindo em média de 7,5 cm de comprimento, localizando-se entre L5 e S3. Este achado nos leva a sugerir como sítio provável para a aplicação de anestesia epidural, o espaço entre S3 e Cc1.

Comparative safety assessments of the biosimilar APZ001 and Erbitux in pre-clinical animal models

Abstract Purpose: To evaluate the toxicity of Erbitux as well as its biosimilar APZ001 antibody (APZ001) in pre-clinical animal models including mice, rabbits and cynomolgus monkeys. Methods: We performed analysis of normal behavior activity, autonomic and non-autonomic nervous functions, nervous-muscle functions, nervous excitability and sensorimotor functions on CD-1 mice. Subsequently, we studied that effects of APZ001 and Erbitux on respiratory system, cardiovascular system and kidney in Cynomolgus monkey models and performed local tolerance experiments on New Zealand rabbits. Results: The comparisons between APZ001 and Erbitux showed no significant differences in mice autonomic nervous system, nervous muscle functions, non-autonomic nervous functions, nervous excitability and sensorimotor functions between treated and untreated group (p>0.05). APZ001 and Erbitux showed negative effect on CD-1 mice in the present of pentobarbital sodium anesthesia (p>0.05). Single administrations of high, medium or low doses of APZ001 did not lead to monkey urine volume alterations (p>0.05). In human tissues, APZ001 and Erbitux showed positive signals in endocardium, lung type II alveolar epithelial cell and surrounding vessels, but showed negative results in kidney and liver tissues. No hemolysis phenomenon and serious side-effects in vessels and muscles were observed in rabbits when administrated with APZ001 and Erbitux respectively. Conclusion: The safety comparisons between APZ001 antibody and Erbitux showed that these two antibodies showed highly similarities in mice, rabbits and cynomolgus monkey animal models in consideration of pharmaceutical effects, indicating APZ001 might be a suitable substitute for Erbitux.

[Rasagiline protective effect On Rotenone-Induced Neurotoxicity in mice]

Background: Rasagiline is a selective monoamine oxidase [MAO] B inhibitor which has been approved for treatment of Parkinson's disease [PD]

Objectives: This study was performed to evaluate rotenone neurotoxicity in mice and to investigate the possible neuroprotective effect of rasagiline and its mechanism

Methods: Thirty six male mice were used and divided into three equal groups. The first group, the control group, received only sunflower oil intraperitoneally [IP] once daily at a volume of 4 ml/kg for 49 days. The second group was given rotenone [2 mg/kg/day; IP] for 49 days. The third group was given rasagiline [1 mg/kg, IP] which was administered 30 min prior to rotenone [2 mg/kg/day; IP] for 49 days. Behavioral tests were performed a day prior to drug administration and then once weekly along the duration of drugs or vehicle administration. At the end of the 49 days all animals were sacrificed and their midbrains were subjected to immunohistochemical analysis for dopaminergic neurons staining for anti-tyrosine hydroxylase [TH] antibodies. Midbrain tissues were also isolated for biochemical measurements

Results: Rasagiline administration significantly improved the mice activity. Pretreatment with rasagiline significantly attenuated rotenone-induced midbrain dopamine loss. Moreover, rasagiline treatment also significantly prevented the loss of TH immunoreactive neurons within the substantia nigra pars compacta [SNpc]. Furthermore, rasagiline inhibited the remarkable decrease in total antioxidant capacity as well as the increase in the malondialdehyde [MDA] level and nitric oxide generation induced by chronic rotenone administration

Conclusion: These results suggest that chronic intraperitoneal administration of rotenone induced PD-like disorder in mice. Moreover, these results suggest that rasagiline had neuroprotective effect against the rotenone-induced PD. This neuroprotective effect was mediated even in part by the antioxidant properties of rasagiline

Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers / Límites y posibilidades vividas por enfermeras en el tratamiento de mujeres con úlcera venosa crónica / Limites e possibilidades vivenciados por enfermeiras no tratamento de mulheres com úlcera venosa crônica

Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions. .

Objetivo Comprender las experiencias y expectativas de enfermeras en el tratamiento de mujeres con úlcera venosa crónica. Método Investigación fenomenológica fundamentada en Alfred Schutz, que buscó Se realizó entrevista semiestructurada con siete enfermeras, en enero del 2012. Resultados La enfermera revela dificultades presentadas por la mujer para realizar el autocuidado, percibe limitaciones en el tratamiento relacionadas con la desmotivación, los valores y las creencias de las mujeres. Refiere frustración profesional debido a la recidiva de la lesión, a la falta de insumos, al deficiente trabajo interdisciplinar y a la limitada capacitación del equipo de enfermeras. Espera la adhesión de la mujer al tratamiento y resalta la necesidad del cuidado continuo, del autocuidado apoyado y de estandarizar conductas de tratamiento. Conclusión El tratamiento de la úlcera venosa crónica es un desafío que requiere contribución colectiva, involucrando a las mujeres, a los profesionales, a los gestores y a las instituciones de salud. .

Objetivo Compreender as experiências e expectativas de enfermeiras no tratamento de mulheres com úlcera venosa crônica na Atenção Primária à Saúde. Método Pesquisa fundamentada na fenomenologia social de Alfred Schütz, com depoimentos obtidos em janeiro de 2012, por meio de entrevista semiestruturada com sete enfermeiras. Resultados As enfermeiras revelam dificuldades apresentadas pelas mulheres com úlcera venosa crônica para realizar o autocuidado, percebem limitações na terapêutica ancoradas na desmotivação e nos valores e crenças das mulheres. Referem frustração profissional em razão da recidiva da lesão, falta de insumos e tecnologia, de trabalho interdisciplinar e da capacitação da equipe de enfermagem. Esperam a adesão das mulheres ao tratamento e ressaltam a necessidade do cuidado contínuo, do autocuidado apoiado e da padronização de condutas no tratamento. Conclusão O tratamento da úlcera venosa crônica constitui-se em um desafio que requer investimento coletivo, envolvendo a mulher, os profissionais, os gestores e as instituições de saúde. .

Environmental Mercury and Its Toxic Effects / 예방의학회지

Mercury exists naturally and as a man-made contaminant. The release of processed mercury can lead to a progressive increase in the amount of atmospheric mercury, which enters the atmospheric-soil-water distribution cycles where it can remain in circulation for years. Mercury poisoning is the result of exposure to mercury or mercury compounds resulting in various toxic effects depend on its chemical form and route of exposure. The major route of human exposure to methylmercury (MeHg) is largely through eating contaminated fish, seafood, and wildlife which have been exposed to mercury through ingestion of contaminated lower organisms. MeHg toxicity is associated with nervous system damage in adults and impaired neurological development in infants and children. Ingested mercury may undergo bioaccumulation leading to progressive increases in body burdens. This review addresses the systemic pathophysiology of individual organ systems associated with mercury poisoning. Mercury has profound cellular, cardiovascular, hematological, pulmonary, renal, immunological, neurological, endocrine, reproductive, and embryonic toxicological effects.

Efectos de la marihuana en la cognición: una revisión desde la perspectiva neurobiológica / Effects of marijuana on cognition: a review form the neurobiological perspective

La marihuana es una sustancia psicoactiva ampliamente usada en la sociedad, especialmente entre los más jóvenes. El uso de esta sustancia ha sido asociado consistentemente con diversos problemas de salud, muchos de los cuales tienen en común una alteración en las manifestaciones cognitivas de la conducta, incluyendo la memoria, la atención, la emoción y la toma de decisiones. Se encontró evidencia que los cannabinoides, la sustancia activa de la marihuana, impactan negativamente en la memoria a corto plazo, memoria de trabajo y la toma de decisiones. Asimismo, los cannabinoides afectan la atención y la interacción entre los eventos cognitivos y la emoción. Esta información puede ser usada como argumento de plausibilidad biológica para interpretar una serie de hallazgos clínicos y epidemiológicos en los que el uso de marihuana se ha mostrado relacionado con problemas tales como accidentes de tránsito, psicosis, depresión, pobre trayectoria académica, entre otros.

Marijuana is one of the most commonly used psychoactive substances in society, mainly among youths. Its use has been consistently associated with several health problems, many of which have in common an impairment in the cognitive processes of behavior, including the memory, attention, emotion and decision making. There is evidence suggesting that cannabinoids, marijuana´s primary psychoactive substance, have a negative effect in short-term memory, working memory, and decision making. It has also been found that cannabinoids affect attention and the interaction between cognitive events and emotion. This information can be used as an argument of biological plausibility to assess clinical and epidemiological research findings that show that marijuana`s use is associated to problems such as traffic accidents, psychosis, depression and poor academic records, among others.

A priming role of local estrogen on exogenous estrogen-mediated synaptic plasticity and neuroprotection

The localization of estrogen (E2) has been clearly shown in hippocampus, called local hippocampal E2. It enhanced neuronal synaptic plasticity and protected neuron form cerebral ischemia, similar to those effects of exogenous E2. However, the interactive function of hippocampal and exogenous E2 on synaptic plasticity activation and neuroprotection is still elusive. By using hippocampal H19-7 cells, we demonstrated the local hippocampal E2 that totally suppressed by aromatase inhibitor anastrozole. Anastrozole also suppressed estrogen receptor (ER)beta, but not ERalpha, expression. Specific agonist of ERalpha (PPT) and ERbeta (DPN) restored ERbeta expression in anastrozole-treated cells. In combinatorial treatment with anastrozole and phosphoinositide kinase-3 (PI-3K) signaling inhibitor wortmannin, PPT could not improve hippocampal ERbeta expression. On the other hand, DPN induced basal ERbeta translocalization into nucleus of anastrozole-treated cells. Exogenous E2 increased synaptic plasticity markers expression in H19-7 cells. However, exogenous E2 could not enhance synaptic plasticity in anastrozole-treated group. Exogenous E2 also increased cell viability and B-cell lymphoma 2 (Bcl2) expression in H2O2-treated cells. In combined treatment of anastrozole and H2O2, exogenous E2 failed to enhance cell viability and Bcl2 expression in hippocampal H19-7 cells. Our results provided the evidence of the priming role of local hippocampal E2 on exogenous E2-enhanced synaptic plasticity and viability of hippocampal neurons.

Using systematic reviews and meta-analyses to support regulatory decision making for neurotoxicants: lessons learned from a case study of PCBs / Utilizando revisões sistemáticas e meta-análise de apoio às decisões regulatórias para neurotóxicos: lições de um estudo de caso dos PCBs

We examined prospective cohort studies evaluating the relation between prenatal and neonatal exposure to polychlorinated biphenyls (PCBs) and neurodevelopment in children to assess the feasibility of conducting a meta-analysis to support decision making. We described studies in terms of exposure and end point categorization, statistical analysis, and reporting of results. We used this evaluation to assess the feasibility of grouping studies into reasonably uniform categories. The most consistently used tests included Brazelton's Neonatal Behavioral Assessment Scale, the neurologic optimality score in the neonatal period, the Bayley Scales of Infant Development at 5-8months of age, and the McCarthy Scales of Children's Abilities in 5-year-olds. Despite administering the same tests at similar ages, the studies were too dissimilar to allow a meaningful quantitative examination of outcomes across cohorts. These analyses indicate that our ability to conduct weight-of-evidence assessments of the epidemiologic literature on neurotoxicants may be limited, even in the presence of multiple studies, if the available study methods, data analysis, and reporting lack comparability.

Foram examinados estudos de grupo que avaliaram a relação entre a exposição pré-natal e neonatal aos bifenilos policlorados (PCB) e o desenvolvimento neuropsicomotor em crianças a fim de avaliar a viabilidade da realização de uma meta-análise para suporte à tomada de decisão. Nós descrevemos os estudos em termos de exposição, categorizações, análise estatística e elaboração de relatórios de resultados. Nós utilizamos esta avaliação para verificar a viabilidade de agrupar os estudos em categorias razoavelmente uniformes. Os testes mais utilizados foram Brazelton Neonatal Behavioral Assessment Scale, a pontuação de otimalidade neurológica no período neonatal, as Escalas Bayley de Desenvolvimento Infantil de 5 a 8 meses de idade, e as Escalas McCarthy de habilidades das crianças em 5 anos de idade. Apesar de administrar os mesmos testes com idades semelhantes, os estudos foram muito diferentes para permitir uma análise quantitativa significativa dos resultados entre grupos. Estas análises indicam que a nossa capacidade de realizar avaliações da literatura epidemiológica sobre neurotóxicos pode ser limitada - mesmo na presença de vários estudos - se não existe nenhuma forma de comparação com os métodos de estudo disponíveis e análise dos dados.

Vincristine induced neurotoxicity: Study of 75 cases

Concern for side-effects of therapy related to treatment of childhood malignancies is becoming an increasingly important topic. In this study, we evaluated extent of vincristine [VCR] induced neurotoxicity in a group of children who underwent chemotherapy, with VCR being part of the regimen. In this investigation, for 75 children [54% boys, 46% girls], aged between 1 to 14 [mean 6.5 +/- 4.3] years, serial weekly neurological examinations were performed; of the 75, 70 had acute lymphoblastic leukemia and 5 Wilm's tumor. All patients were on a chemotherapy protocol of at least 4 consecutive VCR [1.5 mg/m[2]] injections. Decreased deep tendons reflexes were seen in the Achilles reflex in 78%, and the patellar reflex in 53% of patients. Muscle weakness was found in 70% of patients, being mild in 76% of them. Four percent of patients showed severe weakness. Petosis, jaw pain, hoarseness, abdominal pain and constipation were seen in 15%, 6%, 12%, 12% and 12% respectively. Paresthesia was observed in 32 of 52 patients, over 4 years old. No cases of foot drop, urinary retention or facial nerve palsy were seen in this patient group. Children on usual doses of vincristine regimen may have neuropathic side effects but most of these side effects are mild and not troublesome

Methylmercury neurotoxicity & antioxidant defenses.

Neurotoxicity induced by methylmercury (MeHg) increases the formation of reactive radicals and accelerates free radical reactions. This review summarizes recent findings in the MeHg-induced formation of free radicals and the role of oxidative stress in its neurotoxicity. Oxidative stress on CNS can produce damage by several interacting mechanisms, including mitochondrial damage with increase in intracellular free Ca(2+), activation and inhibition of enzymes, release of excitatory amino acids, metallothioneins expression, and microtubule disassembly. The nature of antioxidants is discussed and it is suggested that antioxidant enzymes and others antioxidants molecules may protect the central nervous system against neurotoxicity caused by MeHg.

Influence of sevoflurane and desflurane on neurological and adaptive capacity scores in newborns

To evaluate maternal and neonatal effects of desflurane compared with the sevoflurane for general anesthesia for cesarean section. The study was conducted as a prospective randomized blind study between January 2003 to January 2004 at the Hacettepe University, Ankara, Turkey. One hundred and two American Society of Anesthesiologists ASA I patients aged between 20-35 at 37-42 weeks of pregnancy were randomly allocated into 2 groups. All patients received thiopental and succinylcholine for induction. Patients assigned to the first group received desflurane 2.5%, and the second group sevoflurane 1.5% combined with 50% nitrous oxide and oxygen. Maternal blood loss, umbilical arterial blood gas values, delivery intervals, Apgar scores, and neurologic and adaptive capacity score NACS on the fifteenth minute, second hour, and twenty-fourth hour of age were evaluated to assess the neonatal status. One hundred and two 52 sevoflurane group, 50 desflurane group parturients were included in the study. In the desflurane group, NACS were significantly better on the fifteenth minute and second hour evaluations. There were no statistically significant differences in twenty-fourth hour NACS evaluations, Apgar scores, umbilical arterial blood gas values, delivery times, and maternal blood loss between the groups. Desflurane anesthesia offers more favorable results compared to sevoflurane in newborns delivered by elective cesarean section under general anesthesia in the early hours after delivery

Effect of tobacco smoking on renal function.

Nicotine is one of many substances that may be acquired through active and passive smoking of tobacco. In man, nicotine is commonly consumed via smoking cigarettes, cigars or pipes. The addictive liability and pharmacological effects of smoking are primarily mediated by the major tobacco alkaloid nicotine. High stress jobs favour repeated smoking and further reinforce addictive behaviours. There are elevated serum cadmium and lead levels in smokers resulting in glomerular dysfunction. Nephropathies are accelerated by nicotine with an increased incidence of microalbuminuria progressing to proteinuria, followed by type-1 diabetes mellitus induced renal failure. Cigarette smoke-induced renal damage is due, at least in part, to activation of the sympathetic nervous system resulting in an elevation in blood pressure. Ethanol, nicotine, or concurrent intake significantly increases lipid peroxidation in liver, and decreased superoxide dismutase activity and increased catalase activity in the kidney. This review describes the effects of nicotine, smoking, smoke extracts and other tobacco constituents on renal and cardiovascular functions, and associated effects on the nervous system. Both active and passive smoking is toxic to renal function.

Mefloquine - neuropsychiatric side effects profile

Mefloquine is a drug widely used for prophylaxis and treatment of malaria. The current study was aimed at finding out the common neuropsychiatric side effects in Pakistani troops serving abroad on United Nations peace keeping mission in malaria endemic areas and to prescribe alternative therapy in individuals more susceptible to these side effects. In a case control study 76 subjects taking mefloquine on weekly basis and reporting sick to the hospital were assessed for neuropsychiatric symptoms and compared with another 50 subjects not on this drug. This study was conducted at Pak-Field Hospital at Siera leone during 2003 to 2004. Sleep disturbances were found in 52.63%, while 60.52% had depressive and other mood related disorders. Anxiety was present in 35.52% whereas 6.57% subjects had psychotic symptoms. Other neurological symptoms like headache and tremors were common. General fatigue was seen in 61.84% of cases. Visual disturbances, delirium and seizure were not significant in our study. Mefloquine therapy in malaria is frequently associated with serious toxic and neurological side effects. An alternative regimen for prophylaxis and treatment is recommended in subjects who have history of mood disorders, paranoia, anxiety and convulsions

Theophylline toxicity in Thai children.

Theophylline is a useful drug in the treatment of respiratory diseases with bronchospasm but it has very narrow safety margin. The study was carried out in 44 admitted Thai children with plasma theophylline levels > 20 microg/ml to determine the association between blood levels and symptoms of theophylline toxicity. The prevalence of theophylline toxicity (plasma theophylline level > 20 microg/ml) in Thai children is about 11%. Thirty-four percent of the patients who had theophylline levels less than 30 microg/ml and 78% of those who had levels more than 30 microg/ml had symptoms of theophylline toxicity. The symptoms were related to the gastrointestinal tract (34%), cardiovascular system (18.2%), neurological system (6.8%) and metabolism (54.5%). The possible causes of theophylline toxicity were respiratory tract infection, theophylline overdosage, interaction with other drugs, impairment of liver function, congenital heart disease and theophylline usage in neonates. Theophylline is still a useful drug but should be used with caution. Theophylline levels should be checked in every child who receives theophylline.

Neurobehavioural study of subchronic administration of oxydemeton-methyl (insecticide and acaricide) in rats.

Oxydemeton-methyl, an organophosphate insecticide and acaricide produced decrease in the exploratory behaviour and prolongation of barbitone sodium induced hypnosis in rats after intermittent aerosol spray inhalational exposure, for 1/2 hour daily for 7 consecutive days, compared to the saline control group. Further, ED50 +/- SEM value for haloperidol induced catalepsy, CD50 +/- SEM value for pentylenetetrazole induced seizure and CI50 +/- SEM value for electroshock (i.e. the dose of haloperidol, PTZ and intensity of electroshock producing catalepsy or positive seizure response in 50% of rats) were significantly decreased after 7 days exposure to oxydemeton-methyl compared to that of saline control group. The study has established the central nervous system depressant effect, extrapyramidal effect and proconvulsant potential of oxydemeton-methyl which is widely used by the agricultural workers in the form of field spray.

Neurological complications after acute organophosphorus poisoning

Study was done in medical unit 1 BV hospital Bahawalpur to evaluate the neurological complications in Surviving patients of acute organophosphorus poisoning. There were 38 patients of acute poisoning admitted in unit 1 from 1 Jan 1994 to 31st Dec 1995.5 patients died due to poisoning. Out of thitrythree surviving patients five developed pure motor polyneuropathy which was axonal type. The mean duration for appearance of axonopathy clinically following poisoning was 31.8 days. There was no sensory neuropathy and other neurobehavioural changes. On follow up visits for one year there was no improvement

La aspirina, los antiinflamatorios no esteroides y el sistema nervioso central / Aspirin, ANSAIDs and central nervous system

La aspirina es un medicamento que desde 1980 ha sido aceptado formalmente (Food and Drug Administration) como antiagregante plaquetario para prevenir la recurrencia del ataque isquémico transitorio y el infarto cerebral, hecho demostrado en diversos estudios. La dosis ideal áun no se ha definido pero la mayoría de los investigadores sugieren individualizar cada caso y si es posible usar dosis medias (325-600 mg al día) o altas (1,000-1,200 mg al día). En la prevención primaria de la enfermedad vascular cerebral, todavía no ha sido probada la eficacia de este fármaco de manera absoluta. Estudios recientes han demostrado cierto beneficio a corto plazo con el uso de aspirina en la isquemia cerebral aguda, que habrá de confirmarse con futuras investigaciones. En los últimos diez años se han acumulado evidencias de la utilidad de algunos antiinflamatorios no esteroides para mejorar los aspectos cognocitivos de los pacientes con Enfermedad de Alzheimer, lo cual amplía las expectativas de mejorar la calidad de vida de estos enfermos

Behavioural alterations in rats induced by single prenatal exposure of haloperidol.

Haloperidol (50 mg/kg, i.p.) treatment was given once to two different groups of pregnant Charles Foster rats on gestational day 9 and 14, these being respectively the critical periods of neural morphogenesis and rapid neural cell proliferation in this species. Pregnant control rats were similarly treated with equal volume of vehicle. The pups born were subjected to open-field exploratory behaviour and elevated plus-maze behaviour tests of anxiety and learned helplessness test of depression at 9 weeks of age. The results indicate that prenatal haloperidol treatment on gestational day 14 induces a significant increase in open-field ambulation and faecal droppings whereas haloperidol treatment on gestational day 9 caused significantly decreased rearing and unaltered ambulation in rat offsprings. Rat offsprings treated with haloperidol on gestational day 9 and 14 also displayed significant anxiogenic behaviour pattern on elevated plus-maze. Significantly increased number of escape failures were observed in learned helplessness tests indicating presence of depression in haloperidol treated rat offsprings. These behavioural alterations were found to be more marked in rat offsprings treated with haloperidol on gestational day 14. The results suggest that prenatal single exposure of high dose of haloperidol during critical period of neural cell proliferation leaves a lasting imprint on offsprings resulting in abnormal emotional state.