[Peri-ictal electrocardiographic alterations in paediatric epilepsy patients. A prospective study]. / Alteraciones electrocardiográficas periictales en pacientes pediátricos con epilepsia. Un estudio prospectivo.

INTRODUCTION: Epileptic seizures can be associated with peri-ictal heart rhythm disorders and even sudden death (SUDEP). Few paediatric studies have been conducted on the subject. AIM: To determine heart rhythm disorders in paediatric patients with epilepsy who were studied with video-electroencephalogram (video-EEG). METHODS: Prospective, observational study in patients under 18 years of age admitted for video-EEG at the Hospital Clinico Red de Salud UC-Christus, Santiago, Chile. A neurological and cardiological evaluation and electrocardiogram (ECG) were performed, in addition to a Holter ECG simultaneously with the video-EEG. RESULTS: Twenty-five patients were studied, 12 with refractory epilepsies, 23/25 focal and 20 on polytherapy. Altogether 768 hours of video-EEG were recorded, including 281 seizures in 15 patients: 157 clinical and 103 generalised. There were no serious arrhythmias, only non-specific or probably benign disorders, mainly incomplete right bundle branch block in 11 patients, which were more frequent in refractory epilepsies (p<0.036). Heart rate variation occurred mainly in seizures >30 seconds. No patient presented SUDEP. CONCLUSIONS: This is the first prospective study, with a new technique, using video-EEG and Holter ECG simultaneously in paediatrics. Despite the high number of seizures and refractory patients, we found no serious heart rhythm disorders, consistent with the clinical evaluation. Right bundle branch block is considered a non-pathological cardiological finding, but was highly prevalent in our sample compared to the normal population, especially in refractory epilepsy. Given that this is a serious event in epilepsy, it is important to further investigate such studies to assess preventive measures.

TITLE: Alteraciones electrocardiográficas periictales en pacientes pediátricos con epilepsia. Un estudio prospectivo.Introducción. Las crisis epilépticas pueden asociarse a alteraciones del ritmo cardíaco periictales e incluso a muerte súbita (SUDEP). Existen escasos estudios pediátricos al respecto. Objetivo. Determinar las alteraciones del ritmo cardíaco en pacientes pediátricos con epilepsia estudiados con videoelectroencefalograma (video-EEG). Métodos. Estudio prospectivo, observacional, en pacientes menores de 18 años ingresados para video-EEG en el Hospital Clínico Red de Salud UC-Christus, Santiago, Chile. Se realizó una evaluación neurológica y cardiológica, electrocardiograma (ECG) y Holter ECG simultáneo al video-EEG. Resultados. Se estudió a 25 pacientes, 12 con epilepsias refractarias, 23/25 focales y 20 en tratamiento con politerapia. Se registraron 768 horas de video-EEG, incluyendo 281 crisis epilépticas en 15 pacientes: 157 clínicas y 103 generalizadas. No hubo arritmias graves; sólo alteraciones inespecíficas o probablemente benignas, principalmente bloqueo incompleto de la rama derecha en 11 pacientes, más frecuente en las epilepsias refractarias (p menor de 0,036). La variación de la frecuencia cardíaca ocurrió principalmente en crisis > 30 segundos. Ningún paciente ha presentado SUDEP. Conclusiones. Éste es el primer estudio prospectivo, con una nueva técnica, usando simultáneamente video-EEG y Holter ECG en pediatría. Pese al alto número de crisis y pacientes refractarios, no encontramos alteraciones graves del ritmo cardíaco, en concordancia con la evaluación clínica. El bloqueo de la rama derecha se considera un hallazgo cardiológico no patológico, pero tuvo una alta prevalencia en nuestra muestra, comparada con la población normal, especialmente en la epilepsia refractaria. Dado que la SUDEP es un evento grave en la epilepsia, es importante ahondar más en este tipo de estudios para evaluar medidas preventivas.

A study of the histological classification and grading of canine malignant mammary tumours in Trinidad

Objective: Mammary gland tumors are a common occurrence in dogs, cats and humans but a rarity in other species. Histologically, grading these tumors evaluates the relevant prognostic variables which may be useful in treatment. The objective of this study was to classify canine malignant mammary tumours according to their morphological and staining characteristics using a standardized histologic classification scheme. Design and Methodology: A total of n = 78 canine mammary gland tumours (CMTs) were diagnosed during the period March 2013 to April 2017. CMTs were evaluated subsequent to routine tissue processing for microscopic evaluation followed by statistical analyses. Results: The two main tumour groups examined were malignant epithelial neoplasms and malignant epithelial neoplasms ­ special types, n= 69 (88.5%) and n= 9 (11.5%) respectively. The majority, n= 62 (79.5%) of tumours were classified as low grade or well differentiated (grade 1), n= 14 (17.9%) of tumours were intermediate grade or moderately differentiated (grade 2) and n= 2 (2.6%) of tumours were classified as high grade or poorly differentiated (grade 3). The significance of age or breed predilection could not fully be determined with this small sample size n = 78, however, all the dogs in this study were female. Conclusion: This study is the first of its kind to be conducted in Trinidad, which fully applies a standardized classification scheme as an independent prognostic indicator of CMTs.

A review of neoplastic and non-neoplastic canine skin tumours in Trinidad from 2010-2015

This retrospective study was performed on samples submitted to the Pathology Unit of the School of Veterinary Medicine, Faculty of Medical Sciences, St. Augustine, Trinidad, during the period 2010 to 2015. A total of 471 non-inflammatory cutaneous masses were analyzed, of which 225 (47.8%) were malignant, 202 (42.9%) were benign and 44 (9.3%) were non-neoplastic. The most common malignant tumors were haemangiosarcoma, 50 (22.2%); mast cell tumour, 49 (21.8%); soft tissue sarcoma 35 (15.6%), lymphoma, 20 (8.9%) and melanoma 20 (8.9%). The most common benign tumors were haemangioma, 39 (19.3%); lipoma, 27 (13.4%), trichoblastoma, 26 (12.9%), histiocytoma 25 (12.4%), plasma cell tumor, 23 (11.4%) and papilloma 9 (4.5%). Common non-neoplastic skin lesions included collagen naevi, 26 (59.1%) and follicular cysts, 11 (25.0%). Mixed breed dogs 241 (51.2%), was most frequently represented with neoplasms followed by Rottweilers 50 (10.6%) and Pit bulls 48 (10.1%).

Prepartum fatty acid supplementation in sheep I. Eicosapentaenoic and docosahexaenoic acid supplementation do not modify ewe and lamb metabolic status and performance through weaning.

Fatty acids are involved in the regulation of many physiological pathways, including those involved in gene expression and energy metabolism. Through effects on these pathways, fatty acids may have lifelong impacts on offspring development and metabolism via maternal supplementation. Therefore, our objective was to investigate the impact of supplementing a source of omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) during late gestation on productive and metabolic responses of ewes and their offspring. Eighty-four gestating ewes (28 pens) were blocked and randomly assigned to a diet with 0.39% added fat during the last 50 d of gestation (d -0). The fat sources were Ca salts of a palmitic fatty acid distillate (PFAD) or EPA + DHA. After lambing (d 1), all ewes and lambs were placed on the same pasture. The ewes were weighed and BCS was measured on d -50, -20, 30, and 60 (weaning) of the experiment. Blood samples were taken from the ewes on d -50, -20, 1 (lambing), 30, and 60. Milk yield and composition were measured at 30 d postpartum. Lambs were weighed and bled at d 1, 30, and 60, and ADG was calculated. All plasma samples were analyzed for glucose and NEFA. Ghrelin, prostaglandin E metabolites (PGEM), and the prostaglandin D2 metabolite 11ß-PGF2α were measured in d -20 ewe samples. Insulin and adropin were measured in lamb samples at d 60. There was no difference on ewe BW (P = 0.48) or BCS (P = 0.55), or plasma concentrations of glucose (P = 0.57), NEFA (P = 0.44), ghrelin (P = 0.36), PGEM (P = 0.32), and 11ß-PGF2α (P = 0.86) between ewes supplemented with PFAD or EPA + DHA. Neither milk yield nor its composition was different (P > 0.10) among treatments. Lambs born from ewes supplemented with PFAD or EPA + DHA did not have different BW (P = 0.22), ADG (P = 0.21) or plasma NEFA (P = 0.52), glucose (P = 0.50), insulin (P = 0.59), and adropin (P = 0.72) concentrations. These results suggest that supplementation of EPA and DHA during late gestation did not affect ewe metabolic profile or milk production. Lamb performance and metabolism through weaning were not affected by maternal supplementation with an enriched source of EPA and DHA.

A Review of the Cause and Manner of Death of Suspected Animal Abuse Cases in Trinidad And Tobago, 2008-2015

Background: Forensic veterinary pathology is becoming increasingly important in investigation situations of suspected animal abuse. It is thought that the submission of suspected cases of animal abuse has increased over the past seven years in Trinidad and Tobago. Methodology: A search for owner or law-enforcement suspected animal abuse necropsy cases submitted at either the University of West Indies Veterinary Hospital or the Ministry of Agriculture, Land and Fisheries, Veterinary Diagnostic Laboratory for the period of 2008-2015 was performed. Based on pathology records and submission information, cases were categorized by signalment and cause of death (COD) or manner of injury (MOI) if the animal was euthanized. Results: A total of 84 cases of suspected animal abuse were submitted in the years 2008-2015. Although the submission of these cases decreased from 2008-2012, there has been an increased since then. The most commonly submitted animal species were dogs (74%) and sheep (7%). Of the 84 cases, only 22 (24%) had a confirmed COD/MOI. The most common confirmed COD/MOI was trauma (45%), followed by poisoning (27%). The majority of the unconfirmed COD/MOI involve suspected poisoning. Conclusions: Owners are becoming increasingly aware of the importance of pathology to help diagnose suspected animal abuse cases, and are becoming more interested in trying to prosecute those they suspect of harming their pets. Toxicological studies are currently limited, but they would be very useful in confirming cause of death for the majority of unresolved cases.

Identification of Myxozoa Parasite in the Connective Tissue of a Cascadura Fish (Hoplosternum Littorale) In Trinidad and Tobago

Background: Thirty cascadura (Hoplosternum littorale) fish from 5 different ponds were submitted alive to the Aquatic Animal Health Laboratory of the School of Veterinary Medicine, University of West Indies as part of monitoring and quarantine procedures of a commercial aquaculture farm. Cascadura fish are commercially important in Trinidad. Methodology: Water from the five different ponds was tested for quality. All fish were euthanized and necropsies were performed. Pooled samples from each pond were submitted for microbiology, parasitology, and histopathology. Results: All water samples had low alkalinity, low hardness, and low pH. In general, all ponds had evidence of low to moderate ecto- and endoparasitism. A section of connective tissue from the histopathologic samples of the pond with the lowest pH contained an area of hemorrhage and numerous poorly staining oval to tear-drop shaped organisms. These organisms stained brightly acid fast, and some included two polar capsules and a polar filament. No other signs of infection were noted in these fish. Conclusion: This is the first histopathologic description and report of myxozoan parasites in the cascadura in Trinidad. Myxozoa can be pathogenic, and should be included in the differential for causes of death in farmed cascadura, particularly when there is poor water quality which could affect the immune system of the fish.

Consenso chileno de manejo de fármacos antiepilépticos en algunos síndromes electro-clínicos y otras epilepsias en niños y adolescentes / Chilean consensus on the use of antiepileptic drugs in electro-clinical syndromes

Por iniciativa de tres instituciones: Liga Chilena contra la Epilepsia (LICHE), Sociedad de Epileptología de Chile (SOCEPCHI) y Sociedad de Psiquiatría y Neurología de la Infancia y Adolescencia (SOPNIA) de Chile, se constituye un comité de trabajo que convoca a un consenso de uso de fármacos antiepilépticos (FAEs) en un grupo de 16 Síndromes electro-clínicos y otras Epilepsias en niños y adolescentes. Cuarenta y dos médicos neuropediatras especialistas en Epilepsias de todas las regiones de Chile, participaron en la discusión y realizaron una propuesta de tratamiento farmacológico para cada cuadro. El comité de trabajo realizó un análisis exhaustivo y discusión de los documentos, para finalmente concluir en una recomendación de tratamiento para cada cuadro. Este consenso es una guía práctica de orientación para ayudar a las decisiones de tratamiento en situaciones clínicas concretas. Su objetivo final es ofrecer una mejor calidad de atención a los niños y adolescentes con epilepsias, a través de decisiones fundadas que contribuyan a disminuir la variabilidad de las decisiones terapéuticas.

Committed by three institutions: Liga Chilena contra la Epilepsia (LICHE), Sociedad de Epileptología de Chile (SOCEPCHI) y Sociedad de Psiquiatría y Neurología de la Infancia y Adolescencia (SOPNIA) de Chile, a 6-member working committee called for a meeting of 42 Chilean pediatric epileptologists from all over the country, with the aim of reaching a consensus on the use of antiepileptic drugs in 16 selected children and adolescents electro-clinical syndromes and epilepsies. These treatment proposals were analyzed and fully discussed by the working committee, ending in an antiepileptic drug treatment recommendation guideline for each condition. This consensus is a practical guideline to be used in specific clinical situations, which aims to support treatment decision making. Its main purpose is to offer the best evidence based treatments to our children and adolescents patients with epilepsy, thus contributing to diminish variability in therapeutic decisions.

Tiburones y rayss (subclase elasmobranchii) desartados por la flota de arrastrre camaronero en el caribe de Colombia / Sharks and Rays (Subclass Elasmobranchii) Discarded from Commercial Shrimp Trawlers at the Caribbean Sea of Colombia

Con el fin de obtener una aproximación a la estructura del ensamblaje de peces cartilaginosos extraídos por la flota de arrastre camaronero en la costa norte de Colombia, se evaluó la composición y abundancia de tiburones y rayas descartados en dos sectores del Caribe colombiano, entre agosto y noviembre de 2004. Mensualmente se analizaron lances de la flota de arrastre camaronero al interior de cada sector (norte: La Virgen y Portete; sur: Barú, cabo Tiburón, Cascajal, Cispatá, Morrosquillo, Ceycén, Mestizo, río Cedro, Tigua y Tortuguilla). Observadores a bordo de la flota comercial de arrastre camaronero muestrearon 1/5 de la captura previamente homogenizada, tomada al azar de una de las cuatro redes de la embarcación. En 30 lances se registró la presencia de 47 peces cartilaginosos, correspondientes a seis familias y ocho especies. La mayor Captura por Unidad de Esfuerzo (CPUE) en términos de biomasa se registró en ambas zonas durante septiembre, la menor en noviembre en la zona sur; el mayor valor del número de individuos se presentó en septiembre en la zona sur y el menor en noviembre, lo cual puede atribuirse a la mayor disponibilidad del recurso objetivo que está asociado al periodo de mayores lluvias que enriquece las aguas de los ambientes costeros y son usados como hábitat y zonas de alimentación por los peces cartilaginosos.

In order to have an approximation to the cartilaginous fishes assemblage structure exploited by commercial shrimp trawlers from the north coast of Colombia, composition and abundance of the discarded sharks and rays on two zones of the Colombian Caribbean, between August and November of 2004 were evaluated. Each month, a number of trawls were analyzed in each zone (north: La Virgen and Portete; south: Barú, Cabo Tiburón, Cascajal, Cispatá, Morrosquillo, Ceycén, Mestizo, Cedro river, Tigua and Tortuguilla). Observers were placed on board commercial shrimp trawlers, sampling 1/5 from the total capture, previously homogenized, which was randomly taken from one of the four nets of the vessel. Within 30 trawls, there were 47 cartilaginous fishes registered, belonging to six families and eight species. The largest capture per effort unit (CPUE) in biomass was registered on September in both zones, whereas the smallest happened on November in the south one. The greatest value in number of units was in September within the south zone and the opposite occurred in November, registering the smallest values. This could explain the great availability of the objective resource, directly associated with the heavier rainy season that enriches the waters of the coastal environment and characterizes the region, probably used as habitat and feeding grounds for the cartilaginous fishes.

Apolipoprotein E polymorphism in patients with acute pancreatitis.

We have shown that patients with previous acute pancreatitis (AP) may have an abnormal catabolism of chylomicron remnants (CMR). Because apoprotein E (Apo E) genetic polymorphism has an important influence on CMR clearance, we compared frequency distribution of Apo E phenotypes in 52 patients with AP, 109 patients with gallstones, and 110 control subjects. Apo E phenotypes were detected by isoelectric focusing and immunoblotting. After adjusting for differences in age and gender, fasting triglyceride level was comparable between the study groups. The frequency distribution of Apo E phenotypes was not different between the three study groups and it was in Hardy-Weinberg equilibrium. The gene frequency for Apo E2 was 0.212, 0.273, and 0.243 in AP, gallstone, and control group, respectively. For Apo E3 it was 0.701, 0.627, and 0.674, and for Apo E4 0.090, 0.100, and 0.083 in the same groups, respectively. Differences were not statistically significant (chi 2). In conclusion, the abnormal catabolism of CMR in patients with AP is not attributable to Apo E polymorphism. An alternative explanation may be sought in the activity of the recently identified hepatocytic Apo E receptor [LDL-related receptor protein (LRP)].