Alterations in Mesoscopic Oscillations affecting Episodic Memory following Developmental Traumatic Brain Injury.

Certain deficits of episodic memory among young adults are the delayed consequences of an earlier mild or moderate Traumatic Brain Injury (mTBI). We examined alterations in hippocampal Local Field Oscillations (LFOs) of equivalently-impaired juvenile rodents to identify reliable functional markers of single-incidence mTBI. Two persistent, behavior-dependent, electrophysiological markers of injury were identified in the absence of external physiological symptoms by the analysis of wirelessly-transmitted hippocampal LFOs (3-80Hz) during repeat measures of the Novel Object Recognition (NOR) paradigm. Using a new method for detecting functional network activity at a single recording site, we correlated instantaneous increases in theta frequency and gamma magnitude with injury during periods of functional network organization and dissolution, presented here as Theta Epochs (TEs) and Theta Non-Epochs (TNEs), respectively. We estimated the efficacy of networks across pairs of such sites using new metrics such as the Coherence of Theta Phase (PCOH) and Inter-Epoch Intervals (IEIs) and demonstrated that behavioral deficits observed during the NOR testing stage correspond to electrophysiological deficits recorded during the preceding NOR familiarization stage. Increased theta frequency during TNEs and increased smoothness of PCOH during TEs were found to be robust markers of injury during memory-reliant behaviors.

A rare case of recurrence of primary spinal neurocysticercosis mimicking an arachnoid cyst.

Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system but isolated primary spinal NCC is of very rare occurrence. The authors report a case of 44-year-old male, a postoperative case of multiple spinal NCC lesion excision 2 years ago, who presented with cauda equina syndrome and magnetic resonance imaging revealed a lesion mimicking an arachnoid cyst in the D1-9 region of the spinal cord. On intraoperative surgical exposure multiple cysts were found and excised. The suspicion of recurrence of NCC was confirmed by histopathology. Postoperatively there was significant improvement in neurological symptoms of the patient. Recurrence of primary spinal NCC should be considered in differential diagnosis of an arachnoid cyst if there is a definitive past history.

Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery.

BACKGROUND AND AIMS: In an attempt to improve the recovery and early rehabilitation after arthroscopic knee surgery, various medications have been administered via intra-articular route to prolong the duration and improve the quality of postoperative analgesia. Among the potentially effective substances, steroids like dexamethasone could be of particular interest. MATERIALS AND METHODS: Fifty patients undergoing elective knee arthroscopy were randomly assigned to one of the following groups containing 25 patients each. Group D patients received 8 mg (2 mL) of dexamethasone added to 18 mL of 0.25% levobupivacaine intra-articularly, (total volume 20 mL). Group L patients received 18 mL of 0.25% levobupivacaine and 2 mL of isotonic saline (20 mL in total) intra-articularly. Analgesic effect was evaluated by measuring pain intensity visual analogue scale score and duration of analgesia. RESULTS: A longer delay was observed between intra-articular injection of study medication and first requirement of supplementary analgesic in Group D (10.24 ± 2.8 hours) compared with Group L (5.48 ± 1.6 h). Total consumption of diclofenac sodium in first 24 h in postoperative period was significantly less in Group D. No significant side effects were noted. CONCLUSION: Dexamethasone, used as adjunct to levobupivacaine in patients undergoing arthroscopic knee surgery, improves the quality and prolongs the duration of postoperative analgesia.

A comparative study of efficacy of oral nonsteroidal antiinflammatory agents and locally injectable steroid for the treatment of plantar fasciitis.

OBJECTIVES: To compare the effectiveness of oral nonsteroidal antiinflammatory drugs (NSAIDs) and locally injectable steroid (methylprednisolone) in the treatment of plantar fasciitis. MATERIALS AND METHODS: One hundred and twenty subjects with unilateral plantar fasciitis were recruited and randomly allocated to two study groups. Group I (NSAIDs group) (n=60) received oral tablet diclofenac (50 mg) and paracetamol (500 mg) twice a day (BD) along with tab. ranitidine 150 mg BD. Group II (injectable steroid group) (n=60) received injection of 1 ml of methylprednisolone (Depomedrol) (40 mg) and 2 ml of 0.5% bupivacaine into the inflammed plantar fascia. Pain intensity was measured using 10 cm visual analog scale (VAS). Subjects were evaluated clinically before, and 1 week, 2 weeks, 4 weeks, and 8 weeks (2 months) after the initiation of treatment in both the groups. The outcome was assessed in terms of VAS score and recurrence of the heel pain. STATISTICAL ANALYSIS USED: "Z" test and Chi-square test were used wherever applicable. RESULTS: Pain relief was significant after steroid injection (P<0.001) and the improvement was sustained. The recurrence of heel pain was significantly higher in the oral NSAIDS group (P<0.001). CONCLUSION: Local injection of steroid is more effective in the treatment of plantar fasciitis than oral NSAIDs.

Palonosetron and palonosetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: A prospective, randomized, double-blind comparative study.

BACKGROUND: Laparoscopic cholecystectomy (LC) is associated with a high risk of postoperative nausea and vomiting (PONV). Palonosetron is a newer 5HT3 receptor antagonist, which is routinely used in our institution to prevent PONV in patients scheduled for LC, under general anesthesia (GA). We formulated this study to find out whether the palonosetron and dexamethasone combination will be a better choice than palonosetron alone in the prevention of PONV. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists (ASA) physical status I and II patients, scheduled for LC under GA, were randomized to receive either palonosetron or a combination of palonosetron and dexamethasone. The number of complete responders (no emesis, no requirement of rescue anti-emetic medication) and the four-point nausea score was recorded at 2, 6, 24, 48 h postoperatively and the data was analyzed statistically. RESULTS: The number of complete responders, as well as the nausea score, did not vary significantly (P=0.718) between the two groups over the 48-h postoperative period. CONCLUSIONS: The palonosetron and dexamethasone combination was not more effective than palonosetron alone in the prevention of PONV, in patients undergoing LC under GA.

Postoperative tension pneumocephalus following cerebral aneurysm surgery in supine position without prior lumbar drainage.

The occurrence of tension pneumocephalus in neurosurgeries done in the supine position is scarcely reported. We present a case of 57-year-old man who developed tension pneumocephalus postoperatively, following cerebral aneurysm surgery, in supine position, where lumbar drainage before clipping surgery was not done. The patient's neurological status deteriorated rapidly, characterized by convulsion and unresponsiveness to external stimuli, 1 h following the uneventful surgery. Immediate computed tomography scan revealed bi-frontal tension pneumocephalus. Long duration of surgery and cerebrospinal fluid loss were assumed to be the causative factors. The patient was treated immediately with frontal drill hole evacuation for intracranial air, which saved the patient from a life threatening complication.

Incidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports.

Dexmedetomidine has predictable, complex, and negative cardiovascular effects that lead to additional adverse effects such as bradycardia and hypotension in up to 42% of patients and might cause profound left ventricular dysfunction and refractory shock. Usually, these temporary effects can be successfully counteracted with atropine, ephedrine, and volume supplementation. Clinicians need to be well informed about the potential of dexmedetomidine to cause bradycardia, which may progress to pulseless electrical activity, particularly in patients older than 50 years and patients with cardiac abnormalities. Here, we report the clinical characteristics of six patients who were scheduled for various neurosurgical procedures within a period of three months and suffered from cardiac arrest following dexmedetomidine administration. We urge clinicians to take caution against the negative effects of dexmedetomidine, especially when it is used in patients older than 50 years with underlying cardiac disease and in combination with cardiodepressant drugs.

Synthesis, crystal structure and magnetic properties of three unprecedented tri-nuclear and one very rare tetra-nuclear copper(II) Schiff-base complexes supported by mixed azido/phenoxo/nitrato or acetato bridges.

Three novel mixed bridged trinuclear and one tetranuclear copper(II) complexes of tridentate NNO donor Schiff base ligands [Cu(3)(L(1))(2)(mu(1,1)-N(3))(2)(CH(3)OH)(2)(BF(4))(2)] (1), [Cu(3)(L(1))(2)(mu(1,1)-N(3))(2)(mu-NO(3)-1kappaO:2kappaO')(2)] (2), [Cu(3)(L(2))(2)(mu(1,1)-N(3))(2)(mu-NO(3)-1kappaO:2kappaO')(2)] (3) and [Cu(4)(L(3))(2)(mu(1,1)-N(3))(4)(mu-CH(3)COO-1kappaO:2kappaO')(2)] (4) have been synthesized by reaction of the respective tridentate ligands (L(1) = 2-[1-(2-dimethylamino-ethylimino)-ethyl]-phenol, L(2) = 2-[1-(2-diethylamino-ethylimino)-ethyl]-phenol, L(3) = 2-[1-(2-dimethylamino-ethylimino)-methyl]-phenol) with the corresponding copper(ii) salts in the presence of NaN(3). The complexes are characterized by single-crystal X-ray diffraction analyses and variable-temperature magnetic measurements. Complex 1 is composed of two terminal [Cu(L(1))(mu(1,1)-N(3))] units connected by a central [Cu(BF(4))(2)] unit through nitrogen atoms of end-on azido ligands and a phenoxo oxygen atom of the tridentate ligand. The structures of 2 and 3 are very similar; the only difference is that the central unit is [Cu(NO(3))(2)] and the nitrate group forms an additional mu-NO(3)-1kappaO:2kappaO' bridge between the terminal and central copper atoms. In complex 4, the central unit is a di-mu(1,1)-N(3) bridged dicopper entity, [Cu(2)(mu(1,1)-N(3))(2)(CH(3)COO)(2)] that connects two terminal [Cu(L(3))(mu(1,1)-N(3))] units through end-on azido, phenoxo oxygen and mu-CH(3)COO-1kappaO:2kappaO' triple bridges to result in a tetranuclear unit. Analyses of variable-temperature magnetic susceptibility data indicates that there is a global weak antiferromagnetic interaction between the copper(II) ions in complexes 1-3, with the exchange parameter J of -9.86, -11.6 and -19.98 cm(-1) for 1-3, respectively. In complex 4 theoretical calculations show the presence of an antiferromagnetic coupling in the triple bridging ligands (acetato, phenoxo and azido) while the interaction through the double end-on azido bridging ligand is strongly ferromagnetic.

A unique example of structural and magnetic diversity in four interconvertible copper(II)-azide complexes with the same schiff base ligand: a monomer, a dimer, a chain, and a layer.

Four new Cu(II)-azido complexes of formula [CuL(N(3))] (1), [CuL(N(3))](2) (2), [Cu(7)L(2)(N(3))(12)](n) (3), and [Cu(2)L(dmen)(N(3))(3)](n) (4) (dmen = N,N-dimethylethylenediamine) have been synthesized using the same tridentate Schiff base ligand HL (2-[1-(2-dimethylaminoethylimino)ethyl]phenol, the condensation product of dmen and 2-hydroxyacetophenone). The four compounds have been characterized by X-ray structural analyses and variable-temperature magnetic susceptibility measurements. Complex 1 is mononuclear, whereas 2 is a single mu-1,1 azido-bridged dinuclear compound. The polymeric compound 3 possesses a 2D structure in which the Cu(II) ions are linked by phenoxo oxygen atoms and two different azide bridges (mu-1,1 and mu-1,1,3). The structure of complex 4 is a double helix in which two mu-1,3-azido-bridged alternating one-dimensional helical chains of CuL(N(3)) and Cu(dmen)(N(3))(2) are joined together by weak mu-1,1 azido bridges and H-bonds. The complexes interconvert in solution and can be obtained in pure form by carefully controlling the conditions. The magnetic properties of compounds 1 and 2 show the presence of very weak antiferromagnetic exchange interactions mediated by a ligand pi overlap (J = -1.77) and by an asymmetric 1,1-N(3) bridge (J = -1.97 cm(-1)), respectively. Compound 3 presents, from the magnetic point of view, a decorated chain structure with both ferro- and antiferromagnetic interactions. Compound 4 is an alternating helicoidal chain with two weak antiferromagnetic exchange interactions (J = -1.35 and -2.64 cm(-1)).

(Acetato-kappaO)aqua(1H-imidazole-kappaN3)(picolinato-kappa2N,O)copper(II) 0.87-hydrate: a Z' > 1 structure.

The crystal structure of the title compound, [Cu(C6H4NO2)(C2H3O2)(C3H4N2)(H2O)].0.87H2O, has a square-pyramidal-coordinated Cu(II) centre (the imidazole is trans to the picolinate N atom, the acetate is trans to the picolinate -CO2 group and the aqua ligand is in a Jahn-Teller-elongated apical position) and has two symmetry-independent molecules in the unit cell (Z' = 2), which are connected through complementary imidazole-picolinate N-H...O hydrogen bonding. The two partially occupied solvent water molecules are each disordered over two positions. The disordered solvent water molecules, together with pseudosymmetry elements, support the notion that a crystal structure with multiple identical chemical formula units in the structural asymmetric unit (Z' > 1) can represent a crystal 'on the way', that is, a kinetic intermediate form which has not yet reached its thermodynamic minimum. Neighbouring molecules form pi-pi stacks between their imidazole and picolinate N-heterocycles, with centroid-centroid distances in the range 3.582 (2)-3.764 (2) A.

Copper(II) complexes of mono-anionic glutamate: anionic influence in the variations of molecular and supramolecular structures.

Three new polynuclear copper(II) complexes of singly deprotonated L-glutamic acid (L-glu), {[Cu(bipy)2][Cu(bipy)(L-glu)H2O]2(BF4)4 x (H2O)3}n (1), {[Cu(bipy)(L-glu)H2O][Cu(bipy)(L-glu)(ClO4)](ClO4) x (H2O)2}n (2) and [Cu(phen)(L-glu)H2O]2(NO3)2 x (H2O)4 (3) (bipy = 2,2-bipyridine, phen = 1,10-phenanthroline), were synthesized in acidic pH (ca. 2.5) and characterized structurally. In all the complexes, L-glutamic acid acts as a bidentate chelating ligand, leaving the protonated carboxylic acid free. Both in 1 and 2, two different types of species [Cu(bipy)2](BF4)2 and [Cu(bipy)(L-glu)H2O]BF4 for 1 and [Cu(bipy)(L-glu)H2O]ClO4 and [Cu(bipy)(L-glu)(ClO4)] for 2 coexist in the solid state. In complex 1, the [Cu(bipy)(L-glu)H2O]+ units are joined together by syn-anti carboxylate bridges to form an enantiopure (M) helical chain and the [Cu(bipy)2]2+ presents a very rare example of the four-coordinate distorted tetrahedral geometry of Cu(II). In complex 2, the [Cu(bipy)(L-glu)(ClO4)] units are joined together by weakly coordinating perchlorate ions to form a 1D polymeric chain while the [Cu(bipy)(L-glu)H2O]+ units remain as mononuclear species. The different coordinating ability of the two counter anions along with their involvement in the H-bonding network seems likely to be responsible for the difference in the final polymeric structures in the two compounds. Variable-temperature (2-300 K) magnetic susceptibility measurements show negligible coupling for both the complexes. The structure of 3 consists of two independent monomeric [Cu(phen)(L-glu)H2O]+ cations, two nitrate anions and four water molecules. The copper atom occupies a five-coordinate square pyramidal environment with a water molecule in the axial position.

Stabilization of a helical water chain in a metal-organic host of a trinuclear Schiff base complex.

Three heterometallic trinuclear Schiff base complexes, [{CuL1(H2O)}2Ni(CN)4].4H2O (1), [{CuL2(H2O)}2Ni(CN)4] (2), and [{CuL3(H2O)}2Ni(CN)4] (3) (HL1=7-amino-4-methyl-5-azahept-3-en-2-one, HL2=7-methylamino-4-methyl-5-azahept-3-en-2-one, and HL3=7-dimethylamino-4-methyl-5-azahept-3-en-2-one), were synthesized. All three complexes were characterized by elemental analysis, IR and UV spectroscopies, and thermal analysis. Two of them (1 and 3) were also characterized by single crystal X-ray crystallography. Complex 1 forms a hydrogen-bonded one-dimensional metal-organic framework that stabilizes a helical water chain into its cavity, but when any of the amine hydrogen atoms of the Schiff base are replaced by methyl groups, as in L2 and L3, the water chain vanishes, showing explicitly the importance of the host-guest H-bonding interactions for the stabilization of a water cluster.

Anion-directed synthesis of metal-organic frameworks based on 2-picolinate CuII complexes: a ferromagnetic alternating chain and two unprecedented ferromagnetic fish backbone chains.

Three new polynuclear copperII complexes of 2-picolinic acid (Hpic), {[Cu2(pic)3(H2O)]ClO4}n (1), {[Cu2(pic)3(H2O)]BF4}n (2), and [Cu2(pic)3(H2O)2(NO3)]n (3), have been synthesized by reaction of the "metalloligand" [Cu(pic)2] with the corresponding copperII salts. The compounds are characterized by single-crystal X-ray diffraction analyses and variable-temperature magnetic measurements. Compounds 1 and 2 are isomorphous and crystallize in the triclinic system with space group P, while 3 crystallizes in the monoclinic system with space group P21/n. The structural analyses reveal that complexes 1 and 2 are constructed by "fish backbone" chains through syn-anti (equatorial-equatorial) carboxylate bridges, which are linked to one another by syn-anti (equatorial-axial) carboxylate bridges, giving rise to a rectangular grid-like two-dimensional net. Complex 3 is formed by alternating chains of syn-anti carboxylate-bridged copperII atoms, which are linked together by strong H bonds involving coordinated nitrate ions and water molecules and uncoordinated oxygen atoms from carboxylate groups. The different coordination ability of the anions along with their involvement in the H-bonding network seems to be responsible for the difference in the final polymeric structures. Variable-temperature (2-300 K) magnetic susceptibility measurement shows the presence of weak ferromagnetic coupling for all three complexes that have been fitted with a fish backbone model developed for 1 and 2 (J = 1.74 and 0.99 cm(-1); J' = 0.19 and 0.25 cm(-1), respectively) and an alternating chain model for 3 (J = 1.19 cm(-1) and J' = 1.19 cm(-1)).