Detection of myasthenia gravis using electrooculography signals.

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder resulting from skeletal muscle weakness and fatigue. An early common symptom is fatigable weakness of the extrinsic ocular muscles; if symptoms remain confined to the ocular muscles after a few years, this is classified as ocular myasthenia gravis (OMG). Diagnosis of MG when there are mild, isolated ocular symptoms can be difficult, and currently available diagnostic techniques are insensitive, non-specific or technically cumbersome. In addition, there are no accurate biomarkers to follow severity of ocular dysfunction in MG over time. Single-fiber electromyography (SFEMG) and repetitive nerve stimulation (RNS) offers a way of detecting and measuring ocular muscle dysfunction in MG, however, challenges of these methods include a poor signal to noise ratio in quantifying eye muscle weakness especially in mild cases. This paper presents one of the attempts to use the electric potentials from the eyes or electrooculography (EOG) signals but obtained from three different forms of sleep testing to differentiate MG patients from age- and gender-matched controls. We analyzed 8 MG patients and 8 control patients and demonstrated a difference in the average eye movements detected between the groups. A classification accuracy as high as 68.8% was achieved using a linear discriminant analysis based classifier.

Current evaluation and management of excessive daytime sleepiness.

Excessive daytime sleepiness has significant impact on neurological function, and has societal implications. Sleepiness is a common feature of many neurological conditions. A careful history will often reveal one of many common causes of excessive daytime sleepiness and suggest appropriate treatment. Neurophysiological testing can provide objective assessment. Behavioural management is an important first step in management. Treatment of common concurrent sleep disorders is also essential. Currently available medications can further symptomatically improve function in many individuals. The strongest evidence base is for the treatment of narcolepsy--a prototype disorder of excessive daytime sleepiness. Currently used medications include modafinil, stimulants, and sodium oxybate amongst others. This review discusses important features in the diagnosis of daytime sleepiness in adults, and outlines a treatment approach. Further evidence-based information about the management of this common problem is essential.

Posterior cortical atrophy.

BACKGROUND: The term posterior cortical atrophy (PCA) was introduced in 1988 to describe five patients with fairly homogeneous, but otherwise unclassified, symptoms. These patients showed signs of a slowly progressive dementia bearing behavioral and physiologic similarities to Alzheimer's disease, but with notable distinctions. Specifically, PCA is characterized by an early onset of visual agnosia, followed by some or all components of Balint's syndrome, Gerstmann's syndrome, and transcortical sensory aphasia. REVIEW SUMMARY: In this review, the history, epidemiology, pathophysiology, neurobehavioral aspects, assessment (including neurologic and neuropsychologic), differential diagnosis, and treatment recommendations for this disorder are reviewed. CONCLUSIONS: As originally defined, PCA appears to be a clinically homogeneous syndrome. The cluster of symptoms that are common to virtually all examined cases evidences this. Although the behavioral and cognitive properties of the disorder are well established, many aspects of PCA remain unclear. Specifically, available research and understanding of PCA epidemiology and treatment are highly inadequate. In fact, the majority of such information regarding PCA is derived from studies of Alzheimer's disease. To a lesser extent, Pick's disease and Creutzfeldt-Jakob disease research have also provided insight into the underpinnings of PCA. Until PCA is categorically defined as a variant or subgroup of these other neurodegenerative disorders, however, such derivations are merely speculations.

Morphological study of hydroxyapatite nanocrystal suspension.

Nanometer size hydroxyapatite (HA) crystals are prepared by a wet chemical precipitation method at different synthesis temperatures and with various reactant addition rates. The resulting aqueous suspensions are studied in terms of morphology (transmission electron microscope, specific surface area), phase (X-ray diffraction, electron diffraction and infrared spectroscopy) and rheological properties. This work shows that shape, size and specific surface area of the HA nanoparticles are very sensitive to the reaction temperature and also to the reactant addition rate. The measured pH at the end of synthesis, which is strongly linked with the reactant addition rate, is a key parameter which can be used to determine the purity of the synthesized HA nanocrystal and also for the stabilization (dispersion) of the suspension. HA nanoparticles synthesized at low temperature (T < 60 degrees C) are monocrystalline. A transition temperature (T=60 degrees C) can be defined as a limit for the synthesis of monocrystalline HA nanocrystals, above this critical temperature nanocrystals become polycrystalline. HA monocrystals adopt a needle shape and are oriented following the c-axis of the hexagonal HA structure. The as-synthesized suspension is then concentrated and the effect of a dispersing agent addition, which is needed to get a high solid/liquid ratio coupled with good flowability of the suspension, is also shown, because this suspension is used in the suspension plasma spraying process.

[Treatment of american cutaneous leishmaniasis, with lesions in the mucosa, using pentamidine isethionate]. / Tratamento da leishmaniose tegumentar americana, com lesão em mucosa, por meio do isotionato de pentamidina.

Ten patients with mucosal lesions caused by American tegumental leishmaniasis were treated with pentamidine isethionate at the dose 4 mg/kg on alternate days by the intravenous route. The mean posology was 2,140 mg. Healing of the lesions occurred in 9 (90%) of the patients who completed treatment. There was no recurrence during a follow-up time of 1 to 24 months (mean, 7,7 months). One patient discontinued treatment before healing of the lesion because be developed diabetes mellitus. In 3 (30%) patients, blood exams showed increased urea and creatinine levels and leucopenia, which were corrected by increasing the interval between administrations of the drug. Pentamidine isethionate is efficient in bringing about cicatrization of the lesions but needs further evaluation in terms of its value in preventing recurrence.

[The use of a silicone T tube for the treatment of a case of American mucocutaneous leishmaniasis with tracheomalacia]. / Utilização do tubo em "T" de silicone para tratamento de um caso de leishmaniose tegumentar americana com traqueomalácia.

The authors report a case of mucosal leishmaniasis, in which tracheomalacia and respiratory insufficiency occurred. The nature of the illness, the patient's general condition and the great extension of the affected tracheal segment made segmental resection and anastomosis inviable. The silicone T tube, which proved itself useful, was the choice, thus motivating this report of the procedure.

Cleidocranial dysostosis and syringomyelia. Review of the literature and case report.

A 34-year-old woman with congenital cleidocranial dysostosis had scoliosis diagnosed at age 13. The scoliosis was treated during adolescence with spinal orthoses but continued to progress after skeletal maturation. She was diagnosed as having syringomyelia at age 34. The possibility of syringomyelia should be considered in patients with cleidocranial dysostosis, especially those with neurologic symptoms, scoliosis not responding to conservative therapy, or progressive scoliosis after skeletal maturation. Although only two previous patients have been reported in the literature, the condition undiagnosed could be a more common problem than generally supposed.

Uso de antibioticos durante a gravidez. / Use of antibiotics during pregnancy

Faz-se neste trabalho uma revisao critica sobre o uso de antibioticos durante a gestacao. Descrevem-se as alteracoes fisiologicas, proprias da gravidez, dos processos de absorcao, distribuicao, metabolismo e excrecao dos antimicrobianos.Apresentam-se as principais propriedades dos antibioticos que podem ser administrados com seguranca, tanto para a mae como para o feto, durante a gravidez, e discutem-se tambem as caracteristicas daqueles que sao contra-indicados, em determinados periodos ou durante qualquer fase da gestacao