[Predictive value of cerebellar growth and general movements assessments for neurodevelopment of very preterm infants at 18-24 months' corrected age]. / Valor pronostico de las evaluaciones del crecimiento cerebelar y de los movimientos generales para el neurodesarrollo del gran prematuro entre los 18 y 24 meses de edad corregida.

INTRODUCTION: Fidgety movements assessments is very sensitive predicting long-term outcome or cerebral palsy of preterm, disrupted cerebellar growth has been reported in these patients. AIM: To compare the predictive value of cerebellar ultrasound growth and fidgety movements assessments, for neurodevelopment outcome of very preterm at 18-24 month's corrected age (CA). SUBJECTS AND METHODS: Prospective study of 88 infants cohort (<= 32 weeks' gestation), transverse cerebellar diameter was obtained by ultrasound via mastoid fontanel, in a weekly basis, until 40 weeks CA. Fidgety movements were assessed at 3 months CA. Neurodevelopment outcome at 18-24 month's CA was evaluated in 68 using Schedule of Growing Skills II Scale (SGS-II) and Amiel-Tison Neurologic Assessment (ATNA). RESULTS: At term age, cerebellar growth was under 3rd percentile in 11 (10.3%). Fidgety movements were normal in 42 (61.8%) and abnormal or absent in 7 (10.3%). At 18-24 months CA, 54 (79.4%) were normal by the SGS-II and in 6 (8.8%) ATNA classified as cerebral palsy. Cerebellar diameter under 3rd percentile at term was associated with abnormal motor outcome and normal fidgety movements correlated with normal neurodevelopment. CONCLUSION: Ultrasound cerebellar measurements and functional examinations (fidgety movements) have important complementary roles in predicting neurodevelopment of very preterm.

TITLE: Valor pronostico de las evaluaciones del crecimiento cerebelar y de los movimientos generales para el neurodesarrollo del gran prematuro entre los 18 y 24 meses de edad corregida.Introduccion. La evaluacion de los movimientos de ajetreo es sumamente sensible a la hora de predecir el desenlace a largo plazo o la paralisis cerebral del neonato prematuro, un tipo de paciente en el que se ha descrito el crecimiento anomalo del cerebelo. Objetivo. Comparar el valor pronostico de la determinacion ecografica del crecimiento anomalo del cerebelo y el de la evaluacion de los movimientos de ajetreo en el neurodesarrollo de grandes prematuros a los 18-24 meses de edad corregida. Sujetos y metodos. Estudio prospectivo con una cohorte de 88 neonatos (32 semanas o menos de gestacion) en que se analizo el diametro transversal del cerebelo por medio de una ecografia semanal hasta las 40 semanas de edad corregida. Los movimientos de ajetreo se evaluaron a los tres meses de edad corregida. El estado de maduracion neurologica a los 18-24 meses de edad corregida se evaluo en 68 neonatos con la escala de evaluacion de las competencias en el desarrollo infantil (SGS-II) y la escala de evaluacion neurologica de Amiel-Tison (ATNA). Resultados. En la edad a termino, el crecimiento del cerebelo fue inferior al tercer percentil en 11 neonatos (10,3%). Los movimientos de ajetreo eran normales en 42 (61,8%), y anormales o ausentes, en 7 (10,3%). A los 18-24 meses de edad corregida, 54 (79,4%) mostraron resultados normales en la SGS-II y 6 (8,8%) fueron calificados como afectados por paralisis cerebral segun la ATNA. El diametro cerebelar inferior al tercer percentil a termino estuvo asociado con un desenlace motor anomalo y los movimientos de ajetreo normales se correlacionaron con el neurodesarrollo normal. Conclusion. La estimacion del tamaño del cerebelo y las exploraciones funcionales (movimientos de ajetreo) poseen un importante papel complementario en el pronostico del desarrollo nervioso en el gran prematuro.

Intranasal immunisation of mice against Streptococcus equi using positively charged nanoparticulate carrier systems.

In order to potentiate a strong immune response after mucosal vaccination with a low immunogenic S. equi enzymatic extract, two positively charged particulate delivery systems (liposomes and nanoparticles) were created. Positively surface charged particles were expected to efficiently bind to negatively charged cell membranes and facilitate antigen uptake. Phosphatidylcholine-cholesterol-stearylamine liposomes encapsulating S. equi antigens were prepared and dimensionated to 0.22±0.01µm with a polydispersity index <0.242, zeta potential of +12±4mV and an encapsulation efficiency of 13±3% (w/w). Chitosan nanoparticles were prepared by ionotropic gelation with sodium tripolyphosphate, presenting a particle size of 0.17±0.01µm with polydispersity index <0.362, zeta potential of +23±8mV and an encapsulation efficiency of 53±6% (w/w). Both encapsulation methods were recognised as innocuous once antigens structure remained intact after incorporation as assessed by SDS-PAGE. Intranasal immunisation of mice with both formulations successfully elicited mucosal, humoral and cellular immune responses. Mucosal stimulation was confirmed by increased sIgA levels in the lungs, being the chitosan nanoparticles more successful in this achievement probably due to their different mucoadhesive properties. Both formulations share the ability to induce Th1-mediated immune responses characterised by IFN-γ production and high IgG2a antibody titers as well as a Th2 immune response characterised mainly by IL-4 production and IgG1 antibodies.

Development and characterization of a new plasmid delivery system based on chitosan-sodium deoxycholate nanoparticles.

Chitosan is one of the most promising polymers for drug delivery through the mucosal routes because of its polycationic, biocompatible, and biodegradable nature, and particularly due to its mucoadhesive and permeation-enhancing properties. Bile salts are known to interact with lipid membranes, increasing their permeability. The addition of bile salts to chitosan matrices may improve the delivery characteristics of the system, making it suitable for mucosal administration of bioactive substances. In the present study we have developed chitosan nanoparticles using sodium deoxycholate as a counter ion and evaluated their potential as gene delivery carriers. Chitosan-sodium deoxycholate nanoparticles (CS/DS) obtained via a mild ionic gelation procedure using different weight ratios were used to encapsulate plasmid DNA (pDNA) expressing a "humanized" secreted Gaussia Luciferase as reporter gene (pGLuc, 5.7 kDa). Mean particle size, polydispersity index and zeta potential were evaluated in order to select the best formulation for further in vitro studies. The nanoparticles presented an average size of 153-403 nm and a positive zeta potential ranging from +33.0 to +56.9 mV, for nanoparticles produced with CS/DS ratios from 1:4 to 1:0.6 (w:w), respectively. The pDNA was efficiently encapsulated and AFM studies showed that pDNA-loaded nanoparticles presented a more irregular surface due to the interaction between cationic chitosan and negatively charged pDNA which results in a more compact structure when compared to empty nanoparticles. Transfection efficiency of CS/DS-pDNA nanoparticles into moderately (AGS) and well differentiated (N87) gastric adenocarcinoma cell lines was determined by measuring the expression of luciferase, while cell viability was assessed using the MTT reduction. The CS/DS nanoparticles containing encapsulated pDNA were able to transfect both AGS and N87 cell lines, being more effective with AGS cells, the less differentiated cell line. The highest enzymatic activity was achieved with 20% pDNA encapsulated and after 24 h of transfection time. Low cytotoxicity was observed for the CS/DS nanoparticles either with or without pDNA, suggesting this could be a new potential vehicle for mucosal delivery of pDNA.

Congenital ocular motor apraxia.

PURPOSE: Congenital ocular motor apraxia is a rare disease characterized by defective or absent voluntary and optically induced horizontal saccadic movements. Jerky head movements or thrusts on attempted lateral gaze are a compensatory sign. Most affected children have delayed motor and speech development. Cases associated with systemic diseases, neurologic maldevelopment, metabolic deficits, and chromosomal abnormalities have been described. METHODS: Case report and review of the scientific literature. RESULTS: The authors describe the ophthalmologic, pediatric, and neurologic evaluations and follow up of a child with impaired horizontal saccades, jerky head movements, and delayed motor and speech development. CONCLUSIONS: Congenital ocular motor apraxia is an uncommon disorder of ocular motility. Even so, ophthalmologists should be aware of the developmental delay and the other associated conditions, in order to grant the patients the multidisciplinary assistance they often require.