[Rational use of psychotropic medications and sedative load in older adults with and without dementia]. / Uso de psicofármacos y carga sedativa en pacientes adultos con y sin demencia.

Sedative drugs use has been associated with more cognitive impairment and increased mortality. Sedative load refers to cumulative exposure to multiple drugs with sedative properties. OBJECTIVE: Describe the use of psychotropic drugs and sedative load in older adults with and without dementia. MATERIAL AND METHODS: We conducted a cross-sectional study from 2014-2015 (Sanatorio Trinidad Mitre), in hospitalized patients older than 65 years old. Drugs were classified according to the WHO ATC system. The sedative load of drugs was calculated using the Linjakumpu model. RESULTS: 152 PsD and 35 PcD patients were registered, mean age 80.8±8.42. Polypharmacy was present in 44.39% being higher in patients with dementia than without dementia (62.80% vs 40.13%, p=0.0147). In 40.64% at least one psychotropic/sedative medication was used, greater in PcD (60% vs 36.18%, p=0.0097). The CS was: 1.32±1.59; 2.14 in PcD and 1.13 in PsD (p<0.001). Atypical antipsychotics and benzodiazepines were the most common (51.43 and 40% respectively) in patients without dementias. CONCLUSION: we evidenced a high level of prescription psychotropic or sedative drugs, mostly in patients with dementia. In those, the sedative load was greater. This finding highlights the importance of implementing strategies to optimize sedative drug use among older people.

Pseudodystonic Posture Secondary to Klippel-Feil Syndrome and Diastematomyelia.

BACKGROUND: Dystonic postures possess a great number of differential diagnoses. PHENOMENOLOGY SHOWN: We describe a pseudodystonic posture in a 61-year-old woman with skeletal and extra-skeletal abnormalities. EDUCATIONAL VALUE: Klippel-Feil syndrome represents an unusual cause of pseudodystonic posture to be considered in the differential diagnosis of dystonia.

Endothelinergic cells in the subependymal region of mice.

Endothelin (ET) is a small peptide that activates astrocyte proliferation, regulates proliferation and migration of embryonic neural precursor cells and stimulates glioblastoma growth. We found that in mouse brain, ET and its receptor B (ETRB) were highly expressed in the subependymal zone (SEZ), an adult neurogenic niche. Cells with ET immunoreactivity (ET+ cells) selectively appeared along the lateral and dorsal walls of the lateral ventricle. They also appeared in the cingular region of the corpus callosum. Subependymal ET+ cells also displayed prominin (PRO), glial fibrillary acidic protein (GFAP) and ETRB immunoreactivities. ET+ processes traversed the ependymal epithelium and approached the ventricular lumen. Ependymal cells only showed ETRB-ir. A small but consistent number of ET+ cells displayed proliferation markers: 5-bromo-2'-deoxyuridine (BrdU) incorporation, and minichromosome maintenance protein 2 (Mcm2). Cortical injury and G-CSF increased subependymal endothelinergic cells and their proliferation markers. Our findings suggest that ET and ETRB might be associated with regulation of adult neural stem cells and their migration through neurogenic and gliogenic pathways.