Wait and see en epilepsia pediátrica. Nuestra experiencia / Wait and see in paediatric epilepsy. Our experience

Introducción: El tratamiento farmacológico de la epilepsia no es curativo; pretende, en lo posible, evitar crisis en niños que probablemente van a seguir teniéndolas. Pacientes y métodos: El objeto es analizar nuestra experiencia en niños con epilepsia y con primera crisis no sintomática aguda no tratados con antiepilépticos. Se analizó a pacientes atendidos en una consulta de neuropediatría, desde 2017 hasta 2021, que habían sufrido una o más crisis no sintomáticas agudas y a los que no se les había tratado farmacológicamente. Resultados: Sesenta y cinco pacientes cumplieron los criterios de selección. Veinticuatro habían tenido una única crisis, con un tiempo medio de duración de 12 minutos (1-60). En un 66,7% fue nocturna. Un 41,7% presentó electroencefalograma patológico, y un 21%, hallazgos patológicos en la neuroimagen. El tiempo medio de control fue de 2,7 años (0,003-13,6 años). Cuarenta y uno presentaron más de una crisis, con una duración media de nueve minutos (1-60). Cinco pacientes presentaron más de 20 crisis, y el resto, entre dos y 17. Veinticuatro (58,5%) presentaron únicamente crisis nocturnas. Se realizó un electroencefalograma en todos: grafoelementos epileptiformes en el 63,4%; y neuroimagen en todos: patológica en el 4,9%. El tiempo medio de control fue de 3,8 años (0,01-9,1 años). Conclusiones: La frecuencia de las crisis, la patología de base o los resultados de las pruebas complementarias no deberían ser las únicas variables que habría que considerar para iniciar el tratamiento farmacológico antiepiléptico en los niños. Debería prevalecer, por encima de aquéllos, el potencial perjuicio sobre la calidad de vida y el neurodesarrollo, las funciones atencionales y el comportamiento del niño, y siempre consensuar esta decisión con los padres.(AU)

Introduction: Pharmacological treatment of epilepsy is not healing; it tries to avoid seizures, as far as possible, in children who probably would still have them. Patients and methods: Our purpose is to analyse our experience with epileptic children and those who have a first non-symptomatic seizure without pharmacological treatment. Patients seen in a paediatric neurology consultation, from 2017 to 2021, who had suffered one or more acute non-symptomatic crises and who had not been treated pharmacologically, were analysed. Results: Sixty-five patients meet the selection criteria. Twenty-four patients had had a single crisis with a mean duration of 12 minutes (1-60). In 66.7% it was nocturnal. 41.7% presented pathological electroencephalogram, and 21% pathological findings in neuroimaging. The mean control time was 2.7 years (0.003-13.6 years). Forty-one presented more than one crisis, with a mean duration of nine minutes (1-60). Five patients presented more than 20 seizures, the rest between two and 17. Twenty-four (58.5%) presented only nocturnal seizures. An electroencephalogram was performed in all: epileptiform graphoelements in 63.4%; and neuroimaging in all: pathological in 4.9%. Mean control time was 3.8 years (0.01-9.1 years). Conclusions: Seizure frequency, underlying pathology or test results should not be the only variables to take into consideration when starting antiepileptic drug treatment. The repercussion on their quality of life and neurodevelopment should prevail, agreeing on this decision with the parents.(AU)

Development of a matrix solid-phase dispersion method for the screening of polybrominated diphenyl ethers and polychlorinated biphenyls in biota samples using gas chromatography with electron-capture detection.

A low cost method for the screening of six polybrominated diphenyl ethers (PBDEs) and seven polychlorinated biphenyls (PCBs) in biological samples containing up to 100% of fat is presented. Compounds are extracted from the sample and isolated from lipids using a matrix solid-phase dispersion (MSPD) cartridge and 20 ml of n-hexane as elution solvent. PBDEs and PCBs are fractionated on a second cartridge containing 2 g of a normal phase sorbent. The potential of neutral silica, Florisil and basic alumina to separate PBDEs and PCBs in two independent fractions has been evaluated. The best results were obtained using silica. PCBs are eluted, in a first fraction, using n-hexane. PBDEs are further recovered with n-hexane-dichloromethane. The applicability of the method for the screening of PBDEs and PCBs, in samples containing both groups of compounds, has been demonstrated using spiked, certified and real polluted samples from different biota materials. Globally, recoveries higher than 75% and quantification limits around 0.4 ng/g have been achieved using gas chromatography with electron-capture detection (GC-ECD).

Hydroxycinnamic acids and ferulic acid dehydrodimers in barley and processed barley.

Hydroxycinnamic acid content and ferulic acid dehydrodimer content were determined in 11 barley varieties after alkaline hydrolysis. Ferulic acid (FA) was the most abundant hydroxycinnamate with concentrations ranging from 359 to 624 microg/g dry weight. p-Coumaric acid (PCA) levels ranged from 79 to 260 microg/g dry weight, and caffeic acid was present at concentrations of <19 microg/g dry weight. Among the ferulic acid dehydrodimers that were identified, 8-O-4'-diFA was the most abundant (73-118 microg/g dry weight), followed by 5,5'-diFA (26-47 microg/g dry weight), the 8,5'-diFA benzofuran form (22-45 microg/g dry weight), and the 8,5'-diFA open form (10-23 microg/g dry weight). Significant variations (p < 0.05) among the different barley varieties were observed for all the compounds that were quantified. Barley grains were mechanically fractionated into three fractions: F1, fraction consisting mainly of the husk and outer layers; F2, intermediate fraction; and F3, fraction consisting mainly of the endosperm. Fraction F1 contained the highest concentration for ferulic acid (from 77.7 to 82.3% of the total amount in barley grain), p-coumaric acid (from 78.0 to 86.3%), and ferulic acid dehydrodimers (from 79.2 to 86.8%). Lower contents were found in fraction F2, whereas fraction F3 exhibited the lowest percentages (from 1.2 to 1.9% for ferulic acid, from 0.9 to 1.7% for p-coumaric acid, and <0.02% for ferulic acid dehydrodimers). The solid barley residue from the brewing process (brewer's spent grain) was approximately 5-fold richer in ferulic acid, p-coumaric acid, and ferulic acid dehydrodimers than barley grains.

Inhibition of sex pheromone production in female lepidopteran moths by 2-halofatty acids.

Inhibition of sex pheromone production has been observed after topical treatment of pheromonal glands with DMSO solutions of 2-bromohexadecanoic acid, in three lepidopteran insects: Spodoptera littoralis, Thaumotopoea pityocampa, and Bombyx mori. It has been shown that this effect was brought about by action on the reductases and acetyltransferases of the final steps of the pheromones biosynthesis. Other halofatty acids, such as 2-fluoro- and 2-chlorohexadecanoic acids, were less active than the above bromoderivative whereas 2-bromotetradecanoic acid and 2-bromooctanoic acid exhibited activities quite comparable to the C-16 bromoacid. These results indicate that bromosubstitution is very important for this inhibitory action and chain length is of secondary importance.

Difluoropalmitic acids as potential inhibitors of the biosynthesis of the sex pheromone of the Egyptian armyworm Spodoptera littoralis--IV.

2,2-, 3,3- and 4,4-Difluoropalmitic acids (1-3) have been synthesized and fully characterized. Acids 2 and 3 were prepared through fluorination of the corresponding dithioacetal-protected ketoesters followed by enzymatic saponification. The acids 1-3 were evaluated in vivo as inhibitors of the beta-oxidation step of the biosynthesis of (Z,E)-9,11-tetradecadienyl acetate, the major component of the sex pheromone of the Egyptian armyworm Spodoptera littoralis. Only, the 2,2- and 3,3-derivatives, i.e. those containing the two fluorine atoms at the positions involved in the chain-shortened step, have been found to be active, the activity being similar to or lower than that displayed by the corresponding monofluorinated acids.