Vasogenic oedema during stereoelectroencephalography: intracranial pattern and late-onset clinical repercussion.

In patients suffering from focal drug-resistant epilepsy, intracranial explorations are the gold standard for identifying the epileptogenic zone and evaluating the possibility of a surgical resection. Amongst them, stereoelectroencephalography (SEEG), using depth electrodes, is a safe procedure. However, complications occur on average in 2% of cases, notably haemorrhages or infections. Vasogenic cerebral oedema constitutes a rarely reported complication. Amongst the 85 patients explored with SEEG between January 2017 and September 2023, three had a clinically and electrophysiologically relevant vasogenic cerebral oedema. In these three patients, the surgical procedure was uneventful. In all three as well, electrodes exploring areas away from the epileptogenic zone recorded some unexpected focal delta slowing with clinically asymptomatic superimposed discharges, a pattern so far only reported in cases of bleeding. Moreover, one patient experienced confusion 10 days after explantation. Post-explantation magnetic resonance imaging showed, in all three patients, a vasogenic oedema that fully resolved a few months later. We did not identify any contributing factors, and there were no particularities concerning the number of electrodes, their implantation site or the recording duration. Focal delta slowing and rhythmic discharges during SEEG can indicate a vasogenic oedema. Clinical consequences can occur after explantation. Evolution is favourable but this misleading pattern must be identified.

Systematic prolonged video-electroencephalograms identify electrographic seizures in 5% of acute stroke patients with aphasia.

In stroke units, diagnosing seizures may be difficult, especially in aphasic patients. We discuss herein our systematic 4-hour video EEG monitoring of 61 patients with aphasia within the first 72hours after the onset of ischaemic stroke. Five electrographic seizures were identified in 3 patients, with no clinical signs apparent on the video and no symptoms reported by patients. We did not record status epilepticus nor generalized seizure. Comparative analyses disclosed a higher risk of early seizures in patients with haemorrhagic transformation. Video EEG monitoring detected electrographic seizures in 5% of stroke patients with aphasia. This monitoring could be useful for selected patients, especially those with haemorrhagic transformation.

Balthazar Score and Neutrophil-Lymphocytes Ratio in Acute Pancreatitis.

Acute pancreatitis is a pathological entity that poses numerous diagnostic and treatment problems. Severe form is a real challenge for a physician because it has multiple obscure causes, as well as a complex pathophysiology. Thus, the diagnosis is difficult and the choice of the right time for surgical treatment is controversial, the treatment being more frequently nonspecific, supportive for the various affected systems and organs. On a group of 337 patients, laboratory and imaging investigations were performed to diagnose and determine the severity score of acute pancreatitis and the correlation level between the neutrophil-lymphocytes ratio values and the Balthazar score, as a valid assessment method for local and systemic inflammatory changes. The distribution's study of acute pancreatitis by gender according to etiology confirms the predominance of the acute ethanolic pancreatitis in male, but also the higher proportion (54%) of male pancreatitis (181 man vs. 156 women) with gender ratio male/female 1.16/1. The neutrophil-lymphocytes ratio mean value varied according with the Balthazar severity score, that got higher as acute pancreatitis got more advanced and with a certain cut-off value can be considered a simple indicator to determine the severity of acute pancreatitis.

Cytopathological Aspects in the Bronchoalveolar Lavage Fluid in Chronic Obstructive Pulmonary Disease.

Chronic Obstructive Pulmonary Disease (COPD) is a clinical syndrome characterised by a slow progressive decline in expiratory airflow [1], a process that has gradually developed over the years. Studies of patients with COPD show an inflammatory process in the small airways [2]. The aim of this paper is to identify the cytopathological aspects of the liquids present in the bronchoalveolar lavage in patients with COPD. We were performed a descriptive analytical case-control and prospective study on forty patients with COPD and ten asymptomatic smokers (healthy smokers or patients at risk). The percentage of marcophage, the type of the dominant inflamatory cell, in the bronchoalveolar lavage (BAL) liquid was significantly higher at patients with mild and moderate COPD as compared to patients with severe and very severe COPD. In the present work, the percentage of the neutrophil in the BAL liquid was significantly higher at patients with severe and very severe COPD, as compared to the patients with mild and moderate COPD and to aparently healthy smokers. In conclusion, we can say that COPD is characterized by an inflammatory process located in the small airways with predominant participation of macrophages, the procentage of macrophages in BAL fluid variyng inversely proportional to the severity of the disease.

Consequences of human modification of the global nitrogen cycle.

The demand for more food is increasing fertilizer and land use, and the demand for more energy is increasing fossil fuel combustion, leading to enhanced losses of reactive nitrogen (Nr) to the environment. Many thresholds for human and ecosystem health have been exceeded owing to Nr pollution, including those for drinking water (nitrates), air quality (smog, particulate matter, ground-level ozone), freshwater eutrophication, biodiversity loss, stratospheric ozone depletion, climate change and coastal ecosystems (dead zones). Each of these environmental effects can be magnified by the 'nitrogen cascade': a single atom of Nr can trigger a cascade of negative environmental impacts in sequence. Here, we provide an overview of the impact of Nr on the environment and human health, including an assessment of the magnitude of different environmental problems, and the relative importance of Nr as a contributor to each problem. In some cases, Nr loss to the environment is the key driver of effects (e.g. terrestrial and coastal eutrophication, nitrous oxide emissions), whereas in some other situations nitrogen represents a key contributor exacerbating a wider problem (e.g. freshwater pollution, biodiversity loss). In this way, the central role of nitrogen can remain hidden, even though it actually underpins many trans-boundary pollution problems.

Serological identification of Shigella flexneri strains by the coagglutination reaction.

Several variants of reagents were prepared by coupling type (I, II III, IV, V and VI) and group (3, 4, 6 and 7, 8, 9) anti-Shigella flexneri sera with protein A--containing staphylococcal suspension. For most serum lots coagglutination led to a 1/10 minimum dilution. However, different efficiencies were reported between serum lots and even within the same type or group. No improvement by the coagglutination reaction could be obtained for one lot from group 3, 4 and 7, 8, 9 sera and for both type IV serum lots. The coagglutination reactions were specific both with collection strains and with recently isolated strains and the two staphylococcal suspension lots showed an identical behaviour. Coagglutination may be used for obtaining a better efficiency of type and group. Shigella flexneri sera but this varies in terms of the serum lot and the serum/Staphylococcus combination used.

Serotyping of Pseudomonas aeruginosa strains by slide coagglutination.

Serological typing of Pseudomonas aeruginosa strains (228 strains) by slide coagglutination, using our own reagents (5 polyvalent and 22 monovalent ones, corresponding to the 22 serotypes in Meitert-Meitert scheme), led to identical results obtained by conventional slide agglutination. Utilization of live Ps. aeruginosa cells suspensions, killed by boiling or autoclaving, showed a 100% concordance of results, when using the second and the third suspension types and a 97.37% one between them and the live cells suspension. We noticed that reactions intensity was higher when using bacterial suspensions, boiled for 2.5 hours, in comparison with autoclaved cells suspensions, 30 minutes at 120 C. Compared to conventional slide agglutination, the slide coagglutination presents more advantages, being simple, rapid, specific and economical.