Metabolomics of the aqueous humor in the rat glaucoma model induced by a series of intracamerular sodium hyaluronate injection.

Glaucoma models are helpful to study disease characteristics and to design new therapeutic options. Metabolomic profiling approach have been used to elucidating the molecular characteristics of the aqueous humor. Juvenile male Wistar rats experimental (n = 15) and controls (n = 6) were used for these studies. Experimental rats received weekly intracamerular injection of 25 µl of sodium hyaluronate in the left eye and sterile saline solution in the right eye, consecutively for ten weeks. Rats were subjected to anterior/posterior eye segment examinations, intraocular pressure (IOP), and flash electroretinograms (ERG). The aqueous humor was collected at endpoints and analyzed by Nuclear Magnetic Resonance. Elevated IOP and significant reduction of a, b waves and amplitude of oscillatory potential was observed in the left eyes compared to control eyes. The aqueous humor metabolomic profile from control and the experimental eyes were compared. Concentrations of metabolites (amino acids, lipids and carbohydrates) significantly changed after the sodium hyaluronate injections series, compared to the sham-operated eyes. Metabolic changes in the hypertensive eyes correlated with the impaired retinal function. Observed metabolomic changes in aqueous humor in hypertensive state may play a significant role in glaucoma pathogenesis.

Splenic rupture and haemoperitoneum in a patient with non-compaction of the left ventricular myocardium.

The anaesthetic and critical care management of blunt abdominal trauma in a patient previously diagnosed with non-compaction of the left ventricular myocardium (a rare autosomal dominant inherited disease) is reported. The management was influenced by the presence of an implanted automated internal defibrillator and treatment with anticoagulants because of the high frequency of severe arrhythmias and systemic embolism. The pathophysiology of ventricular non-compaction is reviewed briefly.

Nuevo método de inserción de la mascarilla laríngea proseal mediante sonda de aspiración en un caso de vía aérea difícil / No disponible

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[Cesarean section on a full-term parturient with convulsive crises]. / Cesárea en una gestante a término con crisis convulsivas.

A 34-years-old woman in her 35th week of pregnancy experienced epileptic seizures and underwent emergency cesarean delivery of a healthy boy under general anesthesia. The patient had no history of epilepsy and the seizures were later attributed to an intracerebral cavernous angioma. She received treatment with phenytoin and was asymptomatic 3 months later. Although seizures unrelated to preeclampsia or eclampsia in pregnancy are rare, differential diagnosis must determine the etiology of the crisis.

Cesárea en una gestante a término con crisis convulsivas / Cesarean section at full-term with epileptic seizures

Una paciente de 34 años de edad, en la 35 semana de gestación sufrió una crisis epiléptica. No tenía antecedentes previos y precisó una cesárea urgente bajo anestesia general; nació un niño sano. Posteriormente la crisis fue atribuida a un angioma cavernoso intracerebral. Recibió tratamiento con fenitoína y tres meses después estaba asintomática. Aunque la aparición de convulsiones no inducidas por la gestación (preeclampsia-eclampsia) es poco frecuente durante la misma, es necesario hacer el diagnóstico diferencial de las diversas causas que pueden originarlas (AU)

Posibilidades anestesiológicas para la lobectomía por toracotomía a un paciente con alergia a múltiples bloqueantes neuromusculares / Anesthetic options for lobectomy by throracotomy in a patient allergic to multiple neuromuscular blockers

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Estudio histológico de los efectos agudos y crónicos inducidos por la irradiación con láser de diodo en discos intervertebrales de conejo / Histological study of acute and chronic effects induced by diode lase irradiation on the intervertebral discs of rabbits

Objetivo:- El objetivo de este trabajo ha sido evaluar los cambios agudos y crónicos inducidos por la irradiación con láser de diodo en discos intervertebrales (DIV) de conejo. Material y métodos: Se utilizaron 34 conejos de Nueva Zelanda, 20 de ellos fueron irradiados (DIVs Ll-L2 o L2-L3) usando un láser de diodo de 870 nm y dosis comprendidas entre 28 y 153 Julios. Cuatro conejos fueron sacrificados inmediatamente después de la irradiación (0 dpi), dos a los 5 dpi y 14 a los 45 dpi. Otros 14 conejos fueron usados como controles no irradiados. Resultados: Los cambios agudos consistieron en, un cráter de bordes bien definidos en anillo fibroso y núcleo pulposo. Los cambios crónicos consistieron en la proliferación de un osteofito sobre la superficie ventral del disco en el área irradiada, cuyo grosor guardó relación con la dosis de energía irradiada. El anillo fibroso localizado bajo el osteofito presentó una banda de necrosis por coagulación. La irradiación directa de la placa vertebral provocó daño térmico en una banda de 2 a 5 mm. Conclusión: Los resultados de este trabajo sugieren que la correcta localización de la fibra óptica en el disco intervertebral es de gran importancia para el éxito de la discectomía mediante láser, debiendo evitar la irradiación de la periferia del anillo fibroso (AU)

[Autonomic and metabolic sequelae of global and focal cerebral ischemia in an experimental model]. / Repercusiones autonómicas y metabólicas en un modelo experimental de isquemia cerebral global y focal.

INTRODUCTION: During the last decades the influence of cerebrovascular disease on heart and autonomic nervous system has been studied in numerous reports. Autonomic and metabolic changes have been described during brain ischemia. METHODS: We studied some parameters and its modifications during global (GBI) and focal brain ischemia (FBI). Ten Wistar rats were subjected to global ischemia and eleven to focal brain ischemia, during 20 and 90 minutes followed in both cases by reperfusion. Mean blood pressure, heart rate and glycaemia before, during and after brain ischemia were registered. pH, pO2 and pCO2 were maintained within normal range using endovenous tamponed solutions. RESULTS: During GBI the blood pressure rose and returned to normal in the reperfusion period. Heart rate decreased in both stroke models and hyperglycaemia was present from the beginning in two groups. CONCLUSIONS: GBI and FBI bring about autonomic changes as increased mean blood pressure (only in GBI) and decreased heart rate; probably these might be explained by an autonomic nervous system disorder or by intracranial hypertension. Hyperglycaemia could be related to cathecholamines secretion. These effects might influence in the pathophysiology of brain ischemia.

Gene dosage effect in one family with myoclonic epilepsy and ragged-red fibers (MERRF).

OBJECTIVES: We analyzed the percentage of mitochondrial DNA (mtDNA) heteroplasmy in blood samples of 13 individuals belonging to a three family generation of myoclonic epilepsy with ragged-red fibers (MERRF) and compared the 5 affected patients and the 8 unaffected relatives. MATERIAL AND METHODS: DNA was extracted from blood and muscle of the proband and from blood of 12 maternal relatives. A PCR restriction analysis method was used to detect the mutation. RESULTS: The proband had the complete MERRF phenotype. The phenotype in three other individuals in the maternal lineage was consistent with the MERRF syndrome. The remaining were asymptomatic. The np 8344 mutation was observed in muscle and blood of the proband, and in blood from every one of 12 maternal relatives, ranging from 44% to 83% of mutated genomes. Symptomatic individuals had higher levels (P < 0.001) of mutated mtDNA than asymptomatic maternal relatives. However, high proportions of mutant genomes (up to 63%) were found in asymptomatic relatives. CONCLUSIONS: Although there seems to be a gene dosage effect in MERRF, we found no absolute relationship between the relative proportion of mutant genomes in blood and clinical severity. Factors other than gene dosage in blood may account for the differences in clinical phenotype.

[Duration and objectives of hospital admission to stroke units]. / Duración y objetivos de la hospitalización en las unidades de ictus.

OBJECTIVE: The epidemiological importance of Acute Cerebrovascular Disorders (ECVA) has led to a need for specific units to care for these patients. We review the effect of these units on Neurology Departments. Development. In the 1970s Stroke Intensive Care Units were created. In the 1980s these units were replaced by Non-intensive or Intermediate Care Units (Acute Stroke Units). These Acute Stroke Units are more efficient than the previous units and were found to reduce mortality, morbidity, hospital stay and costs. Care was complemented by specific Rehabilitation Units. The design we propose takes into consideration the integration of a Stroke Unit in the Neurology Department, in the Hospital and in the Health Area. After one year results were compared with those of the previous year, when a specific team cared for such patients. There was an 18.5% reduction in total hospital stay and a 23.5% reduction for ECVA patients, with a 21% increase in admissions. The number of complications was reduced by 40.91%. CONCLUSIONS: Stroke Units are extremely useful in Neurology Departments. They lead to reduced morbi-mortality, sequelae, average hospital stay and costs. The functional condition of the patients also improves.

[Association of plasmapheresis and high doses of intravenous immunoglobulins in the treatment of myasthenia gravis]. / Asociación de plasmaféresis y dosis altas de inmunoglobulina intravenosa en el tratamiento de la miastenia gravis.

INTRODUCTION: In the past decade good therapeutic results have been reported with high dosage of intravenous immunoglobulins (Ig i.v.) in various autoimmune disorders, including myasthenia gravis (MG). Plasmapheresis has been used successfully in this disorder on indications similar to those described for the use of Ig i.v.. We have used sequential treatment of plasmapheresis followed by high doses of intravenous gammaglobulin in MG, seeking complementary benefits from the two kinds of treatment. MATERIAL AND METHODS: The sample included 10 patients with MG (7 of Osserman's grade II-B, 1 of II-A and 2 of III). We began treatment with plasmapheresis, and then continued with an i.v. infusion of Ig at a dose of 400 mg/Kg/day for 5 days. To evaluate the response to treatment, we used the classification system for muscle weakness based on the Virginia University modification of Osserman's grades, on the clinical involvement grade scales and on functional activity. RESULTS: All patients showed statistically significant improvement of the parameters studied. Improvement started between the first and sixth day, following administration of Ig i.v. and persisted for the following 16 weeks. CONCLUSIONS: We consider that combined treatment with plasmapheresis and Ig i.v. may synergically potentiate the immunological effects since they have different mechanisms of action. The indication for this is limited to serious clinical conditions resistant to other treatment, to speed recovery.