Pontine activation during focal status epilepticus secondary to hamartoma of the floor of the fourth ventricle

Epileptic seizures associated with hamartoma of the floor of the fourth ventricle (HFFV) are generally resistant to antiepileptic medication, may evolve into status epilepticus, and can respond favorably to surgical therapy. HFFV are rare, and during the neonatal or infantile period may be associated with repetitive and stereotyped attacks of hemifacial spasm, eye blinking, facial movements, head deviation and dysautonomic manifestations. Similarly, to gelastic seizures provoked by hypothalamic hamartomas, it has been suggested that these spells arise from within the HFFV, thus constituting a type of non-cortical seizure. We report an infant female patient that developed continuous left hemifacial attacks since she was 2-month-old, and that underwent presurgical investigation when she was 18-month-old. MRI disclosed a left sided HFFV, Video-EEG showed non-localizing and non-lateralizing findings, and SPECT aligned with MRI showed marked hyperperfusion within the hamartoma, spreading to ipsilateral cerebellar parenchyma and brainstem nuclei. Patient underwent lesionectomy and became seizure-free. We found two evidences on literature supporting the hypothesis of non-cortical seizures related to HFFV. The first, intra-cerebellar recordings surrounding hamartoma showed electrical activity related to seizures. The second, subtracted SPECT co-registered MRI showed hyperemia within hamartoma. The present report provides the third additional evidence. We found the involvement not only of the hamartoma, and pars of cerebellar hemisphere, but also an intense hyperemia involving brainstem nuclei during seizures. We believe that all these findings suggest a short subcortical network responsible for generating seizures in HFFV patients.     

Creation of pneumoperitoneum: noninvasive monitoring of clinical effects of elevated intraperitoneal pressure for the insertion of the first trocar

Aim  

The aim of this work is to analyze, by means of noninvasive monitoring, the clinical effects of high intraperitoneal pressure for enough time to insert the first trocar.     

Giardiasis as zoonosis: between proof of principle and paradigm in the Northwestern region of São Paulo State,Brazil

ObjectiveIn order to evaluate the potential zoonotic transmission of Giardia duodenalis, isolates from humans and dogs in the Northwestern region of the São Paulo State, Brazil were characterized based on the β-giardin gene.MethodsThe samples were analyzed by sequencing of the Nested-PCR products.ResultsThe A1 and A2 subgenotypes were detected in human and dogs. Cysts of assemblage B, C and D have not been found in any isolates studied.ConclusionsThese results are consistent with the view that giardiasis in the largest endemic region of the Brazil should not be seen as a single entity.     

The process of demedicalization of women's health care in nursing education

This objective of this study is to present the pedagogic strategies adopted by the Rio de Janeiro State University Nursing School (UERJ--Brazil) for the demedicalization of care in nursing education in women's health. It presents the context of teaching in this area of knowledge. It also presents, from the perspective of concepts by Pierre Bourdieu, three spheres of students' and teachers' performance in this process.     

Trypanosoma cruzi: analysis of two different strains after piplartine treatment

The hemoflagellate protozoan, Trypanosoma cruzi, mainly transmitted by triatomine insects through blood transfusion or from mother-to-child, causes Chagas’ disease. This is a serious parasitic disease that occurs in Latin America, with considerable social and economic impact. Nifurtimox and benznidazole, drugs indicated for treating infected persons, are effective in the acute phase, but poorly effective during the chronic phase. Therefore, it is extremely urgent to find innovative chemotherapeutic agents and/or effective vaccines. Since piplartine has several biological activities, including trypanocidal activity, the present study aimed to evaluate it on two T. cruzi strains proteome. Considerable changes in the expression of some important enzymes involved in parasite protection against oxidative stress, such as tryparedoxin peroxidase (TXNPx) and methionine sulfoxide reductase (MSR) was observed in both strains. These findings suggest that blocking the expression of the two enzymes could be potential targets for therapeutic studies.     

Natural chromenes and chromene derivatives as potential anti-trypanosomal agents

The aim of the study was to investigate the anti-trypanocidal activities of natural chromene and chromene derivatives. Five chromenes were isolated from Piper gaudichaudianum and P. aduncum, and a further seven derivatives were prepared using standard reduction, methylation and acetylation procedures. These compounds were assayed in vitro against epimastigote forms of Trypanosoma cruzi, the causative agent of Chagas disease. The results showed that the most of the compounds, especially those possessing electron-donating groups as substituents on the aromatic ring, showed potent trypanocidal activity. The most active compound, [(2S)-methyl-2-methyl-8-(3'-methylbut-2'-enyl)-2-(4'-methylpent-3'-enyl)-2H-chromene-6-carboxylate], was almost four times more potent than benznidazole (the positive control) and showed an IC50 of 2.82 microM. The results reveal that chromenes exhibit significant anti-trypanocidal activities and indicate that this class of natural product should be considered further in the development of new and more potent drugs for use in the treatment of Chagas disease.     

Clinical Validation of the Portuguese Version of “Substance Addiction Consequences” Derived from the Nursing Outcomes Classification

Our aim was to contribute to the clinical validation of “Substance Addiction Consequences” (SAC) derived from the nursing outcomes classification (NOC), and to analyse psychometric properties. To that purpose, we applied a methodological design. The study’s outcome comprises 16 nursing-sensitive indicators, within four different consequence factors: psychological and family; physical and cognitive ability; self-care; economic and work. The psychometric properties were considered good. We concluded that the scale can be used as a valid tool to measure the consequences of substance addiction and to assess the health status as a nursing sensitive outcome. The scale is considered valid to monitor nursing interventions in the clinical setting; being a comprehensive tool it allows the nurse to understand better this complex health problem.     

Angolatitan adamastor, a new sauropod dinosaur and the first record from Angola

A forelimb of a new sauropod dinosaur (Angolatitan adamastor n. gen. et sp.) from the Late Turonian of Iembe (Bengo Province) represents the first dinosaur discovery in Angola, and is one of the few occurrences of sauropod dinosaurs in sub-Saharan Africa collected with good chronological controls. The marginal marine sediments yielding the specimen are reported to be late Turonian in age and, thus it represents a non-titanosaurian sauropod in sub-Saharan Africa at a time taken to be dominated by titanosaurian forms. Moreover, Angolatitan adamastor is the only basal Somphospondyli known in the Late Cretaceous which implies in the existence of relict forms in Africa.