AAN Epilepsy Quality Measures in clinical practice: a survey of neurologists

Epilepsy Quality Measures (EQM) were developed by the American Academy of Neurology (AAN) to convey standardization and eliminate gaps and variations in the delivery of epilepsy care (Fountain et al., 2011 [1]). The aim of this study was to identify adherence to these measures and other emerging practice standards in epilepsy care. A 15-item survey was mailed to neurologists in Michigan, USA, inquiring about their practice patterns in relation to EQM. One hundred thirteen of the 792 surveyed Michigan Neurologists responded (14%). The majority (83% to 94%) addressed seizure type and frequency, reviewed EEG and MRI, and provided pregnancy counseling to women of childbearing potential. Our survey identified gaps in practice patterns such as counseling about antiepileptic drug (AED) side effects and knowledge about referral for surgical therapy of intractable epilepsy. Statistical significance in the responses on the AAN EQM was noted in relation to number of years in practice, number of epilepsy patients seen, and additional fellowship training in epilepsy. Practice patterns assessment in relation to other comorbidities revealed that although bone health and sudden unexplained death in epilepsy are addressed mainly in patients at risk, depression is infrequently discussed. The findings in this study indicate that additional educational efforts are needed to increase awareness and to improve quality of epilepsy care at various points of health care delivery.     

Routine transthoracic echocardiography to assess pericardial collections in patients after extensive left atrial catheter ablation: a prospective study

TTE after AF Ablation. Introduction: Little is known about the incidence and timing of reactive pericardial collections developing after left atrial catheter ablation (LACA), and when and if transthoracic echocardiography (TTE) should be performed routinely in these patients postprocedure. Methods and Results: Two hundred consecutive LACA patients for persistent atrial fibrillation (AF) (107), paroxysmal AF (75) or atrial tachycardia (AT) (18) underwent on‐table TTE at the end of the procedure, and the next day prior to discharge. One patient developed tamponade at the time of transseptal puncture. Thirty‐three percent of the remaining 199 who underwent on‐table TTE, had a pericardial collection. On next day TTE, there were significantly more pericardial collections (53%, P < 0.0001). Persistent rather than paroxysmal arrhythmia at the time of the procedure was the only predictor of a pericardial collection, either on‐table (χ²= 9.64; P = 0.002) or next day (χ²= 5.95; P = 0.02). Eight patients had collections on next day TTE ≥ 1.5 cm. One needed drainage because of clinical tamponade. Repeated TTEs in the other 7 patients demonstrated resolution of collections over 1–2 weeks. Conclusion: Pericardial collections are common in LACA patients. Almost all are not associated with clinical compromise. The only predictor of collection size is arrhythmia type at ablation, which may correspond to ablation at sites specific to persistent rather than paroxysmal arrhythmias. Performing on‐table TTE routinely may help guide immediate anticoagulation protocols, but even larger on‐table collections are not associated with tamponade and resolve spontaneously. TTE does not need to be performed routinely unless there are clinical signs of tamponade . (J Cardiovasc Electrophysiol, Vol. 22, pp. 756‐760, July 2011)     

Studies of anticancer and antipyretic activity of Bidens pilosa whole plant

Screening of different extracts and fractions from the plant Bidens pilosa Linn. var. (Asteraceae) has been conducted using the in-vitro comet assay for anticancer and the antipyretic action, which was done with in-vivo models. The extract from whole plant was extracted with n-hexane, chloroform and methanol extract (E1 - E3). The extracts were fractioned by column chromatography method and fractioned with ethyl acetate, acetone and water (F1 - F3). All the extracts and fractions were tested for anticancer and antipyretic activity. Among extracts E1 shows remarkable anticancer activity and E3 bears maximum antipyretic activity. In the antipyretic activity, paracetamol was used as the standard test drug. The most promising material (LC50 < 1500 microg/ml) was F1 ethyl acetate fractions of methanolic extract and methanolic crude extract of whole plants. However, little correlation was observed in the degree of antipyretic activity between the test drug and standard drug. In conclusion, the extract obtained from the whole plant of Bidens pilosa showed a significant cytotoxic effect to methanolic extract against Hela cells by in vitro method and showed a comparable antipyretic activity effect to paracetamol in rabbit pyrogen test.     

Nanosponges: a novel class of drug delivery system--review

Effective targeted drug delivery systems have been a dream for a long time, but it has been largely frustrated by the complex chemistry that is involved in the development of new systems. The invention of nanosponges has become a significant step toward overcoming these problems. Nanosponges are tiny sponges with a size of about a virus, which can be filled with a wide variety of drugs. These tiny sponges can circulate around the body until they encounter the specific target site and stick on the surface and begin to release the drug in a controlled and predictable manner. Because the drug can be released at the specific target site instead of circulating throughout the body it will be more effective for a particular given dosage. Another important character of these sponges is their aqueous solubility; this allows the use of these systems effectively for drugs with poor solubility.     

Characterization of invasive and colonizing isolates of Streptococcus agalactiae in East African adults

Ninety-five colonizing isolates and 74 invasive isolates of Streptococcus agalactiae from Kenyan adults were characterized by using capsular serotyping and multilocus sequence typing. Twenty-two sequence types clustering into five clonal complexes were found. Data support the view that S. agalactiae isolates belonging to a limited number of clonal complexes are invasive in adults worldwide.