Effects of amygdala-hippocampal stimulation on interictal epileptic discharges

Deep brain stimulation (DBS) of different nuclei is being evaluated as a treatment for epilepsy. While encouraging results have been reported, the effects of changes in stimulation parameters have been poorly studied. Here the effects of changes of pulse waveform in high frequency DBS (130 Hz) of the amygdala-hippocampal complex (AH) are presented. These effects were studied on interictal epileptic discharge rates (IEDRs). AH-DBS was implemented with biphasic versus pseudo monophasic charge balanced pulses, in two groups of patients: six with temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) and six with non lesional (NLES) temporal epilepsy. In patients with HS, IEDRs were significantly reduced with AH-DBS applied with biphasic pulses in comparison with monophasic pulse. IEDRs were significantly reduced in only two patients with NLES independently to stimulus waveform. Comparison to long-term seizure outcome suggests that IEDRs could be used as a neurophysiological marker of chronic AH-DBS and they suggest that the waveform of the electrical stimuli can play a major role in DBS. We concluded that biphasic stimuli are more efficient than pseudo monophasic pulses in AH-DBS in patients with HS. In patients with NLES epilepsy, other parameters relevant for efficacy of DBS remain to be determined.

Comparison of the effects of bimatoprost and a fixed combination of latanoprost and timolol on circadian intraocular pressure

OBJECTIVE: To compare the effect of bimatoprost and the fixed combination of latanoprost and timolol (LTFC) on 24-hour mean intraocular pressure (IOP) after patients are switched from a nonfixed combination of latanoprost and timolol. DESIGN: Randomized, double-masked, multicenter clinical trial. PARTICIPANTS: Two hundred patients with glaucoma or ocular hypertension. METHODS: Included were patients who were controlled (IOP < 21 mmHg) on the nonfixed combination of latanoprost and timolol for at least 3 months before the baseline visit or patients on monotherapy with either latanoprost or timolol who were eligible for dual therapy not being fully controlled on monotherapy. The latter group of patients underwent a 6-week wash-in phase with the nonfixed combination of latanoprost and timolol before baseline IOP determination and study inclusion. Supine and sitting position IOPs were recorded at 8 pm, midnight, 5 am, 8 am, noon, and 4 pm at baseline, week 6, and week 12 visits. MAIN OUTCOME MEASURE: An analysis of covariance model was used for a noninferiority test of the primary efficacy variable, with mean area under the 24-hour IOP curve after 12 weeks of treatment as response variable and treatment, center, and baseline IOP as factors. A secondary analysis was performed on the within-treatment change from baseline. RESULTS: Mean baseline IOPs were 16.3+/-3.3 mmHg and 15.5+/-2.9.mmHg in the bimatoprost and LTFC groups, respectively. At week 12, mean IOPs were 16.1+/-2.5 mmHg for the bimatoprost group and 16.3+/-3.7 mmHg for the LTFC group, and no significant difference between the 2 treatment groups could be found. As compared with baseline, mean IOP increased by 0.3+/-3.6 mmHg during the day and decreased by 0.8+/-3.8 mmHg during the night in the bimatoprost group, whereas there were increases of 1.43+/-2.6 mmHg and 0.14+/-3.2 mmHg in the LTFC group, respectively. CONCLUSIONS: Bimatoprost is not inferior to the LTFC in maintaining IOP at a controlled level during a 24-hour period in patients switched from the nonfixed combination of latanoprost and timolol.

Electrode location and clinical outcome in hippocampal electrical stimulation for mesial temporal lobe epilepsy

PURPOSE To study the clinical outcome in hippocampal deep brain stimulation (DBS) for the treatment of patients with refractory mesial temporal lobe epilepsy (MTLE) according to the electrode location. METHODS Eight MTLE patients implanted in the hippocampus and stimulated with high-frequency DBS were included in this study. Five underwent invasive recordings with depth electrodes to localize ictal onset zone prior to chronic DBS. Position of the active contacts of the electrode was calculated on postoperative imaging. The distances to the ictal onset zone were measured as well as atlas-based hippocampus structures impacted by stimulation were identified. Both were correlated with seizure frequency reduction. RESULTS The distances between active electrode location and estimated ictal onset zone were 11±4.3 or 9.1±2.3mm for patients with a >50% or <50% reduction in seizure frequency. In patients (N=6) showing a >50% seizure frequency reduction, 100% had the active contacts located <3mm from the subiculum (p<0.05). The 2 non-responders patients were stimulated on contacts located >3mm to the subiculum. CONCLUSION Decrease of epileptogenic activity induced by hippocampal DBS in refractory MTLE: (1) seems not directly associated with the vicinity of active electrode to the ictal focus determined by invasive recordings; (2) might be obtained through the neuromodulation of the subiculum.

Outbreak of Morel's disease in a Swiss goat flock

Staphylococcus aureus subsp. anaerobius is the causative agent of Morel’s disease in goats and sheep. We report the first outbreak of Morel’s disease in a Swiss goat flock. Multilocus sequence typing revealed that the Swiss isolates belong to sequence type (ST)1464, which is the ST responsible for outbreaks worldwide.

Las edades de Lulú, por fuera de lo erótico : Otros mecanismos de desestabilización

Este trabajo se propone, en primer lugar, realizar una lectura de Las edades de Lulú (1989), relacionando el concepto freudiano de incorporación melancólica del objeto perdido, reelaborado por Judith Butler en The Psychic Life of Power (1997) como mecanismo de construcción de las identidades heterosexuales, con el comportamiento "transgresivo" que Lulú, la protagonista de la primer novela de Almudena Grandes, adopta luego de la separación con Pablo. La adaptación fílmica del texto literario, realizada en 1990 por Bigas Luna, explora mediante la mostración erótica los modos en que se manifiesta la comúnmente denominada "masculinización" de Lulú; sin embargo, la película curiosamente prescinde de otros mecanismos, presentes en el libro, que apuntan a desestabilizar los límites de la "matriz" cultural y social que, en España, dio forma no sólo a las manifestaciones ?aceptables? sino también a sus respectivas transgresiones. En una segunda instancia, por lo tanto, se analizarán las operaciones desestabilizadoras del espacio político, de la memoria y de la tradición católica de la novela de Grandes, que se conectan con algunos aspectos de las propuestas artísticas de otros actores culturales como Ana Rossetti, Pedro Almodóvar y Eduardo Mendicutti

Las edades de Lulú, por fuera de lo erótico : Otros mecanismos de desestabilización

Este trabajo se propone, en primer lugar, realizar una lectura de Las edades de Lulú (1989), relacionando el concepto freudiano de incorporación melancólica del objeto perdido, reelaborado por Judith Butler en The Psychic Life of Power (1997) como mecanismo de construcción de las identidades heterosexuales, con el comportamiento "transgresivo" que Lulú, la protagonista de la primer novela de Almudena Grandes, adopta luego de la separación con Pablo. La adaptación fílmica del texto literario, realizada en 1990 por Bigas Luna, explora mediante la mostración erótica los modos en que se manifiesta la comúnmente denominada "masculinización" de Lulú; sin embargo, la película curiosamente prescinde de otros mecanismos, presentes en el libro, que apuntan a desestabilizar los límites de la "matriz" cultural y social que, en España, dio forma no sólo a las manifestaciones ?aceptables? sino también a sus respectivas transgresiones. En una segunda instancia, por lo tanto, se analizarán las operaciones desestabilizadoras del espacio político, de la memoria y de la tradición católica de la novela de Grandes, que se conectan con algunos aspectos de las propuestas artísticas de otros actores culturales como Ana Rossetti, Pedro Almodóvar y Eduardo Mendicutti

Las edades de Lulú, por fuera de lo erótico : Otros mecanismos de desestabilización

Este trabajo se propone, en primer lugar, realizar una lectura de Las edades de Lulú (1989), relacionando el concepto freudiano de incorporación melancólica del objeto perdido, reelaborado por Judith Butler en The Psychic Life of Power (1997) como mecanismo de construcción de las identidades heterosexuales, con el comportamiento "transgresivo" que Lulú, la protagonista de la primer novela de Almudena Grandes, adopta luego de la separación con Pablo. La adaptación fílmica del texto literario, realizada en 1990 por Bigas Luna, explora mediante la mostración erótica los modos en que se manifiesta la comúnmente denominada "masculinización" de Lulú; sin embargo, la película curiosamente prescinde de otros mecanismos, presentes en el libro, que apuntan a desestabilizar los límites de la "matriz" cultural y social que, en España, dio forma no sólo a las manifestaciones ?aceptables? sino también a sus respectivas transgresiones. En una segunda instancia, por lo tanto, se analizarán las operaciones desestabilizadoras del espacio político, de la memoria y de la tradición católica de la novela de Grandes, que se conectan con algunos aspectos de las propuestas artísticas de otros actores culturales como Ana Rossetti, Pedro Almodóvar y Eduardo Mendicutti

O DISCURSO AMBIENTAL JORNALÍSTICO, POLÍTICO E EMPRESARIAL EM ÂMBITO LOCAL: uma proposta de análise

Esta tese tem como tema principal o discurso ambiental local. Trata-se de uma proposta de análise, que pode ser aplicada a este tipo de discurso em qualquer localidade, e um estudo de caso, que aplicou a análise proposta na tese. O objetivo geral desta pesquisa foi analisar a informação local sobre meio ambiente veiculada por meio dos discursos jornalístico, político e empresarial, estabelecendo relações históricas, sociais e ideológicas do discurso ambiental que permeiam as três áreas em questão. A metodologia incluiu três fases: pesquisa bibliográfica e revisão de literatura sobre os principais conceitos levantados no trabalho; levantamento de discursos locais disponíveis na mídia para análise no estudo de caso; análise dos discursos a partir de protocolo elaborado com base na Análise do Discurso de linha francesa. O estudo de caso traz a análise do discurso ambiental no município de Frutal-MG, onde hoje estão em andamento várias pesquisas e projetos na área ambiental. A principal conclusão do trabalho confirma a hipótese da pesquisa de que a informação ambiental fruto dos discursos político, jornalístico e empresarial em âmbito local tem caráter predominantemente situacional, mercadológico e propagandístico, pouco focada em conscientizar e educar e com ênfase em interesses comerciais e eleitorais e na resolução de problemas emergenciais.