bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respiratory Pattern in a Rat Model of Epilepsy
Authors: Campos Ruy R. , Tolentino‐Silva Fatima R. P. , Mello Luiz E. A. M. 
Published: May 2003

Summary:  Purpose: Apnea is known to occur during seizures, but systematic studies of ictal respiratory changes in adults are few. Data regarding respiratory pattern defects during interictal periods also are scarce. Here we sought to generate information with regard to the interictal period in animals with pilocarpine‐induced epilepsy.Methods: Twelve rats (six chronically epileptic animals and six controls) were anesthetized, given tracheotomies, and subjected to hyperventilation or hypoventilation conditions. Breathing movements caused changes in thoracic volume and forced air to flow tidally through a pneumotachograph. This flow was measured by using a differential pressure transducer, passed through a polygraph, and from this to a computer with custom software that derived ventilation (VE), tidal volume (VT), inspiratory time (TI), expiratory time (TE), breathing frequency (f), and mean inspiratory flow (VT/TI) on a breath‐by‐breath basis.Results: The hyperventilation maneuver caused a decrease in spontaneous ventilation in pilocarpine‐treated and control rats. Although VE had a similar decrease in both groups, in the epileptic group, the decrease in VE was due to a significant (p < 0.05) increase in TE peak in relation to that of the control animals. The hypoventilation maneuver led to an increase in the arterial Paco2, followed by an increase in VE. In the epileptic group, the increase in VE was mediated by a significant (p < 0.05) decrease in TE peak compared with the control group. Systemic application of KCN, to evaluate the effects of peripheral chemoreception activation on ventilation, led to a similar increase in VE for both groups.Conclusions: The data indicate that pilocarpine‐treated animals have an altered ability to react to (or compensate for) blood gas changes with changes in ventilation and suggest that it is centrally determined. We speculate on the possible relation of the current findings on treating different epilepsy‐associated conditions.
Safety and Efficacy of Intravenous Valproate in Pediatric Status Epilepticus and Acute Repetitive Seizures
Authors: Yu Kian‐Ti , Mills Sandra , Thompson Nanora , Cunanan Cedric 
Published: May 2003

Summary: Purpose:To evaluate the safety and efficacy of intravenous valproate (VPA) loading in children with status epilepticus (SE) or acute repetitive seizures.Methods:Retrospective review was performed on 40 pediatric patients with intravenous VPA loading. Patients were classified into two groups: SE (n = 18) and acute repetitive seizures (n = 22). Thirty‐one patients were VPA naïve and received a full loading dose of 25 mg/kg; nine had subtherapeutic plasma VPA levels and received a partial loading dose. Average infusion rate was 2.8 mg/kg/min. Heart rate and blood pressure were measured before, during, and after infusion.Results:Intravenous VPA loading stopped seizures in 18 patients with SE within 20 min. All 18 patients regained baseline mental status within 1 h of seizure cessation. Among 22 patients with acute repetitive seizures, only one had further seizures after VPA infusion. One patient in the SE group complained of transient tremors. No significant changes in blood pressure or heart rate were found in either group. Postinfusion plasma VPA levels ranged from 51 to 138 μg/ml (mean ± SD = 88 ± 21.5 μg/ml).Conclusions:Intravenous VPA loading is safe and effective for treating acute seizure emergencies in children.
Short Bursts of Weak Pulses Break Postictal Inhibition in the Neocortex of Wistar Rats
Authors: Tůma Lukáš , Krýsl David , Mareš Jan 
Published: May 2003

Summary: Purpose:Postictal inhibition (PI) is a decrease in excitability that follows an epileptic seizure and decreases probability of new seizure occurrence. PI may involve both increased inhibition and persisting elevated excitation. Our experiments tested whether shorter trains of weak stimuli are able to unmask this residual increase of excitability during the PI.Methods:Four epileptic afterdischarges (ADs) were evoked by intense electrical stimulation (20 s, 8 Hz, current intensity at 5× threshold) of the neocortex in two groups (A, B) of Wistar rats. Before the first AD and during the 10‐min interictal period, 8‐Hz trains of four weak pulses (half of the intensity used for the AD triggering; 4P) were applied every 20 s in group B and a single pulse with similar parameters in group A.Results:The number of interictal epileptiform events evoked by 4P in the group B was significantly higher than that in the group A (evoked by single pulses) except after the second AD. Epileptic events were triggered by 4P also immediately after the AD termination.Conclusions:It is apparent that weak stimulation can trigger epileptic phenomena during PI. Our results indicate that it is no longer possible to perceive PI only as persisting extreme and active inhibition. An appropriate stimulation can reveal more subtle (but important) excitatory events contributing to the functional status during the postictal period.
Effect of Topiramate on the Anticonvulsant Activity of Conventional Antiepileptic Drugs in Two Models of Experimental Epilepsy
Authors: Borowicz Kinga K. , Luszczki Jarogniew J. , Duda Andrzej M. , Czuczwar Stanislaw J. 
Published: May 2003

Summary:  Purpose: The objective of this study was to evaluate the interaction of the novel antiepileptic drug (AED), topiramate (TPM), with conventional AEDs against amygdala‐kindled seizures in rats and pentylenetetrazol‐induced convulsions in mice.Methods: Experiments were performed on mice and fully kindled rats. In pentylenetetrazol test, the chemoconvulsant was used at its CD97 dose of 105 mg/kg, producing clonic seizures in 97% of mice. Adverse effects were evaluated with the chimney test and passive avoidance task. Plasma levels of AEDs were measured with immunofluorescence.Results: TPM at 20 mg/kg exerted a significant anticonvulsant effect as regards seizure and afterdischarge durations in amygdala‐kindled seizures in rats, being ineffective at lower doses. Coadministration of TPM (10 mg/kg) with valproate (VPA; at a subtherapeutic dose of 50 mg/kg) resulted in essential reductions of seizure and afterdischarge durations. TPM (10 mg/kg) combined with carbamazepine (CBZ; at a subtherapeutic dose of 15 mg/kg) significantly increased afterdischarge threshold, simultaneously decreasing the remaining seizure parameters (duration or severity of seizures and afterdischarge duration). TPM (10 mg/kg) given with phenobarbital (PB; 15 mg/kg) markedly shortened seizure severity and seizure and afterdischarge durations. Combinations of TPM with diphenylhydantoin (PHT) were ineffective against kindled seizures in rats. TPM combined with VPA and PB did not alter their plasma levels, but its combination with CBZ resulted in an increased free plasma CBZ concentration. TPM (10 and 20 mg/kg) alone and its combinations with conventional AEDs affected neither motor coordination nor long‐term memory, evaluated in the chimney and passive avoidance tests, respectively, in rats. In pentylenetetrazol‐evoked convulsions in mice, TPM (175 and 200 mg/kg) showed anticonvulsant effects per se. Moreover, TPM (at its subtherapeutic dose of 150 mg/kg), significantly potentiated the anticonvulsant action of ethosuximide (ESM), but not that of VPA, PB, or clonazepam (CZP) against pentylenetetrazol‐induced seizures. Either TPM alone (150 mg/kg) or its combination with ESM did not result in significant undesired effects.Conclusions: The experimental data indicate that except for PHT, the combinations of TPM with conventional AEDs are beneficial against amygdala‐kindled seizures in rats. In the pentylenetetrazol test, this novel AED potentiated only the protection offered by ESM.
Neuronal Cell Death in a Rat Model for Mesial Temporal Lobe Epilepsy Is Induced by the Initial Status Epilepticus and Not by Later Repeated Spontaneous Seizures
Authors: Gorter Jan A. , Pereira Pedro M. Gonçalves , Van Vliet Erwin A. , Aronica Eleonora , Da Silva Fernando H. Lopes , Lucassen Paul J. 
Published: May 2003

Summary:  Purpose: To determine whether repeated seizures contribute to hippocampal sclerosis, we investigated whether cell loss in the (para) hippocampal region was related to the severity of chronic seizure activity in a rat model for temporal lobe epilepsy (TLE).Methods: Chronic epilepsy developed after status epilepticus (SE) that was electrically induced 3–5 months before. The presence of neuronal damage was assessed by using Fluoro‐Jade and dUTP nick end‐labeling (TUNEL) of brain sections counterstained with Nissl.Results: We found a negative correlation between the numbers of surviving hilar cells and the duration of the SE (r = –0.66; p < 0.01). In the chronic phase, we could discriminate between rats with occasional seizures (0.15 ± 0.05 seizures per day) without progression and rats with progressive seizure activity (8.9 ± 2.8 seizures/day). In both groups, the number of TUNEL‐positive cells in parahippocampal regions was similar and higher than in controls. In the hippocampal formation, this was not significantly different from controls. Fluoro‐Jade staining showed essentially the same pattern at 1 week and no positive neurons in chronic epileptic rats.Conclusions: Cell death in this rat model is related to the initial SE rather than to the frequency of spontaneous seizures. These results emphasize that it is of crucial importance to stop the SE as soon as possible to prevent extended cell loss and further progression of the disease. They also suggest that neuroprotectants can be useful during the first week after SE, but will not be very useful in the chronic epileptic phase.
The Provision of Epilepsy Care across Europe
Authors: Malmgren Kristina , Flink Roland , Guekht Alla B. , Michelucci Roberto , Neville Brian , Pedersen Birthe , Pinto Francisco , Stephani Ulrich , Özkara Cigdem 
Published: May 2003

Summary:  Purpose: To assess the needs and resources available in the provision of basic epilepsy care across Europe.Methods: A mailed questionnaire was used, the European Epilepsy Services inventory (EESI). The EESI was distributed to all 36 European chapters of the International League Against Epilepsy (ILAE), and answers were obtained from 32, a response rate of 89%. For the purpose of studying trends across Europe, the chapters were divided into a Western, an Eastern, a Central, and a Southern group.Results: The survey results showed that there was a wide range in the number of physicians and specialists involved in epilepsy care across Europe, with a trend toward higher numbers of neurologists, pediatricians, and pediatric neurologists in Eastern Europe. Many different specialities were involved in epilepsy care, and many chapters reported differences in the provision of care across their countries, with less possibility for patients to see a specialist in the least provided areas, where most epilepsy patients were cared for by general practitioners and internists. Problems with high costs of the newer antiepileptic drugs were most pronounced in Eastern Europe. Problems with lack of comprehensive care and of epilepsy specialists, with stigma and social problems, and with insufficient professional education and knowledge about epilepsy were reported all across Europe.Conclusions: Knowledge about differences in the pattern of provision of epilepsy care and about the main problems encountered by the European ILAE chapters is of importance in the continuing efforts to improve management of epilepsy all over Europe.
High Body Mass Index Does Not Predict Mortality in Older People: Analysis of the Longitudinal Study of Aging
Authors: Grabowski David C. , Ellis John E. 
Published: May 2003

OBJECTIVE: To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors.DESIGN: Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA).SETTING: Nationally representative sample of community‐dwelling older people.PARTICIPANTS: Seven thousand five hundred and twenty‐seven participants age 70 and older in 1984.MEASUREMENTS: We used Cox regression to calculate proportional hazards ratios for mortality over 96 months. We tested the hypothesis that increased BMI (top 15%) increased mortality rates in older people.RESULTS: Death occurred in 38% of the cohort: 54% of the thin (lowest 10% of the population, BMI <19.4 kg/m2), 33% of the obese (highest 15%, BMI> 28.5 kg/m2), and 37% of the remaining participants (normal) died. Adjustment for demographic factors, health services utilization, and functional status still demonstrated reduced mortality in obese older people (hazard ratio 0.86, 95% confidence interval (CI) = 0.77–0.97) compared with normal. After adjustment, thin older people remained more likely to die (hazard ratio 1.46, 95% CI = 1.30–1.64) than normal older people. Sensitivity analyses for income, mortality during the first two years of follow‐up, and medical comorbidities did not substantively alter the conclusions.CONCLUSION: Obesity may be protective compared with thinness or normal weight in older community‐dwelling Americans.
Adsorption of autoantibodies in the presence of LISS to detect alloantibodies underlying warm autoantibodies
Authors: Chiaroni Jacques , Touinssi Mohammed , Mazet Magali , De Micco Philippe , Ferrera Virginie 
Published: May 2003

BACKGROUND : The safe transfusion of patients with warm autoimmune hemolytic anemia requires an efficient and time‐saving assay to detect alloantibodies underlying autoantibodies. Methods used include RBCs treated with ZZAP reagent, proteolytic enzyme, or untreated RBCs in the presence of PEG. We propose a method using LISS, which presents some advantages over previous methods. STUDY DESIGN AND METHODS : We evaluated the effectiveness of autoantibody adsorption with papain‐treated and untreated RBCs in the presence of LISS for removal of autoantibodies, without affecting alloantibodies. RESULTS
: One‐hundred twenty sera containing autoantibodies were adsorbed with our routine method, which uses papain‐treated allogeneic RBCs. Seven‐hundred twenty adsorptions (mean, 6 per sample) and 21,600 minutes (mean, 180 min per sample) were required to remove autoantibodies. Fifty sera were adsorbed with our routine method that uses papain‐treated allogeneic RBCs in the presence of LISS. The number of adsorptions and the completion time were, respectively, 144 (mean, 2.9 per sample) and 2,880 minutes (mean, 57.6 min per sample). Twenty sera were evaluated with untreated autologous RBCs, in the presence of LISS; 58 adsorptions (mean, 2.9) and 1,160 minutes (mean, 58 min per sample) were required. Three adsorptions with antigen‐negative allogeneic RBCs were performed on 8 sera containing alloantibodies with weak reactivity (anti‐K [1], anti‐D [1], anti‐Fy
a
[2], anti‐S [2], anti‐E [1], and anti‐Jk
a
[1]). Alloantibodies were detected with the LISS procedure with papain‐treated and untreated RBCs and the routine papain method. Alloantibodies with weak reactivity, tested against the same antibody‐detection RBCs, remained unchanged following adsorption of 5 sera. An anti‐S, with very weak reactivity, was no longer detected, and an anti‐Jk
a became weaker (1+), regardless of the procedure used. One anti‐D became weaker only with the LISS adsorption method. CONCLUSION : Autoantibodies can be adsorbed more efficiently in the presence of LISS.
Adverse effects in blood donors after whole‐blood donation: a study of 1000 blood donors interviewed 3 weeks after whole‐blood donation
Authors: Newman Bruce H. , Pichette Shawn , Pichette Dena , Dzaka Ema 
Published: May 2003

BACKGROUND : There are no reports in the transfusion medicine literature that describe adverse reactions and donor arm injuries after whole‐blood donation based on solicited information. STUDY DESIGN AND METHODS : The present study solicited adverse reaction and donor arm injury information from 1000 randomly selected whole‐blood donors approximately 3 weeks after the whole‐blood donation. Two 16‐gauge phlebotomy needles in use were also compared. RESULTS : Thirty‐six percent of the donors had one or more adverse effects (AEs). The most common systemic AEs were fatigue (7.8%), vasovagal symptoms (5.3%), and nausea and vomiting (1.1%). The most common arm findings were bruise (22.7%), arm soreness (10.0%), and hematoma (1.7%). Men were half as likely as women to have an AE (23% AE vs. 48% AE, p < 0.0001). Repeat blood donors had fewer AEs than first‐time blood donors (36% AE vs. 47% AE, p < 0.007), and African‐American donors had numbers of AEs similar to those of Caucasian donors (31% AE vs. 38% AE, p = 0.30). The two phlebotomy needles did not differ in causing blood donor AEs. CONCLUSION : AEs after donation and complaints may be more common than previously thought. The postdonation interview is a good tool for defining the blood donor's experience. It can also be used to evaluate and potentially improve blood donor safety and comfort.
Early neutrophil engraftment following autologous BMT provides a functional predictor of long‐term hematopoietic reconstitution
Authors: Zubair Abba , Zahrieh David , Daley Heather , Schott Daryls , Gribben John G. , Freedman Arnold , Ritz Jerome 
Published: May 2003

BACKGROUND : Previous studies have demonstrated that the number of CD34+ progenitor cells in the stem cell graft is highly predictive of the rapidity of short‐term hematopoietic engraftment. The aim of this study was to identify factors that predict long‐term hematopoietic reconstitution (LHR) following autologous BMT. STUDY DESIGN AND METHODS : To identify predictors of LHR, peripheral blood counts and marrow biopsies were evaluated at 1 year after transplant in 81 patients with B‐cell non‐Hodgkin's lymphoma (NHL) or chronic lymphocytic leukemia who underwent autologous BMT. Results were correlated with CD34+ cell dose, granulocyte‐monocyte colony‐forming units (CFU–GM) infused, and time to neutrophil engraftment (TNE). RESULTS : Total MNC dose, CD34+ cell dose, and CFU–GM infused were significantly associated with TNE (p = 0.011, p < 0.0001, and p = 0.078, respectively). Patients with chronic lymphocytic leukemia were more likely to have received a low CD34+ cell dose than patients with B‐cell non‐Hodgkin's lymphoma (p = 0.01). Among the four principal predictors, only TNE showed consistent significant correlation with WBC, absolute neutrophil, and platelet count at 1 year after transplant. Logistic regression model showed that TNE was a more sensitive predictor of LHR than either CD34+ cell dose or CFU–GM infused. CONCLUSION : TNE is an in vivo functional measure of LHR and is a more sensitive predictor of LHR at 1 year after BMT than either CD34+ cell dose or CFU–GM infused.
TRALI due to granulocyte‐agglutinating human neutrophil antigen‐3a (5b) alloantibodies in donor plasma: a report of 2 fatalities
Authors: Davoren A. , Curtis B.R. , Shulman I.A. , Mohrbacher A.F. , Bux J. , Kwiatkowska B.J. , McFarland J.G. , Aster R.H. 
Published: May 2003

BACKGROUND : TRALI is usually an immunologic reaction to WBC antibodies in infused plasma and ranks second only to ABO mismatch as a cause of transfusion‐associated death. Implicated donors are usually multiparous women (≥3 pregnancies). STUDY DESIGN AND METHODS : Two fatal cases of TRALI were evaluated by reviewing clinical and laboratory findings and characterizing alloantibodies present in donor plasma. Investigation for WBC antibodies was by lymphocytotoxicity (LCT), FlowPRA (FlowPRA, One Lambda, Inc.) and granulocyte immunofluorescence and agglutination assays. Patient 1 was a 62‐year‐old man with chronic T‐cell lymphocytic leukemia, and Patient 2 was a 54‐year‐old woman undergoing a cadaveric kidney transplant. Both patients developed acute respiratory distress and hypotension during (Patient 1) and approximately 30 minutes after (Patient 2) transfusion. Fulminant pulmonary edema ensued in both cases necessitating mechanical ventilation and both patients died within 24 hours of the onset of respiratory complications. RESULTS : The donors of the implicated blood components were women with a history of two pregnancies but no blood transfusions. Weak apparently panreactive granulocyte antibodies were detected with flow cytometry. However, in the granulocyte agglutination test, strong antibodies specific for human neutrophil antigen (HNA)‐3a (5b) were identified in both donors. CONCLUSION : It is concluded that female blood donors with only two previous pregnancies can form clinically important granulocyte‐reactive alloantibodies leading to fatal TRALI reactions in recipients. The sometimes devastating consequences of TRALI should prompt the development of strategies to prevent or reduce its incidence. Further research is warranted to investigate recipient and donor factors responsible for TRALI, including whether 5b (HNA‐3a) alloantibodies are especially prone to cause severe reactions, and to better characterize the HNA‐3a (5b) antigen, particularly at the molecular level.
Attitudes of Swiss mothers toward unrelated umbilical cord blood banking 6 months after donation
Authors: Danzer Enrico , Holzgreve Wolfgang , Troeger Carolyn , Kostka Ulrike , Steimann Sabine , Bitzer Johanes , Gratwohl Alois , Tichelli André , Seelmann Kurt , Surbek Daniel V. 
Published: May 2003

BACKGROUND :During the past decade, the use of umbilical cord blood (CB) as a source of transplantable hematopoietic stem cells has been increasing. Little is known about the psychosocial consequences that later affect parents after unrelated CB donation. The objective of this study was to evaluate the attitudes of mothers toward unrelated donation of umbilical CB for transplantation 6 months after giving birth. STUDY DESIGN AND METHODS : A prospective study was performed with a standardized, anonymous questionnaire distributed to 131 women 6 months after CB donation. The questionnaire included topics concerning views about the ethical accuracy of having donated CB, emotional responses after donation, concerns about genetic testing and research with CB samples, attitude toward anonymity between her child and possible unrelated CB recipient, and willingness to repeatedly donate umbilical CB in a next pregnancy. RESULTS : The vast majority (96.1%) stated that they would donate umbilical CB again, and all respondents were certain that their decision to have donated umbilical CB was ethical. With regard to the potential risks of genetic testing and “experimentation” of umbilical CB, a significant correlation (p = 0.01) was found between negative attitudes and the decision not to donate umbilical CB again. Additionally, it was observed that women who had a negative experience concerning the donation of CB would not donate again (p = 0.004). CONCLUSIONS : This study shows a high degree of satisfaction of unrelated umbilical CB donation for banking in women 6 months after delivery. Despite a well‐performed and detailed informed consent procedure, one of the ongoing issues for the donators in CB banking involves the concern regarding of improper use of the cells, such as genetic testing or experimentation. Accurate and detailed counseling of pregnant women and their partners therefore maximizes the likelihood that they will donate CB for unrelated banking. These data provide a basis for the improvement of donor selection procedures and public education regarding the use of CB for banking and transplantation.