Refractory and super-refractory status epilepticus and evidence for the use of ketamine: a scope review

Espinosa Luis,Gomez Mario,Zamora Adrian,Molano-Franco Daniel 대한신경집중치료학회 2023 대한신경집중치료학회지 Vol.16 No.1

Status epilepticus (SE) is a neurological emergency with serious consequences for neuronal tissues, therefore, it is considered the most serious manifestation of epilepsy. The response to treatment, its evolution time and duration, and the need to use one or more antiseizure drugs define SE as refractory or super-refractory. Ketamine has been used in SE management since the 90s when an article describing its use in treating SE was published. Since then, at least 24 publications have reported the use of ketamine for the treatment of SE in both adult and pediatric patients. This scoping review seeks to synthesize information on the use of drugs in super-refractory SE, specifically ketamine. Twenty articles were chosen for the final document construction. Few studies have investigated the use of ketamine in refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). Most of the information comes from retrospective case series studies, mostly with small sample sizes, and although the information is heterogeneous, it points to the efficacy of ketamine as a third-line drug in RES and SRSE, in controlling seizures.

Diversity in the composition of the accessory genome of Mexican Pseudomonas aeruginosa strains

Luis F. Espinosa-Camacho,Gabriela Delgado,Alejandro Cravioto,Rosario Morales-Espinosa 한국유전학회 2022 Genes & Genomics Vol.44 No.1

Background: Pseudomonas aeruginosa is an important opportunistic pathogen especially in nosocomial infections due to its easy adaptation to different environments; this characteristic is due to the great genetic diversity that presents its genome. In addition, it is considered a pathogen of critical priority due to the high antimicrobial resistance. Objectives: The aim of this study was to characterize the mobile genetic elements present in the chromosome of six Mexican P. aeruginosa strains isolated from adults with pneumonia and children with bacteremia. Methods: The genomic DNA of six P. aeruginosa strains were isolated and sequenced using PacBio RS-II platform. They were annotated using Prokaryotic Genome Annotation Pipeline and manually curated and analyzed for the presence of mobile genetic elements, antibiotic resistances genes, efflux pumps and virulence factors using several bioinformatics programs and databases. Results: The global analysis of the strains chromosomes showed a novel chromosomal rearrangement in two strains, possibly mediated by subsequent recombination and inversion events. They have a high content of mobile genetic elements: 21 genomic islands, four new islets, four different integrative conjugative elements, 28 different prophages, one CRISPR-Cas arrangements, and one class 1 integron. The acquisition of antimicrobials resistance genes into these elements are in concordance with their phenotype of multi-drug resistance. Conclusion: The accessory genome increased the ability of the strains to adapt or survive to the hospital environment, promote genomic plasticity and chromosomal rearrangements, which may affect the expression or functionality of the gene and might influence the clinical outcome, having an impact on the treatment.

Giant Lipoma of the Breast

Luis Ramírez-Montaño,Erik Vargas-Tellez,Walid L Dajer-Fadel,Silvia Espinosa Maceda 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.3

Lipomas are benign mesenchymal tumors that develop in areas of abundant adipose tissue. Due to the fatty composition of the breast, difficulties in diagnosis, treatment, and reconstruction are often encountered. We report a case of a 55-year-old female with a giant tumor of the right breast that comprised most of its mass, causing breast asymmetry. A thorough preoperative evaluation, followed by an uneventful difficult surgical resection and reconstruction, resulted in diagnosis of a benign lipoma. The case prompted this report because of its challenging size,location, diagnosis, and reconstructive solution.

Giant Lipoma of the Breast

Ramirez-Montano, Luis,Vargas-Tellez, Erik,Dajer-Fadel, Walid L.,Maceda, Silvia Espinosa Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.3

Lipomas are benign mesenchymal tumors that develop in areas of abundant adipose tissue. Due to the fatty composition of the breast, difficulties in diagnosis, treatment, and reconstruction are often encountered. We report a case of a 55-year-old female with a giant tumor of the right breast that comprised most of its mass, causing breast asymmetry. A thorough preoperative evaluation, followed by an uneventful difficult surgical resection and reconstruction, resulted in diagnosis of a benign lipoma. The case prompted this report because of its challenging size, location, diagnosis, and reconstructive solution.

Prolonged excretion of a low-pathogenicity H5N2 avian influenza virus strain in the Pekin duck

José Manuel Carranza-Flores,Luis Padilla-Noriega,Elizabeth Loza-Rubio,Gary García-Espinosa 대한수의학회 2013 Journal of Veterinary Science Vol.14 No.4

H5N2 strains of low-pathogenicity avian influenza virus (LPAIV) have been circulating for at least 17 years in some Mexican chicken farms. We measured the rate and duration of viral excretion from Pekin ducks that were experimentally inoculated with an H5N2 LPAIV that causes death in embryonated chicken eggs (A/chicken/Mexico/2007). Leghorn chickens were used as susceptible host controls. The degree of viral excretion was evaluated with real-time reverse transcriptase-polymerase chain reaction (RRT-PCR) using samples from oropharyngeal and cloacal swabs. We observed prolonged excretion from both species of birds lasting for at least 21 days. Prolonged excretion of LPAIV A/chicken/Mexico/2007 is atypical.

Recoverable Slippage Mechanism in Multilayer Graphene Leads to Repeatable Energy Dissipation

Wei, Xiaoding,Meng, Zhaoxu,Ruiz, Luis,Xia, Wenjie,Lee, Changgu,Kysar, Jeffrey W.,Hone, James C.,Keten, Sinan,Espinosa, Horacio D. American Chemical Society 2016 ACS NANO Vol.10 No.2

<P>Understanding the deformation mechanisms in multilayer graphene (MLG), an attractive material used in nanodevices as well as in the reinforcement of nanocomposites, is critical yet challenging due to difficulties in experimental characterization and the spatiotemp oral limitations of atomistic modeling. In this study, we combine nanomechanical experiments with coarse-grained molecular dynamics (CG-MD) simulations to elucidate the mechanisms of deformation and failure of MLG sheets. Elastic properties of graphene sheets with one to three layers are measured using film deflection tests. A nonlinear behavior in the force vs deflection curves for MLGs is observed in both experiments simulations: during loading/unloading cycles, MLGs dissipate energy through a 'recoverable slippage' mechanism. The CG-MD simulations further reveal an atomic level interlayer slippage process and suggest that the dissipated energy scales with film perimeter. Moreover, our study demonstrates that the finite shear strength between individual layers could explain the experimentally measured size dependent strength with thickness scaling in MLG sheets.</P>

Minimally Invasive versus Open Surgery for Spinal Metastasis: A Systematic Review and Meta-Analysis

Hinojosa-Gonzalez David Eugenio,Roblesgil-Medrano Andres,Villarreal-Espinosa Juan Bernardo,Tellez-Garcia Eduardo,Bueno-Gutierrez Luis Carlos,Rodriguez-Barreda Jose Ramon,Flores-Villalba Eduardo,Martin 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.4

Bones are the third most common location for solid tumor metastasis affecting up to 10% of patients with solid tumors. When the spine is involved, thoracic and lumbar vertebrae are frequently affected. Access to spinal lesions can be through minimally invasive surgery (MIS) or traditional open surgery (OS). This study aims to determine which method provides an advantage. Following the PRISMA (Preferred Inventory for Systematic Reviews and Meta-Analysis) guidelines, a systematic review was conducted to identify studies that compare MIS with OS in patients with spinal metastatic disease. Data were analyzed using Review Manager ver. 5.3 (RevMan; Cochrane, London, UK). Ten studies were included. Operative time was similar among groups at -35.23 minutes (95% confidence interval [CI], -73.36 to 2.91 minutes; <i>p</i>=0.07). Intraoperative bleeding was lower in MIS at -562.59 mL (95% CI, -776.97 to -348.20 mL; <i>p</i><0.00001). OS procedures had higher odds of requiring blood transfusions at 0.26 (95% CI, 0.15 to 0.45; <i>p</i><0.00001). Both approaches instrumented similar numbers of levels at -0.05 levels (95% CI, -0.75 to 0.66 levels; <i>p</i>=0.89). We observed a decreased need for postoperative bed rest at -1.60 days (95% CI, -2.46 to -0.74 days; <i>p</i>=0.0003), a shorter length of stay at -3.08 days (95% CI, -4.50 to -1.66 days; <i>p</i>=0.001), and decreased odds of complications at 0.60 (95% CI, 0.37 to 0.96; <i>p</i>=0.03) in the MIS group. Both approaches revealed similar reintervention rates at 0.65 (95% CI, 0.15 to 2.84; <i>p</i>=0.57), effective rates of reducing metastasis-related pain at -0.74 (95% CI, -2.41 to 0.94; <i>p</i>=0.39), and comparable scores of the Tokuhashi scale at -0.52 (95% CI, -2.08 to 1.05; <i>p</i>=0.41), Frankel scale at 1.00 (95% CI, 0.60 to 1.68; <i>p</i>=1.0), and American Spinal Injury Association Scale at 0.53 (95% CI, 0.21 to 1.37; <i>p</i>=0.19). MIS appears to provide advantages over OS. Larger and prospective studies should fully detail the role of MIS as a treatment for spine metastasis.

Antibiotic resistance and tolerance to simulated gastrointestinal conditions of eight hemolytic Bacillus pumilus isolated from pulque, a traditional Mexican beverage

Raquel González-Vázquez,Lino Mayorga-Reyes,Armando Monroy-López,Luis A. Reyes-Nava,Yadira Rivera-Espinoza,Alejandro Azaola-Espinosa 한국식품과학회 2017 Food Science and Biotechnology Vol.26 No.2

Traditional fermented sap beverages from two provinces of Mexico were studied for the isolation of pathogenic bacteria from these beverages. Eight strains of hemolytic Gram positive bacteria, identified as Bacillus pumilus (B. pumilus), were isolated. They showed different antibiotic resistance profiles and tolerances to the simulated gastrointestinal conditions. All the B. pumilus isolated were resistant to at least one antibiotic tested. Regarding the simulated gastrointestinal conditions, strains S1 and S3 were able to tolerate all the conditions. Hemolytic activity has been associated with a health risk and is often considered as a virulence determinant associated with pathogenicity. Therefore, the hemolytic activity along with the ability to tolerate gastrointestinal conditions and the resistance to antibiotics exhibited by B. pumilus strains S1 and S3 could be associated with a health risk for pulque consumers.

Spatial and Temporal Assessment of Particulate Matter Using AOD Data from MODIS and Surface Measurements in the Ambient Air of Colombia

Marco Andrés Guevara Luna,Fredy Alejandro Guevara Luna,Juan Felipe Méndez Espinosa,Luis Carlos Belalcázar Cerón 한국대기환경학회 2018 Asian Journal of Atmospheric Environment (AJAE) Vol.12 No.2

Particulate matter (PM) measurements are important in air quality, public health, epidemiological studies and decision making for short and long-term policies implementation. However, only few cities in the word have advance air quality-monitoring networks able to provide reliable information of PM leaves in the ambient air, trends and extent of the pollution. In Colombia, only major cities measure PM concentrations. Available measurements from Bogota, Medellin and Bucaramanga show that PM concentration are well above World Health Organization guidelines, but up to now levels and trends of PM in other cities and regions of the country are not well known. Satellite measurements serve as an alternative approach to study air quality in regions were surface measurements are not available. The aim of this study is to perform a spatial and temporal assessment of PM in the ambient air of Colombia. We used Aerosol optical depth (AOD) retrieved by the Moderate Resolution Imaging Spectroradiometer (MODIS) satellite of NASA and surface measurements from the air quality networks of Bogota, Medellin and Bucaramanga. In a first step, we estimated the correlation between MODIS-AOD and monthly average surface measurements (2000 to 2015) from these three cities, obtaining correlation coefficient R values over 0.4 for the cities under study. After, we used AOD and PM10 measurements to study the temporal evolution of PM in different cities and regions. Finally, we used AOD measurements to identify cities and regions with the highest AOD levels in Colombia. All the methods presented in this paper may serve as an example for other countries or regions to identify and prioritize locations that require the implementation of more accurate air quality measurements.