TREATMENT-RESISTANT EPILEPSY AND TREATMENT-RESISTANT SCHIZOPHRENIA; A REAL CHALLENGE FOR THE PSYCHIATRIC TEAM

Schizophrenia and epilepsy may exist together, but it is very rare to have a resistant form of both illnesses in one patient. We present a case report of a 49-year-old woman who was managed at our psychiatric facility suffering from treatment-resistant schizophrenia and epilepsy. She presented with suspiciousness, fearfulness and with a belief that people in the hostel wanted to harm her and were putting hair on her bed. She was also having recurrent seizures weekly due to her refractory epilepsy secondary to mesial temporal sclerosis. She was non-compliant with medication and refused surgical management of mesial temporal sclerosis. Whilst in the hospital was on five antiepileptic drugs prescribed by the neurology team and these control the seizures. Olanzapine and paliperidone depot was used for schizophrenia which had a partial response. Clozapine was notconsidered in view of her severe uncontrolled epilepsy. Concerns were raised regarding her capacity to decide about treatment options. The possibility of an organic cause for both schizophrenia and epilepsy were considered.

Techniques for inactivating Toxoplasma gondii oocysts: a systematic review

The oocyst, a resistant form of Toxoplasma gondii, plays an important role in the transmission of this protozoan. The objective of this review was to report the methods capable of inactivating oocysts through a systematic review of the literature carried out in the Scientific Electronic Library Online, Web of Science, Science Direct, PubMed and Scopus databases. The keywords searched were (((effects OR infectivity OR resistance) AND Toxoplasma) AND oocyst). We selected 16 articles that described 309 different treatments. Among all the protocols evaluated, 35.60% (110/309) were effective in inactivating oocysts. Physical methods were more effective than other methods (p <0.05). Sporulated oocysts and the T. gondii VEG strain were more resistant (p <0.05) to treatments. Although it is effective against viruses and bacteria, the use of disinfectants in water has little or no effect on T. gondii oocysts. The use of radiation and pressure were effective in inactivating oocysts, as these treatments do not include changes in temperature, they can be used in foods for raw consumption, such as vegetables, as it will not cause substantially changes in their physical and chemical characteristics. Therefore, these methods can be viable alternatives for the control of T. gondii.

DIFFICULTIES OF DIAGNOSIS AND CLINICAL AND MORPHOLOGICAL FEATURES OF BRONCHIOLOALVEOLAR PULMONARY CANCER AMONG PATIENTS WITH PHYSIATRIC AND PULMONOLOGICAL PROFILE

This is a clinical case of a patient whose deterioration was regarded as a manifestation of a drug-resistant form of a specific tuberculosis process, although all the results of studies on Mycobacterium tuberculosis were negative. Due to the lack of oncological alertness and the insufficient use of morphological diagnostic methods, it was not possible to diagnose the bronchioloalveolar lung cancer in this patient during examination.

Novel Approach to Tooth Chemistry: Quantification of Human Enamel Apatite in Context for New Biomaterials and Nanomaterials Development

A series of linear profiles of the elements of the enamel in human molar teeth were made with the use of an electron microprobe and a Raman microscope. It is postulated that the enamel can be treated as the superposition of variable “overbuilt” enamel on the stable “core” enamel at the macro-, micro- and nanoscale level. The excessive values characterize the “overbuilt enamel”. All the profiles of excessive parameters along the enamel thickness from the enamel surface to the dentin enamel junction (DEJ) can be approximated very precisely with the use of exponential functions, where Ca, P, Cl and F spatial profiles are decaying while Mg, Na, K and CO32− ones are growing distributions. The “overbuilt” apatite formed on the boundary with DEJ, enriched in Na, Mg, OH and carbonates, reacts continuously with Ca, Cl and F, passing into an acid-resistant form of the “overbuilt” enamel. The apparent phases arriving in boundary regions of the “overbuilt enamel” were proposed. Microdiffraction measurements reveal relative variation of energy levels during enamel transformations. Our investigations are the milestones for a further new class of biomaterial and nanomaterial development for biomedical applications.

Proving the Mode of Action of Phytotoxic Phytochemicals

Knowledge of the mode of action of an allelochemical can be valuable for several reasons, such as proving and elucidating the role of the compound in nature and evaluating its potential utility as a pesticide. However, discovery of the molecular target site of a natural phytotoxin can be challenging. Because of this, we know little about the molecular targets of relatively few allelochemicals. It is much simpler to describe the secondary effects of these compounds, and, as a result, there is much information about these effects, which usually tell us little about the mode of action. This review describes the many approaches to molecular target site discovery, with an attempt to point out the pitfalls of each approach. Clues from molecular structure, phenotypic effects, physiological effects, omics studies, genetic approaches, and use of artificial intelligence are discussed. All these approaches can be confounded if the phytotoxin has more than one molecular target at similar concentrations or is a prophytotoxin, requiring structural alteration to create an active compound. Unequivocal determination of the molecular target site requires proof of activity on the function of the target protein and proof that a resistant form of the target protein confers resistance to the target organism.

A systems approach delivers a functional microRNA catalog and expanded targets for seizure suppression in temporal lobe epilepsy

Temporal lobe epilepsy is the most common drug-resistant form of epilepsy in adults. The reorganization of neural networks and the gene expression landscape underlying pathophysiologic network behavior in brain structures such as the hippocampus has been suggested to be controlled, in part, by microRNAs. To systematically assess their significance, we sequenced Argonaute-loaded microRNAs to define functionally engaged microRNAs in the hippocampus of three different animal models in two species and at six time points between the initial precipitating insult through to the establishment of chronic epilepsy. We then selected commonly up-regulated microRNAs for a functional in vivo therapeutic screen using oligonucleotide inhibitors. Argonaute sequencing generated 1.44 billion small RNA reads of which up to 82% were microRNAs, with over 400 unique microRNAs detected per model. Approximately half of the detected microRNAs were dysregulated in each epilepsy model. We prioritized commonly up-regulated microRNAs that were fully conserved in humans and designed custom antisense oligonucleotides for these candidate targets. Antiseizure phenotypes were observed upon knockdown of miR-10a-5p, miR-21a-5p, and miR-142a-5p and electrophysiological analyses indicated broad safety of this approach. Combined inhibition of these three microRNAs reduced spontaneous seizures in epileptic mice. Proteomic data, RNA sequencing, and pathway analysis on predicted and validated targets of these microRNAs implicated derepressed TGF-β signaling as a shared seizure-modifying mechanism. Correspondingly, inhibition of TGF-β signaling occluded the antiseizure effects of the antagomirs. Together, these results identify shared, dysregulated, and functionally active microRNAs during the pathogenesis of epilepsy which represent therapeutic antiseizure targets.

Class A PBPs have a distinct and unique role in the construction of the pneumococcal cell wall

In oval-shapedStreptococcus pneumoniae, septal and longitudinal peptidoglycan syntheses are performed by independent functional complexes: the divisome and the elongasome. Penicillin-binding proteins (PBPs) were long considered the key peptidoglycan-synthesizing enzymes in these complexes. Among these were the bifunctional class A PBPs, which are both glycosyltransferases and transpeptidases, and monofunctional class B PBPs with only transpeptidase activity. Recently, however, it was established that the monofunctional class B PBPs work together with transmembrane glycosyltransferases (FtsW and RodA) from the shape, elongation, division, and sporulation (SEDS) family to make up the core peptidoglycan-synthesizing machineries within the pneumococcal divisome (FtsW/PBP2x) and elongasome (RodA/PBP2b). The function of class A PBPs is therefore now an open question. Here we utilize the peptidoglycan hydrolase CbpD that targets the septum ofS. pneumoniaecells to show that class A PBPs have an autonomous role during pneumococcal cell wall synthesis. Using assays to specifically inhibit the function of PBP2x and FtsW, we demonstrate that CbpD attacks nascent peptidoglycan synthesized by the divisome. Notably, class A PBPs could process this nascent peptidoglycan from a CbpD-sensitive to a CbpD-resistant form. The class A PBP-mediated processing was independent of divisome and elongasome activities. Class A PBPs thus constitute an autonomous functional entity which processes recently formed peptidoglycan synthesized by FtsW/PBP2×. Our results support a model in which mature pneumococcal peptidoglycan is synthesized by three functional entities, the divisome, the elongasome, and bifunctional PBPs. The latter modify existing peptidoglycan but are probably not involved in primary peptidoglycan synthesis.

Dynamics of non-psychotic mental disorders and suicidal intentions in a patient with epilepsy before and after VNS therapy (clinical observation)

Epilepsy affects millions of people around the world. Stimulation of the left vagus nerve (VNS) has proven to be effective in reducing the frequency of seizures for over 30 years, and some authors have noted the positive dynamics of the effect of stimulation on the emotional status of patients. In this clinical observation, we describe changes in the pathopsychological condition before and after VNS therapy in a patient with a drug-resistant form of epilepsy and suicidal intentions.

Use of Erbium Laser in the Treatment of a Patient with Acute Purulent Periostitis and a Resistant Form of Primary Immune Thrombocytopenia

In our article, we described a clinical case of a patient with an acute periostitis of the maxilla with a comorbidity (primary immune thrombocytopenia, resistant form) who was treated using laser technology allowing us to provide good results: an intensive regeneration process and a decreased risk of developing infection complications and unpleasant signs for the patient, such as postoperative edema and intraoperative and postoperative pain syndrome.