Clinical significance of focal topographic changes in the electroencephalogram (EEG) and evoked potentials (EP) of psychiatric patients

The relationship between psychiatric symptoms that respond to anticonvulsants and epileptic activity is still debated. Evidence linking electroencephalographic changes to treatment response is scarce and controversial, partly because of the poor scalp representation of limbic electrical activity. We studied the clinical relevance of focal topographic changes in the resting EEG, the visual evoked potential and the P300 response in 90 psychiatric patients, by evaluating response to anticonvulsants and development of neurological complications. The group with focal changes was compared to a group with epileptiform activity but no focal changes and a group with normal or diffusely altered EEG. Focal EEG and EP changes predicted good response to anticonvulsants, while the presence of epileptiform activity did not. Clinical seizures developed only in patients with focal changes and no anticonvulsants medication. Structural abnormalities and selective neuropsychological deficits were seen only in the focal group. There was an association of symptom type and the site of focus. We concluded that focal EEG and EP changes in psychiatric patients have important theoretical as well as practical implications.

[Campylobacter jejuni infection in children of a rural community]

Colonization of the intestine with Campylobacter jejuni was followed longitudinally from birth in a cohort of 75 rural children with fecal cultures taken every fortnight and every time they had diarrhea. Only 25% of children initially colonized with C. jejuni during the first year of life, and 12% of children initially colonized during the second had diarrhea. The age at which a child was initially infected with C. jejuni was not a risk factor in relation with presence of disease. A higher illness-to-infection ratio (P less than 0.05) was found during subsequent colonization with C. jejuni when initial infection was associated with diarrhea. Risk of diarrhea during initial or subsequent colonization with C. jejuni was not related with the production of cholera-like enterotoxin, a cytotoxic active on HeLa cells or with adhesive ability to HEp-2 cells by the infecting strains.

Inhibition of localized adhesion of enteropathogenic Escherichia coli to HEp-2 cells by immunoglobulin and oligosaccharide fractions of human colostrum and breast milk

Secretory IgA (sIgA) purified from colostrum and breast milk obtained from 14 women inhibited the localized adherence of an enteropathogenic Escherichia coli (EPEC) to HEp-2 cells. Inhibition decreased as lactation continued even when the concentration of sIgA was maintained constant at 1 mg/ml. sIgA responded to a 94-kDa plasmid-encoded outer membrane protein implicated as the EPEC adherence factor. An oligosaccharide-enriched fraction (OEF) from these samples also inhibited the attachment of this EPEC. Inhibition by OEFs decreased as lactation continued because of a general reduction in oligosaccharide content. Localized adherence of six other EPEC was also inhibited by sIgA and OEF, whereas attachment of isolates with diffuse or aggregative adherence was not inhibited by these fractions. Experiments with purified oligosaccharide fractions revealed that EPEC attach to HEp-2 cells through a carbohydrate-mediated mechanism based on the preferential recognition of fucosylated residues in human milk.

[Patterns in the household acceptance of oral rehydration therapy in a cohort of rural mothers]

The household acceptance of oral rehydration solution salts was studied in a cohort of 75 rural mothers over a two year period. The study was carried out in a rural Mexican village between August 1985 and February 1988. There were 636 episodes of diarrhea, with an average of four episodes per child per year. There were no deaths due to diarrhea or its complications and only 2% of these episodes required the use of parenteral solutions. Acceptance of oral rehydration remained around 50% during subsequent bouts of diarrhea. Variables such as a medium high socioeconomic level of the family, and the reading of journals and newspapers by the mother and the presence of water supply in the home were significantly associated with the acceptance of oral rehydration treatment. On the other hand, families classified as traditional rejected the procedure with significantly higher frequency. The data presented indicates the need for redesigning oral rehydration, treatment programs to increase their impact at the community level.

Association of Escherichia coli HEp-2 adherence patterns with type and duration of diarrhoea

373 (59%) out of 636 faecal specimens obtained during the first 2 years of life of 72 Mexican children yielded adherent Escherichia coli (HEp-2 cells). Strains with localised adherence were significantly associated with acute non-bloody diarrhoea, whereas strains with aggregative adherence were significantly associated with persistent diarrhoea. Half the strains with localised adherence were not enteropathogenic E coli serotypes nor did they hybridise with an enteropathogenic E coli adherence factor DNA probe. All strains with localised adherence gave a positive fluorescent actin staining (FAS) assay, irrespective of serotype. One-third of children colonised by aggregative strains had bloody diarrhoea. Isolation of strains with diffuse adherence was not related to type or duration of diarrhoea but was generally associated with isolation of another pathogenic organism.

[Incontinentia pigmenti. Concerning 9 new cases, 2 of them associated with different genetic syndromes]

Nine girls with Incontinentia Pigmenti are presented, two of them associated to different genetic syndromes. All the patients are female, characteristic of genetic transmission, linked to dominant x, lethal for males; one of the patients also presents the Larsen Syndrome and another has got her illness associated to the Chotzen Syndrome; in these cases we can observe the coexistence of two syndromes, genetically determined. A revision of the clinical, histopathological and genetic characteristics of this disease is made.