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Study design:Observational study in rats subjected to traumatic spinal cord injury (SCI).Objectives:To describe the features of spinal subarachnoid bleeding (SSB) occurring after graded SCI. SSB after SCI has been reported previously, but has not been studied systematically despite the fact that cerebral subarachnoid bleeding often produces severe neurological damage.Setting:Mexico.Methods:Anesthetized rats were subjected to mild or severe spinal cord contusion at T9. Occurrence, size, progression and location of SSB were characterized morphologically and scored from T7-T12 at 1 h and 1, 3 and 7 days post injury. Besides, contusions were videotaped to visualize bleeding at the moment of impact.Results:SSB started immediately after contusion (severe or mild) and decreased gradually over time. For all vertebral segments, at all time points examined by histology, 48% of areas scored after severe contusion showed bleeding: 25% minor, 17% moderate and 6% major. After mild contusion, only 15% showed bleeding: 13 minor and 2% moderate. Maximum bleeding occurred early after injury in dorsal area of the epicenter in 100% of severe contusions (6% minor, 38 moderate and 56% major), and in 69% of mild contusions (63 minor and 6% moderate).Conclusion:Here, we detail SSB patterns occurring after graded SCI. Further studies are warranted to elucidate the possible role extramedullary events, such as SSB, in the pathophysiology of SCI that might encourage the development of new strategies for its management. [ABSTRACT FROM AUTHOR]

Background: In humans elective spine surgery can cause iatrogenic spinal cord injury (SCI). Efforts for neuroprotection have been directed to avoid mechanical injury by using intraoperative monitoring and improving surgical techniques. There is, however, uncertainty regarding the efficacy of neuroprotective drugs.Study design: Experimental study on the effectiveness of pharmacological neuroprotection in an animal model of spine surgery simulating anticipated mechanically induced neurological damage.Objective: To compare the efficacy of four drugs to protect against the neurological effects of iatrogenic SCI.Setting: Research Unit for Neurological Diseases, IMSS-Proyecto Camina, Mexico City, Mexico.Methods: Erythropoietin, melatonin, cyclosporine-A and methylprednisolone were administered to rats before, during and after controlled spinal cord contusion of mild intensity. Dosage was in accordance with their pharmacokinetic properties and experience gained with experimental SCI. Drug efficacy was assessed by motor function recovery over a period of 6 weeks and by spinal cord morphometry.Results: Compared with animals treated with saline, the drug-treated groups showed no differences in their locomotor performance, nor in the amount of spared cord tissue. Notably, spontaneous activity was significantly reduced in rats treated with cyclosporine-A.Conclusion: The neuroprotectant drugs used here perioperatively did not reduce the extent of neurological damage in a model simulating iatrogenic SCI. Therefore, for now, the only protection in elective spine surgery is avoidance of primary injury altogether.Spinal Cord (2009) 47, 156–160; doi:10.1038/sc.2008.85; published online 8 July 2008 [ABSTRACT FROM AUTHOR]

Porcine Taenia solium cysticercosis, recognized as a model of the human disease, was used to analyze the effect of the anthelminthic drug praziquantel on hosts and parasites. The drug (50 mg/kg daily) was given over 15 days in the feed of 13 cysticercotic and 9 control pigs. Changes in the number, size and appearance of brain parasites were seen by computerized tomography immediately after the last dose of praziquantel, although not all cysticerci had disappeared by day 47 following the end of the treatment. Muscle parasites became small and hyperdense shortly after treatment and disappeared from tomographic images afterwards. No alterations were found in EEGs or in brain-stem auditory and somatosensory evoked potentials. Muscle cysticerci showed increasing degrees of degeneration with time after treatment, and an augmented inflammatory reaction was concomitantly observed. In contrast, more heterogeneous results were obtained in parasites lodged in the brain, since viable cysts and less intense inflammatory reactions were found in the brain at different times after treatment. Physiological evaluation of the parasites showed that evagination was inhibited immediately after treatment and that oxygen consumption decreased with time. The results of this investigation suggest that praziquantel damages cysticerci and that the inflammatory reaction destroys and eliminates them. [ABSTRACT FROM AUTHOR]

Abstract: Secondary damage after spinal cord (SC) injury remains without a clinically effective drug treatment. To explore the neuroprotective effects of cell-permeable reduced glutathione monoethyl ester (GSHE), rats subjected to SC contusion using the New York University impactor were randomly assigned to receive intraperitoneally GSHE (total dose of 12 mg/kg), methylprednisolone sodium succinate (total dose of 120 mg/kg), or saline solution as vehicle. Motor function, assessed using the Basso–Beattie–Bresnahan scale for 8 weeks, was significantly better in GSHE (11.2±0.6, mean±S.E.M., n=8, at 8 weeks) than methylprednisolone (9.3±0.6) and vehicle (9.4±0.7) groups. The number of neurons in the red nuclei labeled with FluoroRuby placed caudally to the injury site was significantly higher in GSHE (158±9.3 mean±S.E.M., n=4) compared with methylprednisolone (53±14.7) and vehicle (46±16.4) groups. Differences in the amount of spared SC tissue at the epicenter and neighboring areas were not significant among experimental groups. In a second series of experiments, using similar treatment groups (n=6), regional changes in microvascular SC blood flow were evaluated for 100 min by laser-Doppler flowmetry after clip compression injury. SC blood flow fell in vehicle-treated rats 20% below baseline and increased significantly with methylprednisolone approximately 12% above baseline; changes were not greater than 5% in rats given GSHE. In conclusion, GSHE given to rats early after moderate SC contusion/compression improves functional outcome and red nuclei neuron survival significantly better than methylprednisolone and vehicle, and stabilizes SC blood flow. These results support further investigation of reduced glutathione supplementation after acute SC injury for future clinical application. [Copyright &y& Elsevier]

Introduction Twenty-two years ago, the murder of the wife, the parents and the children of a doctor shook France. Some time later, it was discovered that the doctor was the murderer and that he had been faking his profession and social status. The prospect of being caught determined his decision of killing all his close relatives and trying – unsuccessfully – to commit suicide. Objectives Review of the literature on the concept of pathological narcissism from the analysis of the notorious case of Jean-Claude Romand and establish its differences from mythomania and psychopathy. Aims Gaining a better understanding of the mechanisms and defenses of narcissism that determine certain behaviours and actions. Methods Study of the biography and the psychopathological features of Jean-Claud Romand from books and interviews in relation to the concepts of pathological and malignant narcissism proposed by Otto Kernberg. Results Features such as grandiosity, aggressive behaviors, hostility or paranoid traits can be found in both psychopathy and malignant narcissism. In Romand's case, the final diagnosis fits to malignant narcissism due to the ability to internalize the social contexts and to maintain constant representative and relational figures. Conclusions It is important not to fall into reductionism habits and to study deeply each case to a better understanding of all the factors that contribute to the development of these kinds of personalities. [ABSTRACT FROM AUTHOR]