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Introduction: The abused child syndrome is related to a variety of emotional disorders, among which are the "post-traumatic stress syndrome" and the phenomena "re-experience," which is related to disturbances of the normal sleep-wake cycle., Objective: To determine the polysomnographic characteristics of the abused child syndrome and compare them with paired healthy children., Material and Methods: After two-night habituation, all-night video-digital polygraphic recordings following recommendations of the International Federation of Clinical Neurophysiology were performed in 15 abused child syndrome and 15 healthy controls., Results: In the abused child syndrome patients, the main sleep changes were decreased sleep efficiency, decreased sleep onset sleep latency, increased wakefulness, decreased REM sleep and total sleep time., Conclusions: The abused child syndrome have abnormal sleep patterns, independent of the type of abuse, age or sex. Sleep alterations are a new characteristic of the abused child syndrome, not previously described.

Objective: To review the actual concepts concerning perioperative nerve injuries during surgical or anesthetic procedures., Material and Methods: A summary of published medical literature from Medline search files and published reviews. CONFLICT IF INTEREST: We have not conflicts of interest., Results: Perioperative nerve injuries during surgical and anesthetic procedures of the lower extremities are the most common. Many possible etiologies have been proposed to explain perioperative nerve injury and include stretch, compression, and ischemia. Commonly this injuries are under recognition and an important aspect of perioperative nerve injuries is that they can occur for multiple reasons. It is necessary to have a good communication among surgeons, neurologists and clinical neurophysiologists, so it can lead to a more detailed neurological assessment with transoperative procedures that may prevent such injuries.

Background: Cisplatin is a widely used chemotherapy agent that has several adverse effects, such as ototoxicity. Evaluation of hearing loss due to cisplatin therapy in children is difficult. The purpose of this study was to compare the validity of distortion product otoacoustic emissions (DPOAEs) with pure tone audiometry (PTA) in assessing hearing loss in children under cisplatin therapy., Methods: We reviewed the files of 26 children aged between 2 and 15 years; 14 were girls. All were under treatment with cisplatin for malignancy. PTA and DPOAEs were obtained at the same session. Three subjects were studied twice; thus, there were 29 sets of studies., Results: Determining a cut-off point at 45 dB HL for PTA and 4 dB SPL difference for DPOAEs, diagnostic specificity for the latter was 0.97 while sensitivity was 0.57., Conclusions: DPOAEs represent a highly valuable test for evaluating hearing loss due to cisplatin treatment. DPOAEs is a quick and objective hearing assessment method not requiring much cooperation from children.

Transcranial magnetic stimulation is a non-invasive method used to assess motor function in humans; however, some reports suggest it may cause internal ear damage (cochlear). Eighteen patients with normal auditory function (ages 2 months to 16 years, mean 6.8 years), two medical doctors and two technicians who performed the studies were tested with brain stem auditory evoked potentials, otoacoustic emissions, acoustic reflex and a pure tone audiometric and logoaudiometric test when possible, before and after transcranial magnetic stimulation for central motor conduction studies in different neurological conditions. All the tests were repeated two weeks and two months later. Patients had no auditory protection nor history of seizures. Motor evoked potentials and silent periods were recorded from the right abductor pollicis brevis and the first dorsal interosseous muscles at rest and during weak voluntary contraction when possible. A mean of 48 transcranial magnetic stimulations with 50%-75% Tesla intensity were used. Natural logarithmic transformation of latency and amplitude data had a normal distribution. There were no significant differences in auditory function testing.

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.

Gonadal function was studied in three post-pubertal siblings (two male and one female) and one unrelated male patient with myotonic dystrophy. The diagnosis was confirmed in all cases by electromyography and muscle biopsy. Basal levels of plasma immunoreactive LH, FSH, testosterone, and estradiol were measured. Hypothalamic, pituitary, and gonadal reserve and responsiveness were evaluated by clomiphene, LHRH, and HCG tests. Histologic examination of gonadal biopsies was also performed. The results showed that gonadal failure present in the four patients had different characteristics. In the same family, hypothalamic amenorrhea was observed in the female patient, and hypothalamic eunuchoidism and hypergonadotropic hypogonadism with marked tubular and leydig cells failure in the male patients. The non-related male patient had hypergonadotropic hypogonadism with tubular failure but with a compensatory leydig-cell hyperplasia. These data are interpreted as demonstrating different expressivity of the hypogonadism associated with the same inherited muscle disease.

This report is based on a review of the present situation of the sudden infant death syndrome through the presentation of four cases studied at the Unidad de Pediatría, Hospital General de México, S.S.A. All cases were in apparent good health before death. All babies were less than ten months of age. In three cases, necropsy was not performed, and the other one did not show significant abnormalities at the post-mortem examination. A complete review of the literature was made including: historical, epidemiological, genetic, clinical and pathological aspects. Special emphasis is made on the pathophysiology of the syndrome during MOR phase of sleep and muscular hypertrophy of the lungs arteriolae suggesting chronic hypoxia which are the most relevant theories in the sudden infant death syndrome. Psychological aspects and the family management by the physician and detection of possible future victims of the syndrome are finally discussed.

1 Morphine-theophylline interactions were investigated in both acute and narcotic-dependent preparations, in vitro and in vivo, using four different experimental models: LD50 doses of morphine and naloxone in the mouse; naloxone-induced contractions in the electrically-stimulated and opiate-dependent isolated ileum of the guinea-pig; naloxone-induced jumps in the mouse; an calcium uptake in synaptosomal preparations. 2 The LD50 of morphine was significantly increased by theophylline. 3 The lethal effect of theophylline was potentiated by pretreatment of the animals with naloxone. 4 Theophylline displayed protective effects in the inhibitory response to morphine and antagonism to the withdrawal response induced by naloxone in the electrically-stimulated isolated ileum of the guinea-pig. 5 The number of jumps induced by naloxone in morphine-dependent mice was significantly diminished by theophylline. 6 The inhibitory effect of morphine on the synaptosomal uptake of calcium was decreased by theophylline. 7 The effects of both morphine and theophylline on the cyclic nucleotides and the possible role of calcium in these actions are discussed.

Computer-averaged auditory evoked potentials were found to be abnormal in infants hospitalized because of severe malnutrition (marasmus). They improved as the infants' somatic growth improved during the course of treatment, but were still deviant at the time of discharge from the hospital and at subsequent outpatient follow-up. Abnormalities in evoked potentials may reflect a long-lasting effect of malnutrition on brain function.

Hypothalamic-pituitary-ovarian axis function was assessed in a postpubertal female patient with myotonic dystrophy and secondary amenorrhea. The results suggested a hypothalamic basis for the amenorrhea, confirming previous reports regarding the nature of gonadal failure in women with this multisystemic disorder.

Swines with cysticercosis are a useful model to study human disease. A multidisciplinary approach was undertaken to study in detail the effect of praziquantel treatment on hosts and parasites. Computerised tomographic scans showed changes in the number and size of parasites in treated pigs. These changes were more apparent in muscle than in brain cysticerci. Neurophysiologic data were normal in cysticercotic pigs before and after drug treatment. An increase in antibody response was seen immediately after treatment regarding the amount of antibodies and number of antigens recognised. A lower number of polyploid lymphocytes was seen after treatment in cysticercotic pigs as compared to untreated pigs. At different times after treatment pigs were humanely euthanised. Oxygen consumption rate of cysticerci decreased after treatment and evagination was abolished. The inflammatory reaction that surrounded parasites increased in number and type of cells. This was more apparent around cysticerci obtained from muscle than from the brain.