Biomedical subjects

P Mares

Publications and source records attributed to P Mares.

At least 19 recordsLinked to original sources

PubMed2006

Different effects of nonNMDA and NMDA receptor antagonists (NBQX and dizocilpine) on cortical epileptic afterdischarges in rats.

Excitatory amino acids play an important role in generation of epileptic seizures. To study the participation of different types of their receptors in cortical epileptic afterdischarges, a noncompetitive NMDA receptor antagonist dizocilpine and a competitive AMPA receptor antagonist NBQX were used. Adult rats with implanted epidural stimulation and registration electrodes were pretreated either with NBQX (30 or 60 mg/kg i.p.) or with dizocilpine (0.1 or 0.5 mg/kg i.p.) and low-frequency stimulation of sensorimotor cortical area was repeatedly applied with stepwise increased current intensities. Lower dose of NBQX unexpectedly decreased thresholds for elicitation of spike-and-wave afterdischarges (ADs), clonic seizures accompanying this type of ADs and for transition into the second, limbic type of ADs. Lower dose of dizocilpine increased these three thresholds. Higher doses of either drug did not significantly change threshold intensities. Duration of ADs was also influenced by the two antagonists in opposite directions: higher dose of NBQX resulted in prolongation of ADs mainly due to an increased duration of the spike-and-wave part of ADs whereas dizocilpine shortened ADs in a dose-dependent manner affecting both types of ADs. In addition, NBQX did not influence interhemispheric responses meanwhile dizocilpine moderately suppressed these evoked potentials. According to our results, NMDA receptors are important for generation of cortical epileptic afterdischarges meanwhile the role of AMPA receptors is not clear and has to be analyzed.

Animals↗

PubMed2006

Depression and/or potentiation of cortical responses after status epilepticus in immature rats.

Lithium-pilocarpine status epilepticus (SE) resulted in delayed changes of single cortical interhemisperic (transcallosal) responses in immature rats. Low-frequency stimulation inducing depression and/or potentiation was studied to analyze possible dynamic changes in cortical responses. Status was elicited in 12-day-old (SE12) or 25-day-old (SE25) rats. Control siblings received saline instead of pilocarpine. Interhemispheric responses were elicited by stimulation of the sensorimotor region of the cerebral cortex 3, 6, 9, 13, or 26 days after status. A series of 5 biphasic pulses with intensity equal to twofold threshold were used for stimulation. The interval between pulses was 100, 125, 160, 200 or 300 ms, eight responses were always averaged. Peak amplitude of the first positive, first negative and second positive waves was measured and responses to the second, third, fourth and fifth pulse were compared with the first one. Animals after status epilepticus as well as lithium-paraldehyde controls exhibit a frequency depression at nearly all the intervals studied. An outlined increase of responses in SE rats in comparison with the controls three days after SE stayed just below the level of statistical significance. In addition, animals in the SE12 group exhibited potentiation of responses at this interval after SE. With longer intervals after SE, the relation between SE and control animals changed twice resulting in a tendency to lower amplitude of responses in SE than in control rats 26 days after SE. Rats in the SE25 group exhibited higher responses than controls 13 days after status, but this difference was not present at the longest interval after SE. Low-frequency stimulation did not reveal increased cortical excitability as a long-lasting consequence of status epilepticus induced in immature rats. In addition, the outlined differences between SE and control rats changed with the time after SE.

Animals↗

PubMed2006

Anticonvulsant action of allopregnanolone in immature rats.

Anticonvulsant activity of allopregnanolone, a neurosteroid allosterically modulating GABA(A) receptor was tested in a model of motor seizures elicited by pentetrazol in immature rats. Rats 7, 12, 18, 25 or 90 days old were pretreated with allopregnanolone in doses from 5 to 40 mg/kg i.p. and 15 min later pentetrazol was injected subcutaneously in a dose of 100 mg/kg. Rats were observed in isolation for 30 min. Allopregnanolone dose-dependently suppressed both generalized tonic-clonic and minimal clonic seizures with the highest efficacy in 12-day-old rats. Anticonvulsant action was least expressed in adult animals. Duration of anticonvulsant action tested after a dose of 20 mg/kg in 12- and 90-day-old rats demonstrated markedly longer effects in young rats. Allopregnanolone compromised motor performance of rats but duration of this unwanted effect in 12-day-old rats was shorter than duration of anticonvulsant action. This difference can be important for possible clinical use of neurosteroids.

Age Factors↗

PubMed2006

[Antenatal perineal rehabilitation in patients with stress urinary incontinence during pregnancy: preliminary study].

OBJECTIVE: To evaluate the results of antenatal perineal rehabilitation (APR) in patients complaining of stress urinary incontinence (SUI) during pregnancy. MATERIAL AND METHODS: Ten patients complaining of SUI during pregnancy participated in a standardizedAPR program. A phone investigation was carried late after delivery to evaluate patient satisfaction, improvement of SUI and effect of this therapeutic approach on sexual function and pelvic floor stability. The patients were invited to respond to two quality of life and symptom questionnaires (ISP, QIP). Results obtained were compared with those of a control group of 10 patients who did not present SUI during pregnancy, and who did not participate in APR, but took part in a conventional program of postnatal perineal rehabilitation (PPR). The groups were matched for age, BMI, parity and obstetrical history. Delivery modalities (instrumental deliveries and episiotomy rate) were analyzed in both groups. RESULTS: The rate of satisfaction with perineal rehabilitation were 10/10 and 7/10 for the APR and the PPR respectively. Delivery modalities were not different in the APR group. Four of the 10 patients who presented SUI during pregnancy had persistent SUI 14 months after childbirth. One of the 10 patients who did not present SUI during pregnancy presented SUI 22 months after the childbirth. CONCLUSION: This study provides incentive to conduct a prospective study to demonstrate that antenatal perinealrehabilitation is an effective way to reduce the risk of persistent SUI after childbirth. Although these preliminary results have to be confirmed by larger series, this management scheme can be proposed.

Adult↗

PubMed2006

[Episiotomy and prevention of perineal and pelvic floor injuries].

OBJECTIVES: The objective of this review was to assess the efficacy of episiotomy to prevent severe perineal tears, urinary incontinence, faecal incontinence and genital prolapse. MATERIAL AND METHODS: A systematic review on Medline database was performed between 1980 and 2005. One hundred seventy seven articles were selected. Trial quality was assessed on the following parameters: design (prospective, randomized, meta-analysis), sample size (>50) and relevant results. Finally, 43 articles were analysed. RESULTS: The routine use of episiotomy did not prevent severe perineal tears. It decreased the risk of moderate anterior perineal lacerations. The risk of severe perineal tears during episiotomy increased in the following circumstances: primiparity, Asian women, perineal length<or=3cm, forceps or vacuum-assisted deliveries and macrosomia. Relevant studies were consistent in demonstrating no benefit for routine episiotomy to prevent urinary or faecal incontinence or pelvic floor relaxation, even if there is a lack of data concerning long-term effects on pelvic floor support. CONCLUSION: The routine use of episiotomy to prevent severe perineal tears, urinary incontinence, faecal incontinence and genital prolapse should be abandoned.

Adult↗

PubMed2006

[Radical parametrectomy in women with invasive cervix cancer after previous simple hysterectomy].

OBJECTIVE: Evaluate technique, indications and limits of surgical procedure in the treatment of cervical cancer diagnosed from uterus specimen from simple hysterectomy. DESIGN: Retrospective observational study, review of literature. SETTINGS: Department of Obstetrics and Gynecology, 1st Medical Faculty and General Faculty Hospital, Charles University, Prague, Czech Republic. METHODS: Women following radical parametrectomy with upper vaginectomy and pelvic lymphadenectomy were enrolled to the study. In all patients unexpected invasive cervical cancer was found from the uterus specimen after simple hysterectomy. RESULTS: Together 10 patients were enrolled to the study. CIN was the indication for primary hysterectomy in all but two patients. There were two operative complications, cystostomy in both cases, treated properly during surgery. In the specimen from radical procedure residual tumor in parametria was found in 2 cases, and metastasis to pelvic nodes in 4 cases. There was no postoperative complication. Adjuvant radiotherapy was recommended in 4 patients due to positive lymph nodes, in one case due to residual tumor in parametria, and in one case for both reasons. CONCLUSIONS: Radical parametrectomy with upper vaginectomy and pelvic lymphadenectomy should be considered as an alternative solution in patients following simple hysterectomy with unexpected finding of invasive cervical cancer. Morbidity of the procedure is higher in comparison to standard radical hysterectomy, however majority of complications are easy to repair. The most significant criteria for patient's selection for surgical approach is a depth of invasion to cervical stroma. In our group radical procedure obviated the need for radiotherapy in half of the patients.

Adult↗

PubMed2005

Action of two neuroactive steroids against motor seizures induced by pentetrazol in rats during ontogeny.

The anticonvulsant action of two neuroactive steroids, 3alpha-hydroxy-5beta-pregnan-20-one (pregnanolone) and triethylammonium 3 alpha-hydroxy-20-oxo-5 alpha-pregnan-21-yl hydrogensuccinate (THDOC-conjugate), was tested against motor seizures induced by pentetrazol in immature rats. Five age groups (7, 12, 18 and 25 days old and adult rats) were pretreated with the steroids in doses from 2.5 to 40 mg/kg i.p. Twenty minutes later pentetrazol (100 mg/kg s.c.) was administered. Minimal seizures (clonic seizures of head and forelimb muscles with preserved righting ability) could be induced in the three older age groups. They were suppressed by pregnanolone in all these tested groups (this effect was best expressed in 18-day-old rats and decreased with age), whereas significant changes in THDOC-conjugate-pretreated animals appeared only in 18-day-old rats. Generalized tonic-clonic seizures were suppressed by both neuroactive steroids in all age groups, this effect being more marked with pregnanolone and again decreased with age. The 7- and 12-day-old rats exhibited higher sensitivity of the tonic phase so that generalized clonic seizures were observed. Duration of the effect was studied in 12- and 25-day-old animals; it was substantially shorter in the older rats than in 12-day-old animals. Both drugs exhibited an anticonvulsant action in developing rats but, unfortunately, their effect was only shortlasting.

Age Factors↗

PubMed2005

Anticonvulsant action of an antagonist of metabotropic glutamate receptors mGluR5 MPEP in immature rats.

Antagonists of type I of metabotropic glutamate receptors exhibit anticonvulsant action in adult as well as immature rodents. To know the anticonvulsant profile of a specific mGluR5 antagonist MPEP in developing rats, two models of epileptic seizures were used. MPEP (10, 20 or 40 mg/kg i.p.) suppressed in a dose-dependent manner epileptic afterdischarges induced by electrical stimulation of sensorimotor cortical area in three age groups (12, 18 and 25 days old). The anticonvulsant action was more expressed in the youngest group than in older animals so that in 25-day-old rats an additional dose of 80 mg/kg was used. In contrast to this marked anticonvulsant action, MPEP at a dose of 40 mg/kg i.p. in 18-day-old rat pups and at doses of 40 and 80 mg/kg in 25-day-old rat pups did not affect episodes of spike-and-wave rhythm elicited by low doses of pentetrazol. Our results delineate the profile of the anticonvulsant action of MPEP and confirm the higher efficacy of this antagonist at early developmental stages in comparison with prepubertal animals.

Age Factors↗

PubMed2005

Cannulation of the axillary artery: the decision between direct cannulation and cannulation via side graft.

BACKGROUND: The axillary artery has emerged as promising alternative cannulation site when the ascending aorta is unsuitable for cannulation. However, in order to minimize vascular injury, the decision to cannulate the artery directly or via graft has to be considered carefully. METHODS: Seventy patients underwent axillary artery cannulation during a two-year period. Indications for operation were acute aortic dissection type A in 25(36 %), ascending aortic or arch aneurysm in 32 (46 %), redo surgery in 6 (9 %), and severely atherosclerotic aorta in 3 (4.3 %) patients. Depending on the diameter of the vessel and the rigidity of the wall, the artery was either cannulated directly or via an 8-mm prosthetic Dacron graft. RESULTS: Direct cannulation was performed in 46 patients (66 %) and cannulation via graft in the remaining 24 patients (34 %). The complication rate associated with axillary artery cannulation was 3.8 %. These two patients developed retrograde type A dissection and further dissection into the descending aorta caused by forceful insertion of a 20-French cannula in a very elastic and small artery. CONCLUSIONS: Cannulation of the axillary artery is an attractive approach with a wide indication spectrum. However, the decision to cannulate directly or via graft should be based on the diameter and elasticity of the vessel, to minimize the complications of vascular injury and subsequent dissection.

Adult↗

PubMed2005

Effects of a free radical scavenger N-tert-butyl-alpha-phenylnitrone (PBN) on short-term recovery of immature rats after status epilepticus.

The present study examined the effects of a free radical scavenger, N-tert-butyl-alfa-phenylnitrone (PBN) on lithium-pilocarpine-induced status epilepticus (SE) and its short-term consequences in rats 12 (P12) or 25 (P25) days old. PBN (2 x 100 mg/kg i.p.) was injected according to the following schedules: 1) PBN-pretreated animals received the first dose 30 min prior to pilocarpine, the second dose was given 1 min after SE onset, and 2) PBN-treated animals received the first dose of PBN 1 min after SE onset and the second one 60 min later. Paraldehyde was administered to decrease mortality. Effects of PBN were highly age-dependent. In P25 group, PBN-pretreatment increased latency to SE onset and significantly suppressed the severity of motor manifestation of SE. Both PBN pretreatment and treatment improved recovery after SE. In contrast, administration of PBN in P12 animals did not affect SE pattern or recovery after SE. Administration of PBN had no effects on the motor performance of animals 3 and 6 days after SE. Neuronal damage was examined 24 h and 7 days after SE using Fluoro-Jade B staining. Mild neuroprotective effects of PBN in hippocampal fields CA1 and CA3 occurred in P25 rats in both experimental schedules. In contrast, administration of PBN aggravated neuronal injury in the hippocampus in P12 rats. Administration of PBN to intact rats did not induce neurodegeneration in either age group.

Age Factors↗

PubMed2005

[Neonatal consequences of maternal smoking during pregnancy].

In utero tobacco consumption is a serious public health problem in France; it is very frequent and the long term consequences are not only numerous but also misinterpreted by our population. 25 to 29% of women arrive at the end of their pregnancy without stopping smoking and 50% of non smoking mothers live in an environment polluted by tobacco during pregnancy. The authors would like to stress the gravity of this situation. At the maternity hospital in Nîmes, 358 women who gave birth at term and after a normal pregnancy were enrolled in a survey and monitored with thiocyanate for their tobacco consumption. Birth weight, height, and cranial perimeter of the infants were noted at birth. Results confirmed earlier work on this subject: the three variables studied were consistently weakened by the mother's addiction to tobacco. The authors recall previous medical literature on the pathophysiology and other consequences on the brain: such as I.Q. behavior, sudden infant death syndrome, vascular alterations with possible long-term complications, as well as pulmonary alterations on which there has recently been much research. The question is raised as to why this problem is so neglected in our society and what could be done to change this state of affairs.

Child Development↗

PubMed2005

[Exenteration procedures in the pelvis].

Exenteration pelvic procedures are surgical options for treatment of locally advanced pelvic tumors. Due to the procedure's success rates, it has become a standard therapeutic procedure, when indicated. From the medical point of view, the following factors characterize the level of seriousness of these procedures: the fact that the procedure is extensive, its complicated reconstruction phase and high postoperative morbidity rates. From the patient's point of view, it is characterized by a principal change in the quality of life. In this case review the authors present their experience with a multidisciplinary approach to these procedures.

Adult↗

PubMed2004

Comparison of different methods of time shift measurement in EEG.

Digital signal processing techniques are often used for measurement of small time shifts between EEG signals. In our work we tested properties of linear cross-correlation and phase/coherence method. The last mentioned method was used in two versions. The first version used fast Fourier transform (FFT) algorithm and the second was based on autoregressive modeling with fixed or adaptive model order. Methods were compared on several testing signals mimicking real EEG signals. The accuracy index for each method was computed. Results showed that for long signal segments all methods bring comparably good results. Accuracy of FFT phase/coherence method significantly decreased when very short segments were used and also decreased with an increasing level of the additive noise. The best results were obtained with autoregressive version of phase/coherence. This method is more reliable and may be used with high accuracy even in very short signals segments and it is also resistant to additive noise.

Algorithms↗

PubMed2004

[Quality assessment of information about female urinary incontinence from French speaking websites].

OBJECTIVES: An increasing number of patients look for medical information on Internet, and find hardly accurate answers to their questions. The objective of this study was to assess the quality of information about urinary incontinence on free access Web-sites. MATERIAL AND METHODS: A search using the most used search engines in French speaking countries and key words given by patients located 24 Web-sites on female urinary incontinence to review. A general description of each site was done. Then a specially designed assessment scale, whose criteria were extracted from a literature review and from practice guidelines for the management of female urinary incontinence, was used by two reviewers to assess each Web-site content. RESULTS: Three key terms (urinary incontinence, urine loss, urine leak) were used on three search engine (Google, Yahoo, Voila) and the first 10 Web-sites located for each search were analyzed. The mean score was low (7.92 (+/-3.1) range 0-24, maximum 24) and only four sites received the "highly recommended" mention. CONCLUSIONS: This study using medical evidence-based criteria to assess the quality content of French speaking Web-sites about female urinary incontinence highlights the poor quality of information available for Internet "typical users". Doctors should play a greater role in evaluating these sites and/or developing their quality.

Health Education↗

PubMed2004

[Resurgence of syphilis: a prospective study at an University Hospital, Nimes].

BACKGROUND: Since 2000, the incidence of syphilis has increased in France. The study objective was to estimate the frequency of syphilis in Languedoc Roussillon region in Southern France. METHOD: The prospective study was conducted between January 1, 2003 and June 30, 2003 in different medical wards in a French University Hospital, Nimes. The diseased patients in this study answered to a questionnaire, providing epidemiological and socio-economic data, symptomatology and treatment-seeking behaviour. Blood specimens were tested for syphilis by the serological methods (TPHA, VDRL, FTA). RESULTS: In 6 months, serologic evidence of syphilis infection was found in 30 patients. Men were more than twice as likely as women to be infected with syphilis. Most men (64.7%) acquired the infection homosexually. Four women acquired infection during pregnancy. The mean age of study population was 46.3 years. 40.7% were married. Out of 27 cases, 70.4% cases had an associated sexually transmitted infection (HIV, hepatitis, herpes, and gonorrhoea). CONCLUSIONS: These data confirm the increase of syphilis in south of France and underline the importance of a permanent monitoring of sexually transmitted infection in target populations to allow a timely diagnosis and an appropriate treatment, and to plan preventive strategies.

Adult↗

PubMed2004

Excitatory aminoacids and epileptic seizures in immature brain.

Data on convulsant and anticonvulsant action of drugs influencing excitatory amino acid receptors in developing rats are reviewed. Agonists of NMDA type of receptors NMDA and homocysteic acid, elicited an age-related seizure pattern--flexion, emprosthotonic seizures--in the first three postnatal weeks of rats. Generalized clonic-tonic seizures appeared only after a longer latency. Kainic acid administration resulted in epileptic automatisms and later in minimal, clonic seizures followed by generalized tonic-clonic seizures. A decrease of sensitivity to convulsant action with age is a general rule for all agonists tested. Different anticonvulsant action of NMDA and nonNMDA antagonists was demonstrated in a model of generalized tonic-clonic seizures induced by pentetrazol, whereas their action against epileptic afterdischarges elicited by electrical stimulation of cerebral cortex was similar. Again, higher efficacy in younger animals was a rule. As far as metabotropic glutamate receptors are concerned, agonists of groups II and III were shown to protect against convulsant action of homocysteic acid in immature rats and an antagonist of group I receptors MPEP suppressed the tonic phase of generalized tonic-clonic seizures induced by pentetrazol more efficiently in younger than in more mature rat pups. Unfortunately, a higher sensitivity to the action of antagonists of ionotropic glutamate receptors was demonstrated also for unwanted side effects (motor functions were compromized). In contrast, glutamate metabotropic receptor antagonist MPEP did not exhibit any serious side effects in rat pups.

Age Factors↗

PubMed2004

Hippocampal afterdischarges in rats. I. Effects of antiepileptics.

Hippocampal afterdischarges (ADs) are considered to be a model of complex partial seizures. To study the pharmacology of these ADs, stimulation electrodes were implanted into the dorsal hippocampus of 33 male Wistar rats. Stimulation (15-s series of monophasic rectangular pulses with a duration of 1 ms and frequency of 8 Hz) was applied four times with interstimulation intervals of 15 min. Drugs (carbamazepine 50 and 100 mg/kg; clonazepam 0.2 and 0.5 mg/kg; ethosuximide 125 and 250 mg/kg; phenobarbital 40 and 80 mg/kg) as well as solvent and isotonic saline were injected intraperitoneally 2 min after the cessation of the first AD. Duration of AD, of the latent period between AD and recurrent AD and duration of recurrent AD and the number of wet dog shakes were measured. ADs were markedly shortened by both doses of clonazepam and phenobarbital and by the higher dose of carbamazepine. The action of ethosuximide was negligible. Wet dog shakes were influenced in the same way as AD duration. Recurrent ADs were more sensitive to antiepileptics than ADs and wet dog shakes.

Action Potentials↗

PubMed2004

[Initial experience in exenteration interventions in the pelvis].

OBJECTIVE: Discussion of experiences with pelvic exenterations. DESIGN: Case-report. SETTING: Department of Obstetrics and Gynecology, Department of Urology, Department of Surgery, Department of Pathology, Department of Clinical Oncology, General Teaching Hospital and Ist Medical Faculty of the Charles University, Prague, Czech Republic. METHODS: Presentation of 4 cases of pelvic exenterations. Discussion with published data. RESULTS: Altogether four cases of pelvic exenterations are presented, one case of supralevator total exenteration for recurrent cervical cancer, one case of infralevator total exenteration for recurrent vaginal cancer, one case of supralevator anterior exenteration in the treatment of locally advanced cancer of urinary bladder, and one case of supralevator posterior exenteration for recurrent vaginal cancer.

Adult↗