Treatment Of Se Research Articles

Resective surgery in the treatment of super-refractory partial status epilepticus secondary to NMDAR antibody encephalitis

BackgroundAnti-NMDAR encephalitis is an increasingly described clinical entity in children, comprising 40% of all cases. We present a case of super-refractory status epilepticus secondary to anti-NMDAR encephalitis treated with emergent resective surgery. Case studyA 7 years-old boy presented with progressive abnormal irritability. On the day after admission he had multiple seizures, characterized by head and eye version to the right. EEG revealed left parietal-occipital continuous paroxysmal activity. Anti-NMDAR antibodies were positive in CSF and serum. After almost 3 months in the Intensive Care Unit, in barbituric coma, and given the failure of all treatment regimens, a preoperative evaluation was conducted. Ictal SPECT showed significant hiperperfusion and brain FDG-PET a cortical hypometabolism in the left occipital lobe; a left occipital lobectomy was performed. In the next days it was possible to progressively suspend Thiopental. Currently, patient presents right homonymous hemianopsia, eats by his own hand but needs help in almost all other activities. DiscussionStatus epilepticus (SE) in the setting of anti-NMDAR encephalitis is unusual but described. Whilst the role of surgery in the management of refractory focal epilepsy is established, it is seldom used in the treatment of SE. In the patient with refractory SE (RSE), awareness of surgery as a potentially life saving treatment is an important issue. To our knowledge, this is the first report of a partial RSE secondary to anti-NMDAR encephalitis treated with resective surgery and illustrates the need to consider anti-NMDAR encephalitis as a cause of super-refractory SE.

Selenium(IV) Uptake by Maghemite (γ-Fe2O3)

The mechanism of selenium(IV) uptake by maghemite was investigated on both the macroscopic and the molecular level. Maghemite nanoparticles exhibited fast adsorption kinetics toward selenium(IV). Batch experiments showed a decreased sorption with increasing pH (3.5-11). Ionic strength variations (0.01 to 0.1 M NaCl) had no significant influence on selenium(IV) uptake. Electrophoretic mobility measurements revealed a significant shift toward lower values of the isoelectric point of maghemite upon selenium(IV) uptake, suggesting the formation of inner-sphere surface complexes. At the molecular level, using X-ray Absorption Fine-Structure Spectroscopy (EXAFS), the formation of both bidentate binuclear corner-sharing ((2)C) and bidentate mononuclear edge-sharing ((1)E) inner-sphere surface complexes was observed, with a trend toward solely (1)E complexes at high pH. The absence of a tridentate surface complex as observed for arsenic(III) and antimonite(III) might be due to the relatively small size of the Se(IV)O3 unit. These new spectroscopic results can be implemented in reactive transport models to improve the prediction of selenium migration behavior in the environment as well as its monitoring through its interaction with maghemite or maghemite layers at the surface of magnetite. Due to its chemical stability even at low pH and its magnetization properties allowing magnetic separation, maghemite is a promising sorbing phase for the treatment of Se polluted waters.

Intravenous lacosamide or phenytoin for treatment of refractory status epilepticus

To compare intravenous phenytoin (PHT) and intravenous lacosamide (LCM) for treatment of status epilepticus after failure of the first and second drug. We retrospectively identified patients from a large community hospital in northern Germany who had been diagnosed with SE between August 2008 and December 2010. Patients who had failed to respond to the first two drugs were selected for this analysis. Forty-six patients (23 female, median age 68 years) were identified. LCM was used as third drug in 21 patients (median bolus 400 mg) and PHT in 15 patients (median bolus 1500 mg). Pretreatment was similar regarding substance groups (benzodiazepine as first line, levetiracetam as second line drug) and bolus doses. Status epilepticus was terminated in six patients (40%) of the PHT group and in seven patients (33%) of the LCM group. Four patients (27%) of the PHT group and no patient of the LCM group suffered from a relevant, treatment-related side effect during administration of the third drug. Lacosamide and PHT showed similar success rates for treatment of SE when used after failure of benzodiazepines and levetiracetam. However, PHT was associated with relevant side effects that were not seen with LCM.

Inpatient treatment costs of status epilepticus in adults in Germany

PurposeStatus epilepticus (SE) is an important neurological emergency and a significant source of direct costs related to hospitalization; however, no cost-of-illness (COI) studies have been performed in Europe. The objective of this study was to determine and characterize hospital costs related to the acute inpatient treatment of SE and to provide national estimates of SE hospitalization costs. MethodsAdult inpatient treatment costs related to SE and costs attributable to epilepsy-related hospital admissions were derived from billing data of participating hospitals. ResultsDuring the 4-month study period a total of 96 patients (59.5±21.6 years; 52 male) received inpatient treatment for epilepsy-related reasons, 10 of these (10.4%) were treated for SE. Epilepsy was newly diagnosed in 30/96 patients (31.3%), of whom five presented with SE. The admission costs related to SE (€8347±10,773 per patient per admission) were significantly higher than those related to admissions of patients with newly diagnosed (€1998±1089; p=0.014) or established epilepsy (€3475±4413; p=0.026). Of the total inpatient costs (€346,319) 24.4% were attributable to SE, 14.4% to newly diagnosed epilepsy without SE (n=25) and 61.2% to complications of established epilepsy (n=61). Extrapolation to the whole of Germany (population 82 million) indicates that SE causes hospital costs of more than €83 million per year while the total of epilepsy-related inpatient treatment costs amounts to €342 million. ConclusionAcute treatment of SE is responsible for a high proportion of hospital costs associated with epilepsy. With a high incidence of SE in the elderly population, the health care systems will face an increasing number of presentations with SE and its associated costs, underlining the necessity to further evaluate the burden and optimize the treatment of SE.

ASSA13-03-38 Selenium Ameliorate Myocardial Fibrosis in Diabetic Rats Through Inhibiting GPx- ROS-Smad- CTGF Signalling Pathway

ObjectiveIt has been mentioned that myocardial fibrosis which contributes to cardiac dysfunctions is one of the hall markers of diabetic cardiomyopathy. Up-regulation of reactive oxidative species (ROS)/TGF- beta 1/Smad signalling...

ASSA13-06-3 Selenium Prevents Cardiomyocyte Apoptosis During Hyperglycemia in Diabetic Rats Via TLR4 Pathway

<h3>Objective</h3> Previous studies have showed that TLR4 (Toll-like receptor 4) may trigger apoptosis of cardiomyocytes under conditions of cardiac inflammation and oxidative stress. Studies also presented that oxidative stress played an important role in the development of diabetic cadiomyopathy. Selenium (Se) is an essential trace element which is known as an antioxidant agent. This work aimed to investigate the cadioprotective effect and the possible mechanism of sodium selenite treatment in experimental diabetic rats. <h3>Methods</h3> Diabetes was induced in SD rats using intraperitoneal injections of streptozotocin (STZ). Rats were divided into four groups: nondiabetic rat group, nondiabetic rats received sodium selenite (Se) intraperitoneally for 3 weeks, diabetic rats received Se (DMSe group) intraperitoneally for 3 weeks and the diabetic rats were injected saline intraperitoneally for 3 weeks. Myocardial apoptosis was detected using TUNEL assay, TLR4 and caspase-3 expression was measured by RT-PCR and western-blot, left ventricular functions was examined by cardiac catheterization, NADPH activity and intracellular reactive oxygen species (ROS) were also assessed. <h3>Results</h3> After treatment with STZ, the rats developed diabetes evidenced by hyperglycemia. Compared with nondiabetic rats, myocardial apoptosis was detected in rat with hyperglycemia, and then left ventricular data demonstrated a significant depression in the left ventricular developed pressure (LVDP) measurement. Mechanistically, significantly increased expression of TLR4 and caspase-3 in myocardial tissue was observed, meanwhile, increased NADPH oxidase activity and ROS production was also detected in rats with hyperglycemia. In contrast, treatment of Se significantly reduced hyperglycemia up-regulated TLR4 and caspase-3 expression, minimised apoptosis in myocardial tissues, and inhibited NADPH oxidase activity and ROS production. Furthermore, the diabetic rats with Se treatment eventually showed greater improvement of LVDP compared to the untreated diabetic rats. <h3>Conclusions</h3> We concluded that hyperglycemia induces TLR4 expression in cardiac tissue; Se may act effectively against hyperglycemia-induced cardiac apoptosis as an antioxidant by modulating TLR4 signalling.

Selenium improves recovery of wheat seedlings at rewatering after drought stress

Rewatering after drought is beneficial to plants subjected to moderate drought stress, and selenium (Se) could increase the tolerance of plants to stressful environment. The role of Se in rewatering of drought-treated wheat seedlings (Triticum aestivum L., cv Hengmai5229) was studied. The objective was to elucidate whether Se could improve recovery of wheat seedlings at rewatering after drought stress. Drought stress induced a significant reduction in growth parameters, total chlorophyll and soluble protein contents, and increased the rate of superoxide radical (O 2 ·− ) production, MDA content, and the activities of peroxidase, catalase (CAT), and superoxide dismutase in wheat seedlings. Rewatering after drought did not significantly affect biomass accumulation of seedlings over drought treatment, although it decreased the rate of O 2 ·− production and MDA content. However, the combined treatment of rewatering and Se evidently promoted biomass accumulation of seedlings over drought treatment and rewatering alone; and the rate of O 2 ·− production, MDA content, soluble protein content and CAT activity were recovered to the control values. This indicates that Se improved recovery of wheat seedlings at rewatering after drought stress.

Treatment of status epilepticus in a large community hospital

BackgroundStatus epilepticus (SE) is a neurological emergency usually requiring immediate medical treatment. Due to the lack of adequate studies, treatment guidelines and their application vary between countries and institutions. We intended to analyze current treatment of SE in a German community hospital. MethodsWe retrospectively identified patients from a large community hospital in northern Germany who had been diagnosed with SE between August 2008 and December 2010. Their charts were reviewed regarding sociodemographic variables, treatment and outcome. ResultsWe studied the first SE episode in 172 patients with a median age of 69years (range 18–90years). The etiology was acute symptomatic in 30 patients, progressive symptomatic in 22 patients and remote symptomatic in 120 patients. Presentation was generalized convulsive in 60 patients, non-convulsive in 72 patients and simple motor/aura in 40 patients. Median latency from onset to treatment start was 0.75h (range 0.2–336h). Initial treatment had a success rate (SR) of 40%. Second line treatment had a success rate of 54%. In patients whose seizures were refractory to the first two drugs, success rates were between 31% and 55%, with only a minority of the patients receiving established drugs such as phenytoin or barbiturates.Multivariate analysis revealed non-convulsive semiology as the only factor significantly associated with refractoriness. SE could be terminated in 95% of the patients and in-hospital mortality was 10%. Benzodiazepines and phenytoin had the most severe side effects. ConclusionsStatus epilepticus can be terminated successfully and with low in-hospital mortality in the vast majority of the patients treated in a large community hospital. The success rate of each treatment step is between 30% and 55% regardless of the substances used.

Effects of Organic Selenium and Zinc on the Aging Process of Laying Hens

The objective of the study was to determine whether supplementing the diets of post-molted hens with organic selenium (Se) (Sel-Plex®) and/or organic Zinc (Zn) (Bio-Plex®)1 could improve laying hen performance. Prior to molting, 120-78 wk old laying hens were separated into four treatment groups of 30 hens per treatment and were subjected to molting. Molting was induced by reducing photoperiod from 16 h per day to 8 h, and the diet was changed from a standard layer diet (17% CP; 2830 ME/kg) to a straight crushed corn diet. When egg production was reduced to zero, the hens were fed a control diet, or a diet supplemented with 0.3 ppm Se/kg of feed; 20 ppm Zn/kg of feed, or a combination of Se and Zn. Lighting was restored gradually to post-molting period. Changes in daily egg production, egg weight, egg quality (albumen, yolk, and shell weights), feed utilization and hen mortality were recorded. Results indicated that mean egg production was significantly (P<0.05) greater and feed utilization was significantly (P<0.05) lower for hens fed diet supplement with the combined treatment of Se and Zn compared to the other diets. Single treatment of Zn significantly (P<0.05) lowered mortality and increased egg production, but significantly (P<0.05) reduced egg, albumen and shell weights.

Successful treatment for refractory convulsive status epilepticus by non‐parenteral lacosamide

Lacosamide (Vimpat) is a newly licensed novel antiepileptic drug. We report a case of refractory convulsive status epilepticus (CSE) that was successfully controlled with lacosamide. The 38-year-old male patient was admitted for a series of complex partial seizures with secondary generalization leading to refractory CSE. During the transport to the hospital the patient was given 22.5 mg diazepam, 12.5 mg etomidate, and 5 mg midazolam without success. An additional dose of 4 mg lorazepam and a dose of 1,500 mg levetiracetam after admission were yet without clinical effect. A further treatment with lacosamide (300 mg via percutaneous gastric fistula) resulted in complete clinical remission of the epileptic activity within 30 min. The application of lacosamide resulted in cessation of CSE and was well tolerated. To our knowledge, this is the first case of successful treatment of refractory CSE with lacosamide. Further studies are needed to evaluate the safety and efficacy of lacosamide in treatment of SE.

Intravenous Levetiracetam as first-line treatment of status epilepticus in the elderly

Status epilepticus is a condition of prolonged/repetitive seizures that often occurs in the elderly. Treatment in the elderly can be complicated by serious side effects associated with traditional drugs. The aim of this pilot study was to evaluate the short-term efficacy/safety of intravenously administered LEV (IVLEV) as the treatment of choice for SE in the elderly. We enrolled nine elderly patients (five female/four male; median age 78 years) with SE. Two patients had a previous diagnosis of epilepsy; in the remaining seven, SE was symptomatic. SE was convulsive in five and non-convulsive in four. All the patients presented concomitant medical conditions (arrhythmias/respiratory distress/hepatic diseases). As the traditional therapy for SE was considered unsafe, IVLEV was used as first-line therapy (loading dose of 1500 mg/100 ml/15 min, mean maintenance daily dose of 2500 mg/24 h) administered during video-EEG monitoring. In all the patients but one, IVLEV was effective in the treatment of SE and determined either the disappearance of (7/8), or significant reduction in (1/8), epileptic activity; no patient relapsed in the subsequent 24 h. No adverse events or changes in the ECG/laboratory parameters were observed. These data suggest that IVLEV may be an effective/safe treatment for SE in the elderly.

Protective Effects of Selenium and Vitamin E Combination on Experimental Colitis in Blood Plasma and Colon of Rats

Ulcerative colitis increases oxidative damage accompanied by production of free oxygen radicals. Selenium (Se) and vitamin E are two natural antioxidants. The present study was undertaken to investigate the possible protective role of Se and vitamin E combination in experimental colitis induced by acetic acid (AA) in rats. This study was carried out on three groups, namely the first (control), the second (experimental colitis group, 2 ml 5% acetic acid), and the third groups (2 ml 5% acetic acid, vitamin E (100 mg/kg body weight (bw)) plus Se (0.2 mg/kg bw)). The activities of catalase (CAT), prolidase (PRS), myeloperoxidase (MPO), total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), total thiol (T-SH) were determined in plasma and colon samples. Macroscopic and microscopic damages in colon were increased by AA treatment (p < 0.01 and p < 0.01, respectively), whereas they were decreased by selenium and vitamin E treatment (p < 0.05 and p < 0.01, respectively). The activities of CAT and PRS in the plasma and colon were significantly affected (p < 0.05 and p < 0.01) by treatment of AA, Se, and vitamin E. MPO activity in colon was increased (p < 0.01) by AA treatment and decreased (p < 0.05) by Se and vitamin E administration. The values of TOS and OSI in plasma were increased (p < 0.5) by AA. The TAC and T-SH in colon were decreased (p < 0.05) by AA and increased (p < 0.05) by Se and vitamin E. Based upon these results, Se and vitamin E may play an important role in preventive indication of the oxidative damage associated by acetic acid caused inflammation.

Morphological evolution of selenium micro-crystals

A simple solution phase approach using dimethyl formamide (DMF) as solvent is utilized to obtain selenium (Se) microcrystals. Different morphological modifications of the products result from varied reaction environments. Solvothermal treatment of Se with DMF in an autoclave at 170°C yields rod-like, and feather-shaped microcrystalline structures while reduction of selenium dioxaide (SeO2) by DMF generates microspheres at 30°C and 80°C, rods admixed with spherical particles at 120°C and predominantly micro rods at 150°C. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

The pharmacological potential of Sorbus commixta cortex on blood alcohol concentration and hepatic lipid peroxidation in acute alcohol-treated rats

The effect of Sorbus commixta cortex, a traditional herbal medicine used for the treatment of bronchitis, gastritis and dropsy, on blood alcohol concentration (BAC) and hepatic lipid peroxidation was examined in acute alcohol-treated rats. A 30-min pretreatment with a methanol extract of S. commixta cortex (SC) at concentrations higher than 200 mg kg(-1) resulted in a significant decrease in BAC and the ethyl acetate fraction (SE) of the extract showed the highest potency, with a maximum of a 46% decrease at 150 mg kg(-1) 2 h after alcohol administration (3.0 g kg(-1)) compared with the control group (P < 0.005). The rapid reduction in BAC did not appear to be due to the protection or activation of hepatic alcohol dehydrogenase (ADH) activity by SE. Hepatic malondialdehyde (MDA) levels were significantly increased by acute alcohol administration within 6 h, although pretreatment with the SE caused a significant decrease in MDA levels compared with alcohol treatment alone. Hepatic glutathione (GSH) levels and superoxide dismutase (SOD) activity remained unchanged by alcohol, SE alone or by the combined treatment of alcohol and SE. However, catalase activity was significantly reduced by acute alcohol administration and pretreatment with the SE led to significant protection of its activity. These results suggest that pretreatment with SE reduces hepatic lipid peroxidation by decreasing the bioavailability of alcohol and its oxidative metabolites, such as H2O2, at least partly, through the protection of hepatic catalase in acute alcohol-treated rats.

Cd and Se atomic environments during the growth of CdSe nanoparticles in glass

Thermal treatment of Cd and Se doped borosilicate glass yields CdSe nanoparticles that are interesting for applied and fundamental studies of quantum and size effects in semiconductors. Using x-ray absorption spectroscopy at both the Cd and Se K-edges, we have studied the local atomic structure for each of these reactants at several stages of particle growth. When the doped glass is quenched from 1050 °C, the Cd neighbor is mostly oxygen and the Se neighbor is mostly Zn. With heat treatment at 600–750 °C, the concentration of nearest neighbor Cd-Se bonds increases and becomes dominant while the optical spectrum evolves toward that of a composite containing CdSe.

Bonding changes during the growth of CdSe nanoparticles in glass

Thermal treatment of Cd and Se doped borosilicate glass yields CdSe nanoparticles that are interesting for applied and fundamental studies of quantum and size effects in semiconductors. Using X-ray absorption spectroscopy at both the Cd and Se K-edges, we have studied the local atomic structure for each of these reactants at several stages of a particle growth. When the doped glass is quenched from 1050°C, the Cd neighbor is mostly oxygen and the Se neighbor is mostly Zn. With heat treatment at 600–750°C, the concentration of nearest neighbor Cd–Se bonds increases and becomes dominant while the optical spectrum evolves toward that of a composite containing CdSe.

Effect of selenium supplementation on the influence of cadmium on glutathione and glutathione peroxidase system in mouse liver

In the present study, cadmium (Cd) administration (8 mg of Cd/kg bw, daily, orally for 8 weeks) in mice resulted in a significant accumulation of Cd in the liver. However, when selenium (Se; 0.35 mg of Se as sodium selenite/kg bw, daily, orally for 8 weeks) was administered concurrently, a reduction (approximately 18%) in the Cd concentration was seen in the liver. A significant inhibition in glutathione peroxidase (GSH-Px) in liver was seen in the Cd-treated group, which improved significantly (P < 0.05) during co-administration of Se. A significant increase in the reduced glutathione (GSH) concentration in the liver was seen after Cd treatment. Following the combined administration of Cd and Se, the values were close to the control. The increase in the glutathione after Cd administration is attributed to stressful conditions and also to its lower utilization due to inhibition of glutathione peroxidase. No alterations were seen in the oxidized glutathione (GSSG), the ratio of GSH/GSSG, or in the glutathione reductase, both during Cd and Cd + Se administration in liver. These results clearly indicate that the concomitant treatment of Se significantly decreased the Cd accumulation in liver and simultaneously protected the antioxidant enzyme, i.e., GSH-Px from the influence of Cd. J. Trace Elem. Exp. Med. 13:299–304, 2000. © 2000 Wiley-Liss, Inc.

Management of status epilepticus in children.

Treatment of SE is based on the age of the patient and the possible underlying etiology. Initial treatment should include a benzodiazepine (lorazepam 0.1 mg/kg or diazepam 0.5 mg/kg). Specimens for laboratory tests should be drawn early in the event of a prolonged seizure and geared toward the clinical presentation and age of the patient. If a seizure lasts longer than 10 minutes, phenobarbital 20 mg/kg dose should be administered with strict adherence to the proper rate of administration. Further seizure activity during drug administration can be treated with additional doses of lorazepam or diazepam. If a seizure lasts longer than 10 minutes, a second long-acting anticonvulsant should be administered, followed by induction of general anesthesia.

INAA of elemental contents in fingernails of esophageal cancer patients

Fingernails of pathologically diagnosed normal people, light esophageal epitheliosis patients, severe esophageal epitheliosis patients and esophageal cancer patients were irradiated and their elemental contents were determined by INAA. Multivariate statistical treatment of Ca, Cl, K. Mg, Se and Zn data shows that esophageal cancer patients are distinguishable from non-cancer patients. The accuracy computed by neural networks is greater than 80%.

Synthese, Strukturen und Eigenschaften von Cl2TeSeN2S und [Se2N2S]22+ [XSO3−]2 (X = F, CF3)

Synthesis, Structures, and Properties of Cl2TeSeN2S and [Se2N2S]22+ [XSO3−]2 (X = F, CF3)Treatment of Se(NSO)2 with TeCl4 provides the colvalent five‐membered ring species (1). Reaction of Se(NSO)2 with XSO3H (X = F or CF3) leads to bis(1,3,4,2,5‐thiadiselenadiazolium) cations with the anions FSO3− (2a) and CF3SO3− (2b). X‐ray structure analyses for 1 and 2b are presented.