No abstract

Hippocampal dysfunction is the hallmark of mesial temporal lobe epilepsy (MTLE), the most common epileptic syndrome in adults and the most often refractory to medical therapy. Deep brain stimulation (DBS) may ameliorate drug-refractory MTLE, but it still cannot guarantee a seizure-free life. One major drawback is that the stimulation policy is informed by trial-and-error rather than by the operating mode of the brain. Thus, optimizing DBS parameters is still an unmet clinical need. Here, we propose the deployment of hippocampal interictal activity in a biohybrid approach to control limbic ictogenesis. Specifically, an electronic bridge establishes a graft-host interaction between the hippocampal subfield CA3 (graft) and the parahippocampal cortex (CTX - host) of distinct rodent brain slices, both treated with 4-aminopyridine; the electronic bridge relays the graft interictal events to the host via electrical pulses. We show that interictal activity generated by the graft CA3 controls limbic ictogenesis in the host CTX even in the absence of feedback from it, thus likely reflecting an intrinsic anti-ictogenic clock of this brain region. This work opens a translational perspective for MTLE treatment via biohybrid neuroprostheses relying on the intrinsic clock of incorporated hippocampal cells.

BackgroundThe Spanish National Institute of Security and Hygiene at Work has just published a new technical note ‘Hazardous drugs: prevention measures for their preparation and administration’, based on the list of biohazardous drugs published by the National Institute for Occupational Safety and Health (NIOSH).PurposeTo determine the degree of implementation of the document recommendations in the pharmacy unit of our hospital. In particular, to quantify the number of drugs whose preparation meets the standards set out in the technical note with the intention to improve the adequacy of the pharmacy unit protocols.Material and methodsThe drugs available in the pharmacy unit that are included in the technical note ‘Biohazardous drugs’ are classified into the three categories: biosafety cabinet (BSC) I and II and reproductive risk (RR).ResultsPresently, 121 of 213 drugs included in the technical note are available in our hospital pharmacy. Of these, 53 (43.8%) should be handled into BSC II according to the standards. The preparation of 48 (90.6%) hazardous drugs was performed in accordance with the recommended prevention measures. Only 5 drugs (9.4%) (phenytoin, leuprorelin, risperidone, tacrolimus, triptorelin) were not handled according to the standards. 61/121 drugs should be handled in BSC I (43 only BSC I and 18 BSC I and RR). None of these drugs were prepared in accordance with the recommended prevention measures. From the 7 drugs with a proven RR, 5 (71.4%) were not handled according to the standards.ConclusionAt present, 90.6% of biohazardous drugs BSC II, none of biohazardous drugs BSC I and 28.6% with RR were handled according to the standards set in the technical note, which leads us to conclude that implementation of the recommendations reported is still low in our hospital. Setting up multidisciplinary groups of professionals, including labour union representatives and experts in occupational health and safety, would undoubtedly be helpful to improve the implementation of these recommendations in the healthcare system. The resulting increase in the workload of the pharmacy units is a fact that must be taken into account by the authorities in each centre.References and/or acknowledgementsTechnical note.No conflict of interest