Probability of Remission of the Main Epileptic Syndromes in Childhood

2021 ◽  
pp. 088307382110567
Author(s):  
Julio Ramos-Lizana ◽  
Gema Martínez-Espinosa ◽  
Patricia Aguilera-López ◽  
Javier Aguirre-Rodriguez
Keyword(s):  
West Syndrome ◽  
Childhood Epilepsy ◽  
Antiepileptic Treatment ◽  
Neurologic Deficits ◽  
Epileptic Syndromes ◽  
Study Results ◽  
Syndromic Diagnosis ◽  
Infantile Epilepsy ◽  
Panayiotopoulos Syndrome

Aim To determine the long-term probability of remission without antiepileptic treatment of common epileptic syndromes and of children without a specific syndromic diagnosis. Patients and methods All children less than 14 years old with 2 or more unprovoked seizures seen at our hospital between June 1, 1994, and March 1, 2011 (n = 680), were included and prospectively followed up until August 15, 2020. Syndromic diagnosis was made retrospectively but blinded to subsequent evolution, employing the data available at 6 months after diagnosis and under predefined operational criteria. Results The Kaplan-Meier estimate of the probability of achieving a remission period of at least 5 years, with neither seizures nor antiepileptic treatment at 14 years was 97% for well-defined childhood epilepsy with centrotemporal spikes, 82% for uncertain childhood epilepsy with centrotemporal spikes, 85% for well-defined Panayiotopoulos syndrome, 88% for uncertain Panayiotopoulos syndrome, 93% for nonfamilial self-limited infantile epilepsy, 100% for familial self-limited infantile epilepsy, 86% for absence epilepsy, 6% for juvenile myoclonic epilepsy, 71% for cryptogenic West syndrome, 72% for patients with no associated neurologic deficits and no specific syndromic diagnosis, 65% for symptomatic West syndrome, and 40% for patients with associated neurologic deficits and no specific syndromic diagnosis. Conclusions The study results highlight the long-term outcomes of the main epileptic syndromes and also of the patients with no syndromic diagnosis.

Health Literacy and Long-Term Care Needs among Thai Elderly in Rural Communities

2020 ◽  
Vol 103 (12) ◽  
pp. 1315-1324
Keyword(s):  
Depressive Symptom ◽  
Health Literacy ◽  
Rural Communities ◽  
Long Term Care ◽  
Health Knowledge ◽  
Elderly Persons ◽  
Care Needs ◽  
Term Care ◽  
Study Results

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community

scholarly journals A Holistic Framework for Evaluating Adaptation Approaches to Coastal Hazards and Sea Level Rise: A Case Study from Imperial Beach, California

Water ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1324
Author(s):  
David Revell ◽  
Phil King ◽  
Jeff Giliam ◽  
Juliano Calil ◽  
Sarah Jenkins ◽  
...  
Keyword(s):  
Sea Level Rise ◽  
Sea Level ◽  
Public Trust ◽  
Adaptation Strategy ◽  
Public Benefits ◽  
Study Results ◽  
Local Risk ◽  
Over Time

Sea level rise increases community risks from erosion, wave flooding, and tides. Current management typically protects existing development and infrastructure with coastal armoring. These practices ignore long-term impacts to public trust coastal recreation and natural ecosystems. This adaptation framework models physical responses to the public beach and private upland for each adaptation strategy over time, linking physical changes in widths to damages, economic costs, and benefits from beach recreation and nature using low-lying Imperial Beach, California, as a case study. Available coastal hazard models identified community vulnerabilities, and local risk communication engagement prioritized five adaptation approaches—armoring, nourishment, living shorelines, groins, and managed retreat. This framework innovates using replacement cost as a proxy for ecosystem services normally not valued and examines a managed retreat policy approach using a public buyout and rent-back option. Specific methods and economic values used in the analysis need more research and innovation, but the framework provides a scalable methodology to guide coastal adaptation planning everywhere. Case study results suggest that coastal armoring provides the least public benefits over time. Living shoreline approaches show greater public benefits, while managed retreat, implemented sooner, provides the best long-term adaptation strategy to protect community identity and public trust resources.

scholarly journals French Firms and COVID-19: Do the Debt Status, Crisis Management System, and Monetary Policy Play a Role?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mina Sami
Keyword(s):  
Monetary Policy ◽  
Stock Returns ◽  
Crisis Management ◽  
Management System ◽  
Daily Growth ◽  
Listed Firms ◽  
Study Results ◽  
Major Outbreak

Abstract This study has two main objectives: first, it assesses the effect of outbreak pandemic diseases on the French firms’ stock returns by considering the sector of activity as the main center of analysis. Second, it investigates the role of the crisis management system, firm debt strategy, and monetary policy in dealing with the adverse shocks of the major outbreak of the COVID-19. The study results can be summarized as follows: (1) the daily growth in COVID-19 cases and deaths are associated with lower stock returns of the listed firms, especially for the firms operating in the energy, industrial and health care sectors. In contrast, telecommunication and consumer sectors are not significantly affected. (2) The pandemic’s adverse effect is much more tolerant with the French firms with an efficient crisis management system and low long-term debt commitments than the firms that do not have such a system and engaged with long term debts. (3) Euribor rates and monetary policy are still playing an essential role during the pandemic period.

scholarly journals Reproductive Performance Following Hysteroscopic Surgery for Uterine Septum: Results from a Single Surgeon Data

2021 ◽  
Vol 10 (1) ◽  
pp. 130
Author(s):  
Ertan Saridogan ◽  
Mona Salman ◽  
Lerzan Sinem Direk ◽  
Ali Alchami
Keyword(s):  
Reproductive Performance ◽  
Observational Studies ◽  
Patient Characteristics ◽  
Reproductive Outcomes ◽  
Hysteroscopic Surgery ◽  
High Quality Evidence ◽  
Study Results ◽  
Significant Difference ◽  
Uterine Septum

Uterine septum can negatively affect reproductive outcomes in women. Based on evidence from retrospective observational studies, hysteroscopic incision has been considered a solution to improve reproductive performance, however there has been recent controversy on the need for surgery for uterine septum. High quality evidence from prospective studies is still lacking, and until it is available, experts are encouraged to publish their data. We are therefore presenting our data that involves analysis of the patient characteristics, surgical approach and long-term reproductive outcomes of women who received treatment for uterine septum under the care of a single surgeon. This includes all women (99) who underwent hysteroscopic surgery for uterine septum between January 2001 and December 2019. Of those 99 women treated for intrauterine septum who were trying to conceive, 91.4% (64/70) achieved pregnancy, 78.6% (55/70) had live births and 8.6% (6/70) had miscarriages. No statistically significant difference was found in the live birth rates when data was analyzed in subgroups based on age, reason for referral/aetiology and severity of pathology. Our study results support the view that surgical treatment of uterine septa is beneficial in improving reproductive outcomes.

scholarly journals Parenteral artemisinins are associated with reduced mortality and neurologic deficits and improved long-term behavioral outcomes in children with severe malaria

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Andrea L. Conroy ◽  
Robert O. Opoka ◽  
Paul Bangirana ◽  
Ruth Namazzi ◽  
Allen E. Okullo ◽  
...  
Keyword(s):  
Executive Function ◽  
Hospital Mortality ◽  
Cerebral Malaria ◽  
Severe Malaria ◽  
Behavioral Outcomes ◽  
Artemisinin Derivatives ◽  
Neurologic Deficits ◽  
Adjusted Scores

Abstract Background In 2011, the World Health Organization recommended injectable artesunate as the first-line therapy for severe malaria (SM) due to its superiority in reducing mortality compared to quinine. There are limited data on long-term clinical and neurobehavioral outcomes after artemisinin use for treatment of SM. Methods From 2008 to 2013, 502 Ugandan children with two common forms of SM, cerebral malaria and severe malarial anemia, were enrolled in a prospective observational study assessing long-term neurobehavioral and cognitive outcomes following SM. Children were evaluated a week after hospital discharge, and 6, 12, and 24 months of follow-up, and returned to hospital for any illness. In this study, we evaluated the impact of artemisinin derivatives on survival, post-discharge hospital readmission or death, and neurocognitive and behavioral outcomes over 2 years of follow-up. Results 346 children received quinine and 156 received parenteral artemisinin therapy (artemether or artesunate). After adjustment for disease severity, artemisinin derivatives were associated with a 78% reduction in in-hospital mortality (adjusted odds ratio, 0.22; 95% CI, 0.07–0.67). Among cerebral malaria survivors, children treated with artemisinin derivatives also had reduced neurologic deficits at discharge (quinine, 41.7%; artemisinin derivatives, 23.7%, p=0.007). Over a 2-year follow-up, artemisinin derivatives as compared to quinine were associated with better adjusted scores (negative scores better) in internalizing behavior and executive function in children irrespective of the age at severe malaria episode. After adjusting for multiple comparisons, artemisinin derivatives were associated with better adjusted scores in behavior and executive function in children <6 years of age at severe malaria exposure following adjustment for child age, sex, socioeconomic status, enrichment in the home environment, and the incidence of hospitalizations over follow-up. Children receiving artesunate had the greatest reduction in mortality and benefit in behavioral outcomes and had reduced inflammation at 1-month follow-up compared to children treated with quinine. Conclusions Treatment of severe malaria with artemisinin derivatives, particularly artesunate, results in reduced in-hospital mortality and neurologic deficits in children of all ages, reduced inflammation following recovery, and better long-term behavioral outcomes. These findings suggest artesunate has long-term beneficial effects in children surviving severe malaria.

scholarly journals Evaluating Machine Learning and Geostatistical Methods for Spatial Gap-filling of Monthly ESA CCI Soil Moisture in China

2021 ◽  
Vol 13 (14) ◽  
pp. 2848
Author(s):  
Hao Sun ◽  
Qian Xu
Keyword(s):  
Machine Learning ◽  
Soil Moisture ◽  
Water Resource Management ◽  
Large Scale ◽  
Gap Filling ◽  
Spatial Continuity ◽  
Study Results ◽  
Data Gaps

Obtaining large-scale, long-term, and spatial continuous soil moisture (SM) data is crucial for climate change, hydrology, and water resource management, etc. ESA CCI SM is such a large-scale and long-term SM (longer than 40 years until now). However, there exist data gaps, especially for the area of China, due to the limitations in remote sensing of SM such as complex topography, human-induced radio frequency interference (RFI), and vegetation disturbances, etc. The data gaps make the CCI SM data cannot achieve spatial continuity, which entails the study of gap-filling methods. In order to develop suitable methods to fill the gaps of CCI SM in the whole area of China, we compared typical Machine Learning (ML) methods, including Random Forest method (RF), Feedforward Neural Network method (FNN), and Generalized Linear Model (GLM) with a geostatistical method, i.e., Ordinary Kriging (OK) in this study. More than 30 years of passive–active combined CCI SM from 1982 to 2018 and other biophysical variables such as Normalized Difference Vegetation Index (NDVI), precipitation, air temperature, Digital Elevation Model (DEM), soil type, and in situ SM from International Soil Moisture Network (ISMN) were utilized in this study. Results indicated that: 1) the data gap of CCI SM is frequent in China, which is found not only in cold seasons and areas but also in warm seasons and areas. The ratio of gap pixel numbers to the whole pixel numbers can be greater than 80%, and its average is around 40%. 2) ML methods can fill the gaps of CCI SM all up. Among the ML methods, RF had the best performance in fitting the relationship between CCI SM and biophysical variables. 3) Over simulated gap areas, RF had a comparable performance with OK, and they outperformed the FNN and GLM methods greatly. 4) Over in situ SM networks, RF achieved better performance than the OK method. 5) We also explored various strategies for gap-filling CCI SM. Results demonstrated that the strategy of constructing a monthly model with one RF for simulating monthly average SM and another RF for simulating monthly SM disturbance achieved the best performance. Such strategy combining with the ML method such as the RF is suggested in this study for filling the gaps of CCI SM in China.

scholarly journals Efficacy of long‐term adrenocorticotropic hormone therapy for West syndrome: A retrospective multicenter case series

2021 ◽  
Author(s):  
Shimpei Baba ◽  
Tohru Okanishi ◽  
Yoichiro Homma ◽  
Takeshi Yoshida ◽  
Tomohide Goto ◽  
...  
Keyword(s):  
Hormone Therapy ◽  
Adrenocorticotropic Hormone ◽  
Case Series ◽  
West Syndrome

scholarly journals Rationale, Design, and Methodology of a Prospective Cohort Study for Coping with Behavioral and Psychological Symptoms of Dementia: The RECage Project

2021 ◽  
Vol 80 (4) ◽  
pp. 1613-1627
Author(s):  
Eleni Poptsi ◽  
Magda Tsolaki ◽  
Sverre Bergh ◽  
Bruno Mario Cesana ◽  
Alfonso Ciccone ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psychotropic Drug ◽  
Psychological Symptoms ◽  
Cost Of Care ◽  
Community Dwelling ◽  
Drug Consumption ◽  
Study Results ◽  
Short And Long Term ◽  
Behavioral And Psychological Symptoms

Background: Behavioral and psychological symptoms of dementia (BPSD) are quite challenging problems during the dementia course. Special Care Units for people with dementia (PwD) and BPSD (SCU-B) are residential medical structures, where BPSD patients are temporarily admitted, in case of unmanageable behavioral disturbances at home. Objective: RECage (REspectful Caring for AGitated Elderly) aspires to assess the short and long-term effectiveness of SCU-Bs toward alleviating BPSD and improving the quality of life (QoL) of PwD and their caregivers. Methods: RECage is a three-year, prospective study enrolling 500 PwD. Particularly, 250 community-dwelling PwDs presenting with severe BPSD will be recruited by five clinical centers across Europe, endowed with a SCU-B, for a short period of time; a second similar group of 250 PwD will be followed by six other no-SCU-B centers solely via outpatient visits. RECage’s endpoints include short and long-term SCU-B clinical efficacy, QoL of patients and caregivers, cost-effectiveness of the SCU-B, psychotropic drug consumption, caregivers’ attitude toward dementia, and time to nursing home placement. Results: PwD admitted in SCU-Bs are expected to have diminished rates of BPSD and better QoL and their caregivers are also expected to have better QoL and improved attitude towards dementia, compared to those followed in no-SCU-Bs. Also, the cost of care and the psychotropic drug consumption are expected to be lower. Finally, PwD followed in no-SCU-Bs are expected to have earlier admission to nursing homes. Conclusion: The cohort study results will refine the SCU-B model, issuing recommendations for implementation of SCU-Bs in the countries where they are scarce or non-existent.

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