scholarly journals Resolved epilepsy: an updated insight

2019 ◽  
Vol 11 (1) ◽  
pp. 21-26
Author(s):  
S. A. Gromov ◽  
N. A. Sivakova
Keyword(s):  
Medical Care ◽  
Antiepileptic Drugs ◽  
Epileptic Activity ◽  
New Classification ◽  
Antiepileptic System ◽  
Study Support ◽  
Patients With Epilepsy ◽  
Prolonged Absence

Classification of epilepsy is of great importance at the stages of rehabilitation when the disease is considered resolved. This is the time to address various aspects of etiology, pathogenesis, compensation and resolution of epilepsy and to decide upon further medical care. Materials and methods. Here we review clinical-neurophysiological, experimentalpsychological, and neuroimaging results of anti-epileptic treatment and its discontinuation in seizure-free patients. We also discuss the adoption of the new international classification of ILAE 2017 in the domestic epileptology and analyze clinical cases of 270 patients with epilepsy who were in control of seizures for up to 8 years. Results. The study revealed the clinical, neuropsychological and neurophysiological signs of epilepsy regression in patients with long-term control of seizures. In 85% of these patients, seizures were under control; in 45% of them, the issue of “resolution of epilepsy” was a matter of discussion. In this regard, we address the timing and indications for the discontinuation of antiepileptic drugs. Conclusion. The prolonged absence of seizures is due to an inhibition of epileptic activity at the neuronal level with a gradual restoration of the antiepileptic system during 3-5 years of seizure-free period; this mechanism is reflected in the new classification. The data obtained in the present study support the decision of the Russian League against Epilepsy to introduce the new classification of epilepsy proposed by ILAE in 2017. The new term “resolved epilepsy” has been adopted for use in patients previously referred to as “practically recovered”.

Long-term effectiveness and safety of antiepileptic drugs in children and adults

2021 ◽  
Vol 19 (2) ◽  
pp. 221-228
Author(s):  
Roza M. Shaimardanova ◽  
Rimma G. Gamirova
Keyword(s):  
Valproic Acid ◽  
Antiepileptic Drugs ◽  
Focal Epilepsy ◽  
City Hospital ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Long Term Observation ◽  
Patients With Epilepsy

AIM: To conduct a retrospective comparative analysis of the efficacy and safety of epilepsy therapy with antiepileptic drugs. MATERIALS AND METHODS: The analysis of the treatment of 428 patients with epilepsy at the Childrens City Hospital No. 8 in Kazan, receiving antiepileptic drugs. RESULTS: It was found that valproic acid is more effective in the treatment of idiopathic generalized epilepsies compared to focal epilepsies (p = 0.0006). Valproate and carbamazepine were the most effective in the treatment of focal epilepsy with short- and long-term follow-up. Valproic acid is more effective than topiramate (p = 0.02), oxcarbazepine (p = 0.003), and levetiracetam (p = 0.003) in the treatment of focal epilepsy in short- and long-term follow-up. Carbamazepine is more effective than topiramate (p = 0.01), oxcarbazepine (p = 0.02), and levetiracetam (p = 0.001) in the treatment of focal epilepsy in long-term follow-up. It was revealed that more often they complained about side effects when using carbamazepine (63.2%). Levetiracetam was found to be better tolerated compared to valproate (p = 0.0006) and carbamazepine (p = 0.0006). Topiramate is better tolerated than carbamazepine (p = 0.02) and valproate (p = 0.03). Oxcarbazepine is better tolerated than carbamazepine in women (p = 0.04). CONCLUSIONS: When choosing an antiepileptic drug, it is necessary to be guided by the principle: first the basic, and then the drugs of the next generations, in the future, rely on information about the tolerability of the drug. It is necessary to evaluate the therapeutic effect of antiepileptic drugs with long-term observation, and use the criterion of complete absence of seizures as an indicator of the effectiveness of drugs.

Paraphimosis revisited: is chronic paraphimosis a predominantly third world condition?

2008 ◽  
Vol 38 (1) ◽  
pp. 40-42 ◽  
Author(s):  
M Rangarajan ◽  
S M Jayakar
Keyword(s):  
Chronic Condition ◽  
Third World ◽  
New Classification ◽  
The Third ◽  
Long Term Follow Up ◽  
Initial Injury ◽  
Acute Condition

Paraphimosis is an acute condition characterized by all the signs of inflammation. Here we describe a ‘chronic’ variant of paraphimosis where patients often present many days after the initial injury. The aim of this study is to identify and possibly classify this new variation of paraphimosis – the chronic condition. We studied 68 patients with this condition between 1997 and 2005. In all, the prepuce was fibrous and bunched up behind the glans penis and, in some cases, with ulcerations. All patients were treated by excision of the fibrous flap and circumcision, under local anaesthesia. Patients were discharged on the same dayon which the excision was done. Follow-up was on the third, seventh and ninetieth days. Long-term follow-up was possible in only 22 patients. This technique of modified circumcision was effective in treating this condition and we think a new classification of paraphimosis is warranted – acute and chronic.

scholarly journals Transient Edematous Lesions of the Splenium in Epileptic Patients

2005 ◽  
Vol 32 (3) ◽  
pp. 352-355 ◽  
Author(s):  
Giovanna Carrara ◽  
Edoardo Ferlazzo ◽  
Donatella Tampieri ◽  
Frederick Andermann ◽  
Denis Melanson
Keyword(s):  
Antiepileptic Drugs ◽  
Case Reports ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
High Signal ◽  
Focal Lesions ◽  
Epileptic Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Patients With Epilepsy

ABSTRACT:Background:Transient focal lesions in the splenium of the corpus callosum (SCC) have been previously described in patients with epilepsy or without epilepsy but receiving antiepileptic drugs (AED).Case reports:Two epileptic patients were admitted to our long-term monitoring unit. Antiepileptic drugs were completely discontinued a few days later. One patient had no seizures. The other had three attacks, the last of which occurred two days before a brain magnetic resonance imaging (MRI) was performed. In both cases brain MRI showed a lesion in the SCC characterized by high signal on T2-weighted images and no enhancement after Gadolinium infusion. The patients were discharged with their pre-admission medications. A follow-up MRI five weeks later showed resolution of the SCC lesions.Conclusions:The pathogenesis of transient SCC lesions in epileptic patients is still unclear. In our patients, either the sudden AED withdrawal or the seizures activity may be presumed to be the cause, though an individual susceptibility must also be considered.

scholarly journals CLASSIFICATION OF FINANCIAL MECHANISMS OF HEALTHCARE SYSTEMS IN THE COUNTRIES OF EUROPEAN UNION

2020 ◽  
Author(s):  
Nadiya Dubrovina ◽  
◽  
Stanislav Filip ◽  
Vira Dubrovina ◽  
◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Healthcare System ◽  
Quantitative Methods ◽  
System Analysis ◽  
Healthcare Systems ◽  
New Classification ◽  
Eu Countries ◽  
The Eu

In the article the problems of the classification of financial mechanisms of healthcare systems were considered. The well-known types of the financial mechanisms of healthcare systems were described and the authors argued the importance of the development of new classification of financial mechanism of healthcare systems in the EU, which will be based on the application of quantitative methods. The purpose of the research is cluster (or regimes of funding healthcare system) analysis and development for EU countries over long-term period of 2000-2017.The authors used k-means method for the cluster analysis and revealed 5 clusters (groups) for the characteristics of the different regimes of funding healthcare system in the EU countries.

The development of geophysical maps’new classification

2017 ◽  
Vol 923 (5) ◽  
pp. 26-33
Author(s):  
D.S. Loginov ◽  
S.A. Krylov
Keyword(s):  
Geological Mapping ◽  
Natural Phenomena ◽  
New Classification ◽  
New Approaches ◽  
Current State ◽  
The Common ◽  
Definition Of ◽  
Geophysical Mapping

At the present time, the common classification of geophysical maps is missing, which is a consequence of their long-term development of the geological mapping. The features of existing approaches to the definition of geophysical maps’ place among maps of natural phenomena and the limitations of existing lists of mapping themes were determined and identified in this article. New approaches to the classification of geophysical maps that take into account the completeness of their contents and the current state of geophysical mapping were offered. A new classification of geophysical maps was elaborated based on four criteria

Aesthetic Hand Prosthesis: Gadget or Therapy? Presentation of a New Classification

2001 ◽  
Vol 26 (6) ◽  
pp. 523-528 ◽  
Author(s):  
J. PILLET ◽  
A. DIDIERJEAN-PILLET
Keyword(s):  
Functional Role ◽  
Social Function ◽  
New Classification ◽  
Prosthesis Fitting ◽  
Follow Up Care ◽  
Continued Use ◽  
Therapeutic Tools

Aesthetic prostheses must fulfill a functional as well as an aesthetic role. The function of these prostheses may be perceived as an additional passive support, or as an instrument of social function and an aid to the patient. This functional role has been observed in the continued use of these prostheses over several years. We reviewed our experience with prescription, fitting and follow-up care in 2847 patients. Classification of these patients was based on their age, level of amputation (with or without functional pinch) and cause of amputation. Analysis of the data ratifies our indications for prosthesis fitting. The long-term wearing of these aesthetic prostheses confirms their use as therapeutic tools.

Epilepsy and psychosis: a practical approach

2017 ◽  
Vol 18 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Melissa Maguire ◽  
Jasvinder Singh ◽  
Anthony Marson
Keyword(s):  
Antiepileptic Drugs ◽  
Clinical Features ◽  
Temporal Relationship ◽  
Antipsychotic Drugs ◽  
Stepwise Approach ◽  
Best Management ◽  
Appropriate Care ◽  
Antiepileptic Medications ◽  
Patients With Epilepsy

The psychoses of epilepsy can be classified according to their temporal relationship with seizures, namely as ictal, postictal and interictal psychosis. Interictal psychosis is the most common and may resemble schizophrenia. They can be challenging to diagnose and to manage, especially given the perception that some antipsychotic drugs may exacerbate seizures, while some antiepileptic medications may worsen psychosis. The current uncertainty around their best management means that some patients may not receive appropriate care. We propose a practical stepwise approach to managing psychosis in patients with epilepsy, summarising the key clinical features. We provide a framework for diagnosis, investigation and management of psychosis in the acute and long term. We also summarise the available evidence on the risk of psychosis with current antiepileptic drugs and the risk of seizures with antipsychotic drugs.

scholarly journals A proposal for a new classification of complications in craniosynostosis surgery

2017 ◽  
Vol 19 (6) ◽  
pp. 675-683 ◽  
Author(s):  
Dmitri Shastin ◽  
Sharron Peacock ◽  
Velu Guruswamy ◽  
Melpo Kapetanstrataki ◽  
David T. Bonthron ◽  
...  
Keyword(s):  
Medical Records ◽  
Complication Rates ◽  
New Classification ◽  
Unexpected Event ◽  
Prospective Data ◽  
Near Misses ◽  
Quality Improvement Tool

OBJECTIVEComplications have been used extensively to facilitate evaluation of craniosynostosis practice. However, description of complications tends to be nonstandardized, making comparison difficult. The authors propose a new pragmatic classification of complications that relies on prospective data collection, is geared to capture significant morbidity as well as any “near misses” in a systematic fashion, and can be used as a quality improvement tool.METHODSData on complications for all patients undergoing surgery for nonsyndromic craniosynostosis between 2010 and 2015 were collected from a prospective craniofacial audit database maintained at the authors' institution. Information on comorbidities, details of surgery, and follow-up was extracted from medical records, anesthetic and operation charts, and electronic databases. Complications were defined as any unexpected event that resulted or could have resulted in a temporary or permanent damage to the child.RESULTSA total of 108 operations for the treatment of nonsyndromic craniosynostosis were performed in 103 patients during the 5-year study period. Complications were divided into 6 types: 0) perioperative occurrences; 1) inpatient complications; 2) outpatient complications not requiring readmission; 3) complications requiring readmission; 4) unexpected long-term deficit; and 5) mortality. These types were further subdivided according to the length of stay and time after discharge. The overall complication rate was found to be 35.9%.CONCLUSIONSThe proportion of children with some sort of complication using the proposed definition was much higher than commonly reported, predominantly due to the inclusion of problems often dismissed as minor. The authors believe that these complications should be included in determining complication rates, as they will cause distress to families and may point to potential areas for improving a surgical service.

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