138 research outputs found
INTELLECTUAL FUNCTIONS OF PATIENTS WITH CHILDHOOD-ONSET EPILEPSY
The intellectual functions of 64 epileptic patients who had had an initial evaluation between five and 16 years of age, including the WISC, were re-evaluated after a period of at least five years. In general the seizure states had improved, and 50 per cent were in remission for between two and eight years. All but four were still taking at least one anticonvulsant drug. WISC IQ estimates showed a slight decrease. Verbal and performance areas could be differentially affected, and a gain in one could be offset by a loss in the other, so the Full-scale IQ might not be a reliable measure of day-to-day performance. Those whose seizures remained uncontrolled had a statistically significant decrease in performance IQ, whereas in general it was stable or increased for patients in remission. There was evidence that decreased IQ indicated slower mental growth rather than loss of previously acquired function. Phenobarbital but not phenytoin levels were inversely correlated with IQ, suggesting that the upper limit of the âtherapeutic rangeâ of phenobarbital may already be toxic with regard to learning abilities. To optimize an epileptic child's functioning in school and to prevent long-term intellectual problems, it is advisable that IQ testing should be part of the routine initial evaluation, and that drug levels should be checked at regular intervals. RĂSUMĂ Les fonctions intellectuelles de 64 Ăpileptiques dont I'intelligence avait ĂtĂĂvaluĂe entre cinq et 16 ans, notamment par le WISC, ont ĂtĂ remesurĂes aprĂs une pĂriode d'au moins cinq ans. En gĂnĂral IâĂtat des crises sâĂtait amĂliorĂ et 50 pour cent des sujets Ătaient en rĂmission pour des pĂriodes allant de deux Ă huit ans. Tous les sujets sauf quatre prenaient encore une mĂdication anticomitiale. Les QI au WISC montraient une lĂgĂre perte. Les Ăchelles verbale et performance pouvaient Ătre modifiĂes de faĂon diffĂrente et un gain dans l'une des Ăchelles pouvait Ătre compensĂ par une perte dans I'autre, si bien que la pleine Ăchelle de QI pourrait ne pas Ătre une mesure fiable des performances journaliĂres. Les sujets dont les crises demeuraient non contrĂlĂes prĂsentaient une baisse statistiquement significative Ă lâĂchelle de performance, alors que cette Ăchelle Ătait en gĂnĂral stable ou en gain pour les sujets en rĂmission. Des signes indiquaient que la baisse de QI Ătait davantage liĂe Ă un ralentissement de la croissance mentale quâĂ une perte des fonctions antĂrieurement acquises. Les taux de phĂnobarbital mais non de phĂnytoine Ătaient inversement corrĂlĂs au QI, suggĂrant que la limite supĂrieure de âlâĂtendue thĂrapeutiqueâ du phĂnobarbital peut dĂjĂĂtre toxique en ce qui concerne les aptitudes d'apprentissage. Pour optimiser I'activitĂ scolaire d'un enfant Ăpileptique et pour prĂvenir des problĂmes intellectuels Ă long terme, il est souhaitable que des mesures de QI fassent partie des Ăvaluations initiales de routine et que les taux de mĂdication soient contrĂlĂs Ă intervalles rĂguliers. ZUSAMMENFASSUNG 64 Patienten mit Epilepsie, die zwischen fĂnf und 16 Jahren erstmals untersucht und beurteiltâ einschlieĂlich WISCâworden waren, wurden nach mindestens fĂnf Jahren nachuntersucht. Im allgemeinen hatte sich das Anfallsleiden gebessert und 50 Prozent waren seit zwei bis acht Jahren in der Remission. Alle, auĂer vier Patienten, nahmen noch mindestens ein Antikonvulsivum. WISC IQ-SchĂtzungen zeigten eine leichte Verschlechterung. Verbale-und Leistungs- Bereiche konnten unterschiedlich betroffen sein und eine Verbesserung in einem Bereich konnte durch eine Verschlechterung in dem anderen relativiert werden, so ist der Gesamt-IQ nicht unbedingt ein verlĂĂliches MaĂ fĂr die tĂgliche Leistung. Die Patienten mit unkontrolliertem Anfallsleiden zeigten eine statistisch signifikante Verschlechterung des Leistungs-IQ, wĂhrend er bei Patienten in der Remission im allgemeinen stabil war oder besser wurde. Es fanden sich Hinweise dafĂr, daĂ ein abfallender IQ eine verlangsamte geistige Entwicklung anzeigte und nicht einen Verlust von zuvor erworbenen Funktionen. Phenobarbital, jedoch nicht Phenytoinspiegel korrelierten umgekehrt mit dem IQ, was vermuten lĂĂt, daĂ der obere therapeutische Bereich von Phenobarbital schon im Hinblick auf die LernfĂhigkeit toxisch sein kann. Um die Schulleistungen eines Kindes mit Epilepsie zu verbessern und um spĂtere intellektuelle Probleme zu vermeiden, ist es ratsam, IQ-Testungen als Teil der routinemĂĂigen Erstbeurteilung durchzufĂhren und in regelmĂĂigen AbstĂnden Medikamentenspiegel zu kontrollieren. RESUMEN Las funciones intelectuales de 64 pacientes epilĂpticos que habian pasado una primera evaluaciĂn entre los cinco y los 16 aĂos de edad, incluyendo el WISC, fueron reevaluados despuĂs de un periodo de al menos cinco aĂos. En general la incidencia de ataques habĂa mejorado y el 50 por ciento se hallaban en remisiĂn de dos a ocho aĂos. Todos excepto cuatro tomaban todavia un fĂrmaco anticomicial El CI en el WISC mostraba un ligero descenso. Las Ăreas verbales y de manipulaciĂn podĂan afectase diferentemente, de forma que la mejorĂa en un campo podĂa ser desvirtuada por un descenso en el otro, por lo que la escala global de CI podĂa no ser una mediciĂn fidedigna de la realizaciĂn dia a dia. Aquellos cuyas convulsiones permanecĂan sin control tenĂan una disminuciĂn estadisticamente significativa en el CI manipulativo, mientras que en general permanecĂa estable o aumentaba en los pacientes en remisiĂn. Esto evidencia que el descenso en el CI indicaba un crecimiento mental mĂs lento, mĂs bien que una pĂrdida de una funciĂn previamente conseguida. Los niveles de fenobarbital, pero no los de fenitoina, estaban en correlaciĂn inversa con el CI, lo que sugiere que el lĂmite superior del margen terapĂutico del fenobarbital puede ya ser tĂxico con respecto a las capacidades de aprendizaje. Para optimizar el que un niĂo epilĂptico vaya bien en la escuela y para prevenir problemas intelectuales a largo plazo, se aconseja que la mediciĂn del CI forme parte de la rutina de exploraciĂn inicial y que la determinaciĂn de los nivele < refs en sangre de los fĂrmacos se haga a intervalos regulares.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65523/1/j.1469-8749.1986.tb03826.x.pd
ATMOS Spacelab 1 science investigation
Existing infrared spectra from high speed interferometer balloon flights were analyzed and experimental analysis techniques applicable to similar data from the ATMOS experiment (Spacelab 3) were investigated. Specific techniques under investigation included line-by-line simulation of the spectra to aid in the identification of absorbing gases, simultaneous retrieval of pressure and temperature profiles using carefully chosen pairs of CO2 absorption lines, and the use of these pressures and temperatures in the retrieval of gas concentration profiles for many absorbing species. A search for a new absorption features was also carried out, and special attention was given to identification of absorbing gases in spectral bandpass regions to be measured by the halogen occultation experiment
Phase II Trial of IL-12 Plasmid Transfection and PD-1 Blockade in Immunologically Quiescent Melanoma.
PurposeTumors with low frequencies of checkpoint positive tumor-infiltrating lymphocytes (cpTIL) have a low likelihood of response to PD-1 blockade. We conducted a prospective multicenter phase II trial of intratumoral plasmid IL-12 (tavokinogene telseplasmid; "tavo") electroporation combined with pembrolizumab in patients with advanced melanoma with low frequencies of checkpoint positive cytotoxic lymphocytes (cpCTL).Patients and methodsTavo was administered intratumorally days 1, 5, and 8 every 6 weeks while pembrolizumab (200 mg, i.v.) was administered every 3 weeks. The primary endpoint was objective response rate (ORR) by RECIST, secondary endpoints included duration of response, overall survival and progression-free survival. Toxicity was evaluated by the CTCAE v4. Extensive correlative analysis was done.ResultsThe combination of tavo and pembrolizumab was well tolerated with adverse events similar to those previously reported with pembrolizumab alone. Patients had a 41% ORR (n = 22, RECIST 1.1) with 36% complete responses. Correlative analysis showed that the combination enhanced immune infiltration and sustained the IL-12/IFNÎł feed-forward cycle, driving intratumoral cross-presenting dendritic cell subsets with increased TILs, emerging T cell receptor clones and, ultimately, systemic cellular immune responses.ConclusionsThe combination of tavo and pembrolizumab was associated with a higher than expected response rate in this poorly immunogenic population. No new or unexpected toxicities were observed. Correlative analysis showed T cell infiltration with enhanced immunity paralleling the clinical activity in low cpCTL tumors
The Marketing Firm: Retailer and consumer contingencies
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The Earth: Plasma Sources, Losses, and Transport Processes
This paper reviews the state of knowledge concerning the source of magnetospheric plasma at Earth. Source of plasma, its acceleration and transport throughout the system, its consequences on system dynamics, and its loss are all discussed. Both observational and modeling advances since the last time this subject was covered in detail (Hultqvist et al., Magnetospheric Plasma Sources and Losses, 1999) are addressed
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