Seizure control in patients with epilepsy: the physician vs. medication factors

<p>Abstract</p> <p>Background</p> <p>Little is known about the relationship between types of healthcare providers and outcomes in patients with epilepsy. This study compares the relative effects of provider type (epileptologist vs. other neurologist) and pharmacologic treatment (newer vs. older antiepileptic drugs) on seizure control in patients with epilepsy.</p> <p>Methods</p> <p>We conducted a retrospective study of patients with medication-resistant epilepsy. Consecutive charts of 200 patients were abstracted using a standard case report form. For each patient, data included seizure frequency and medication use prior to, and while being treated by an epileptologist. Changes in seizure frequency were modeled using a generalized linear model.</p> <p>Results</p> <p>After transferring care from a general neurologist to specialized epilepsy center, patients experienced fewer seizures (p < 0.001) and were more frequently seizure-free (p < 0.001). The improved seizure control was not related to treatment with newer vs. older antiepileptic drugs (p = 0.305).</p> <p>Conclusion</p> <p>Our findings suggest an association between subspecialty epilepsy care and improved seizure control in patients with medication-resistant epilepsy. Further research should prospectively determine whether patients with medication-resistant epilepsy would benefit from being routinely referred to an epilepsy specialist.</p

Different Effects of Vitamin C-Based Supplements on the Advance of Linseed Oil Component Oxidation and Lipolysis during In Vitro Gastrointestinal Digestion

Although widely consumed, dietary supplements based on Vitamin C contain high doses of this compound, whose impact on lipid oxidation during digestion needs to be addressed. Therefore, the effect of seven commercial supplements and of pure l-ascorbic acid and ascorbyl palmitate on linseed oil during in vitro gastrointestinal digestion was tackled. The advance of lipid oxidation was studied through the generation of oxidation compounds, the degradation of polyunsaturated fatty acyl chains and of gamma-tocopherol, by employing Proton Nuclear Magnetic Resonance. Supplements containing exclusively l-ascorbic acid enhanced the advance of linseed oil oxidation during digestion. This was evidenced by increased formation of linolenic-derived conjugated hydroxy-dienes and alkanals and by the generation of conjugated keto-dienes and reactive alpha,beta-unsaturated aldehydes, such as 4,5-epoxy-2-alkenals; moreover, gamma-tocopherol was completely degraded. Conversely, supplements composed of mixtures of ascorbic acid/salt with citric acid and carotenes, and of ascorbyl palmitate, protected linseed oil against oxidation and reduced gamma-tocopherol degradation. The study through Solid Phase Microextraction-Gas Chromatography/Mass Spectrometry of the volatile compounds of the digests corroborated these findings. Furthermore, a decreased lipid bioaccessibility was noticed in the presence of the highest dose of l-ascorbic acid. Both the chemical form of Vitamin C and the presence of other ingredients in dietary supplements have shown to be of great relevance regarding oxidation and hydrolysis reactions occurring during lipid digestion

Oxidative stability, volatile components and polycyclic aromatic hydrocarbons of cold-smoked sardine (Sardina pilchardus) and dolphinfish (Coryphaena hippurus)

Although a wide variety of compounds are deposited during the smoking process, much more attention has been given to phenols and polycyclic aromatic hydrocarbons (PAHs). However, even though phenols have an important role to play as food antioxidants, some PAHs have cytotoxic and mutagenic effects. In the present work, two fish species differing in composition (dolphinfish (Coryphaena hippurus) and sardine (Sardina pilchardus)) were salted and cold-smoked. Two different smoking treatments were selected in order to compare phenol content and muscle antioxidant activity employing the ferric reducing power (FRAP) method. Both smoking treatments increased fish lipid oxidation stability compared with the salted muscle. The characterization of the volatile components of the headspace of the more intensely processed smoked products was carried out by SPME/GC/MS, which revealed the presence of typical phenol and carbonyl derivatives, as well as some oxidation products and PAHs of low molecular weight. PAH composition was further investigated by extracting and identifying the PAHs by GC/MS. Neither benzo(a)pyerene nor other high molecular weight PAHs were detected, naphthalene and its derivatives being the most abundant compounds in the smoked products. © 2011 Elsevier Ltd.Peer Reviewe

Applying lean thinking concepts to new product development

Lean Thinking can be introduced in the enterprise to ensure an optimal transformation to a lean environment. There is a need in European manufacturing companies of a new model that implies a further stage of lean manufacturing. This paper outlines the first results of a current European project (LeanPPD-Lean Product and Process Development) which aims to develop a new paradigm with its associate methodology and tools based on applying lean thinking concepts in Product Design and Development field. To tackle this objective, a new model will be developed which consider entire product life cycle, providing knowledge based user-centric design and development environment to support value creation to the customers in terms of innovation and customisation, quality as well as sustainable and affordable products. Several of the scientific and technical objectives settled have already met. This paper constitutes a whole explanation of the LeanPPD model proposed by the project consortium and outlines its four main building blocks providing better understanding on how the project addresses these objectives