Мирон Кордуба і Микола Андрусяк: до історії взаємин

У статті проаналізовано взаємини українських істориків М. Кордуби та М. Андрусяка, зокрема висвітлено їхні особисті та творчі контакти. Також подано погляди учених на проблеми розвитку української науки, діяльність НТШ та національне книговидання тощо. Охарактеризовано взаємне листування вчених. У додатку до статті вміщено епістолярій М. Кордуби та М. Андрусяка.В статье проанализированы взаимоотношения украинских историков М. Кордубы и Н. Андрусяка, представлены их взгляды на развитие украинской науки, национальное книгоиздание, деятельность Научного общества имени Шевченко во Львове. Охарактеризовано переписку ученых. В приложении к статье помещены письма М. Кордубы и Н. Андрусяка.The article analyzes relationships of the Ukrainian historians M.Korduba and M.Andrusyak, in particular it highlights their personal and professional contacts. Also, the views of scientists on the problems of the Ukrainian science development, activities of Shevchenko Scientific Society and the national book publishing, etc. are given. The correspondence of two scientists is characterized. Correspondence of M. Korduba and M. Andrusiak is given in the appendix to the article

Catalan Abstracts

OBJECTIVE: This retrospective study addresses the cost-effectiveness of add-on therapy with lamotrigine in clinical practice. METHODS: Two years' observational data of 165 patients were used. Seizure frequency, adverse effects and direct medical costs were recorded for the year before and the year after the start of lamotrigine add-on therapy. Therapy effectiveness was measured by: (1) reduction in seizure frequency and (2) retention time. The incremental cost-effectiveness ratio expressed the direct medical cost per patient treated effectively with lamotrigine. RESULTS: The cost of medication was 492 (95% CI: 399-583) higher after the start of lamotrigine therapy. The extra cost of lamotrigine therapy (622) was partly offset by a reduction of the cost of co-medication (-130; 95% CI: -210 to -50). Overall, the total medical cost was 453 higher in the first year of lamotrigine therapy than in the year before the start of lamotrigine. Lamotrigine was effective in 47% of all the patients, making the resultant incremental cost-effectiveness ratio 954 per year. DISCUSSION: Add-on therapy of lamotrigine for patients with uncontrolled epilepsy offers improved health outcomes. Lamotrigine therapy is associated with increased cost (453) and an annual incremental cost-effectiveness ratio of 954. These data, together with utility data published in the literature, support the notion that lamotrigine should be considered as an add-on therapy in for patients with refractory epilepsy

Overtreatment in adults with epilepsy.

Item does not contain fulltextOvertreatment of epilepsy patients is traditionally associated with the use of polytherapy, i.e. use of more than one antiepileptic drug (AED). Although monotherapy is now being used in 70% of patients with epilepsy, these patients are also at risk at being overtreated. Ten to 20% of patients withdraw from their first drug because of adverse effects. This is partly related to high starting dosages and fast titration rates. The conventional AEDs are still first choice monotherapy drugs, although they potentially have more adverse effects, especially in the elderly. Other problems are the random selection of second or third choice drugs and the uncertainty about when to switch to polytherapy. Several authors have suggested that patients with progressive forms of epilepsy, such as patients with mesiotemporal sclerosis, should be treated adequately as soon as possible and that epilepsy surgery should be considered for them in a much earlier stage. Overtreatment in polytherapy is still a large threat, due to several reasons: drug loads are much higher, and thus more adverse effects are likely to develop; drug combinations are selected randomly, as evidence about effective combinations has been scarce; the constant choice between continuing the existing treatment (which is suboptimal) and trying new drugs (which may disturb a patient's equilibrium); the long-term use of benzodiazepines

Monotherapy versus Polytherapy in Epilepsy. Experimental and Clinical Studies.

Item does not contain fulltextKatholieke Universiteit Nijmegen, 3 november 2000Promotores : Meinardi, H., Hekster, Y.A., Renier, W.O. Co-promotor : Keyser, A.J.M.192 p

Place of polytherapy in the early treatment of epilepsy.

Item does not contain fulltextPolytherapy with antiepileptic drugs is not popular mainly because it is thought to be associated with more adverse effects and to contribute relatively little in terms of efficacy compared with monotherapy. However, there are two reasons to question this assumption: certain combinations are more effective than others and, therefore, generalisations about the poor effectiveness of polytherapy cannot be made; and the total drug load, i.e. the total amount of drug exposure for a certain indication, is usually higher in polytherapy, which may explain the higher toxicity seen during such treatment. In this article, the available literature on the effectiveness of first-line monotherapy, alternative monotherapy and second-line polytherapy is reviewed. There is no conclusive evidence in favour for choosing either alternative monotherapy or polytherapy when first-line monotherapy fails. Therefore, a pragmatic approach is recommended until an evidence-based choice can be made

Long-term treatment retention with topiramate.

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Drug load in clinical trials: a neglected factor

Contains fulltext : 25681___.PDF (publisher's version ) (Open Access

Reappraisal of polytherapy in epilepsy : a critical review of drug load and adverse effects

Contains fulltext : 24762___.PDF (publisher's version ) (Open Access