Convulsive status epilepticus management in adults and children: Report of the Working Group of the Polish Society of Epileptology

Introduction The Working Group was established at the initiative of the General Board of the Polish Society of Epileptology (PSE) to develop an expert position on the treatment of convulsive status epilepticus (SE) in adults and children in Poland. Generalized convulsive SE is the most common form and also represents the greatest threat to life, highlighting the importance of the choice of appropriate therapeutic treatment. Aim of guideline We present the therapeutic options separately for treatment during the early preclinical (>5–30min), established (30–60min), and refractory (>60min) SE phases. This division is based on time and response to AEDs, and indicates a practical approach based on pathophysiological data. Results Benzodiazepines (BZD) are the first-line drugs. In cases of ineffective first-line treatment and persistence of the seizure, the use of second-line treatment: phenytoin, valproic acid or phenobarbital is required. SE that persists after the administration of benzodiazepines and phenytoin or another second-line AED at appropriate doses is defined as refractory and drug resistant and requires treatment in the intensive care unit (ICU). EEG monitoring is essential during therapy at this stage. Anesthesia is typically continued for an initial period of 24h followed by a slow reversal and is re-established if seizures recur. Anesthesia is usually administered either to the level of the “burst suppression pattern” or to obtain the “EEG suppression” pattern. Conclusions Experts agree that close and early cooperation with a neurologist and anesthetist aiming to reduce the risk of pharmacoresistant cases is an extremely important factor in the treatment of patients with SE. This report has educational, practical and organizational aspects, outlining a standard plan for SE management in Poland that will improve therapeutic efficacy

A long-term survival of 45-year old patient with primary metastatic prostate cancer - case report

W pracy przedstawiono opis przypadku 45-letniego mężczyzny z uogólnionym pierwotnie rakiem gruczołu krokowego, u którego do chwili obecnej uzyskano ponad 4-letnie przeżycie pod wpływem stosowania różnych metod leczenia paliatywnego (hormonoterapia, radioterapia, chemioterapia, leczenie wspomagające).A long-term survival of 45-year old patient with primary metastatic prostate cancer treated with various palliative therapeutic methods (hormonotherapy, radiotherapy, chemotherapy and best supportive care) is presented

Badania nad zastosowaniem walproinianu jako leku pierwszego rzutu w padaczce ogniskowej

Celem tego międzynarodowego, otwartego badania prospektywnego było zebranie, w warunkach naturalnych, danych dotyczących skuteczności i tolerancji monoterapii z zastosowaniem kwasu walproinowego jako leku pierwszego rzutu u pacjentów z nowo lub niedawno rozpoznaną padaczką o ogniskowym początku. Pacjenci byli leczeni preparatem walproinianu sodu o spowolnionym uwalnianiu. Po 6 miesiącach oceniono kontrolę napadów i występowanie działań niepożądanych. Do badania włączono 1192 osób dorosłych i 792 dzieci. Średnia dzienna dawka kwasu walproinowego wynosiła 683 mg u dzieci i 987 mg u dorosłych. Odsetek chorych, którzy pozostali uczestnikami badania przez 6 miesięcy, wynosił 90%. Do tego czasu 77% pacjentów nie miało napadów (83,7% dzieci i 72,7% dorosłych). Objawy niepożądane, prawdopodobnie związane z terapią, wystąpiły u 10,2% chorych, prowadząc do zmiany leczenia u 1,7%. Najczęstszymi działaniami niepożądanymi były: zwiększenie masy ciała oraz objawy żołądkowo-jelitowe, neurologiczne i skórne. Walproinian sodu o spowolnionym uwalnianiu jest skuteczny i akceptowany w monoterapii pierwszego rzutu w padaczce o ogniskowym początku

The role of phytoestrogen therapy in relieving postmenopausal symptoms

Summary Side effects and contraindications connected with hormonal replacement therapy in climacterium resulted in search for new methods of softening menopausal symptoms. The aim of the following study was to evaluate, based on literature analysis, the effectiveness of phytohormonal therapy as an alternative method of relieving the symptoms of menopausal period and preventing the diseases connected with deficiency of estrogens after menopause. Phytoestrogens therapy reduces the number and strength of the vasomotor symptoms and improves serum lipid profile. Moreover, phytoestrogens show beneficial effects on bone tissue metabolism, skin and mucous membranes condition and are applicable in chemoprevention. This therapy is an effective method, allowing to avoid further changes in blood and urogenital systems, which result from estrogen stimulation deficiency. Phytoestrogens administration is an efficient method of relieving postmenopausal symptoms, facilitating the difficult menopausal period and keeping good health condition

Targeting BTK with Ibrutinib in Relapsed or Refractory Mantle-Cell Lymphoma – Results of an International, Multicenter, Phase 2 Study of Ibrutinib (PCI-32765) – EHA Encore

Bruton's tyrosine kinase (BTK) is a central mediator of B-cell receptor (BCR) signaling essential for normal B-cell development. Ibrutinib is an oral BTK inhibitor that induces apoptosis and inhibits migration and adhesion of malignant B-cells. Updated results of this international, multicenter, phase 2 study of single agent ibrutinib in relapsed or refractory MCL will be presented.Ibrutinib 560mg PO QD was administered continuously until disease progression. Tumor response was assessed every 2 cycles (one cycle=28 days). The study enrolled 115 patients (65 bortezomib-naïve, 50 bortezomib-exposed); 111 patients were treated; 110 were evaluable for response. Baseline characteristics included: median age 68 years, time since diagnosis 42 months, number of prior treatments 3; bulky disease (>10cm) 13%, prior stem cell transplant 10%, high risk MIPI 49%.Median time on treatment was 9.2 months; 53% of patients remain on therapy. Median PFS was 13.9 months and DOR has not yet been reached. Responses increased with longer treatment: comparing to previous data described at ASH 2011, the CR rate increased from 16% to 39%, and the ORR increased from 69% to 75%