Profile of once-daily zonisamide as monotherapy for treatment of partial seizures in adults.

Epilepsy is one of the most common neurologic disorders, affecting about 50 million people around the world. It is recognized that around 50% of patients with newly diagnosed epilepsy become seizure-free with the first drug treatment, so the choice of first antiepileptic drug is crucial. This paper provides a comprehensive overview of zonisamide as monotherapy for partial seizures, with special attention to the possibility of a once-daily regimen. The available data suggest that zonisamide is an effective and well tolerated option as monotherapy. Once-daily dosing is indicated, considering the long plasma half-life and linear pharmacokinetics of the drug. Zonisamide 300 mg was shown to be noninferior to carbamazepine 600 mg in terms of efficacy and safety, but even lower doses may be effective. Finally, the broad spectrum of efficacy in different seizure types, the low drug interaction potential, and the possibility of weight loss make zonisamide a preferred option in many epilepsy practices. Further data on monotherapy, especially in special populations, such as women of childbearing potential, are needed

Learning in 2030 - what will it be like?

The technologies that are mentioned in this fictional story have been developed and will be available in the next year. The intelligence required to drive the Lpod is not far away. What are now needed are the will and the strategy to attain the vision of a different future for higher education institutions

Suicidal behavior and antiepileptic drugs in epilepsy: analysis of the emerging evidence.

Two years after the warning issued by the Food and Drug Administration on an increased risk of suicide for people taking antiepileptic drugs (AEDs), a number of pharmacoepidemiologic studies have been published but the scientific community is far from definitive answers. The present paper is aimed at reviewing available evidence on the association between AEDs and suicidal behavior, discussing major variables involved such as the relationship between epilepsy, depression, and suicide and the psychotropic potential of AEDs. All studies published so far show a lack of concordance and are constrained by various methodological limitations. What seems to be established is that mood disorders represent a frequent comorbidity in epilepsy and suicide is a serious complication more frequently encountered in epilepsy rather than in the general population. Moreover, a subgroup of patients appears to be at risk of developing treatment-emergent psychiatric adverse effects of AEDs independently of the specific mechanism of action of the drug. The prior history of suicide attempt, especially preceding the onset of the epilepsy, may represent a key element explaining why what is observed is independent of the specific mechanism of the drug. In general terms, risks associated with stopping, or not even starting, AEDs in epilepsy might well be in excess of the risk of suicide in epilepsy, as deaths due to accident and epilepsy itself may predominate. Clinicians need to pay attention not only to seizure patterns when choosing the appropriate AED but also to a number of different parameters (eg, age, gender, working needs, medical comorbidities, history of psychiatric disorders, and suicidality before epilepsy onset) and not the least the mental state of the patient. Missing severe complications such as suicidal behavior or delaying its treatment may worsen the prognosis of epilepsy

Sustainability management accounting system (SMAS): towards a conceptual design for the manufacturing industry

[Abstract]: The study reported in this paper aims to identify an effective management accounting system using sustainability accounting concept for environmental and social cost measurement to add value to organizations. The motivation for undertaking this research is driven by the current practice of activity based costing (ABC), which has not identified and allocated costs of environment and social impacts to a single production activity. This has resulted in inaccuracies in cost accounting information when preparing environmental and social performance disclosures for internal management decisions, as well as external disclosures. This study therefore develops a conceptual model for a Sustainability Management Accounting System (SMAS) to improve the identification and measurement of environmental and social impact costs. A SMAS also provides sustainable organizations with a way to enhance cost allocation and analysis efficiently, thus creating more accurate cost accounting information for management decisions and reporting disclosure purposes. This paper describes preliminary work undertaken to date. Currently, it would appear that most Australian firms fail to report on their environmental performance, however, social indicators make it increasingly important for organisations to embrace corporate social reponsibility in their financial reporting and disclosure. Further, the results of quantitative data anlaysis will be used to identify an effective management accounting of sustainable organizations while supporting the development of a SMAS conceptual model

Depression in epilepsy.

PURPOSE OF REVIEW: To review some aspects of the relationship between epilepsy and depression that have recently received increasing attention and may become major research topics in the near future. RECENT FINDINGS: Epidemiological studies show that depression and suicide are, in some cases, premorbid symptoms preceding the onset of the epilepsy. Suicide is also three times more frequent in epilepsy than in the general population. Reliable screening instruments for depression and suicidality in patients with epilepsy are now available but data from real life clinical settings are needed to develop shared clinical pathways between neurology and psychiatry. Data in children with epilepsy are still limited although it is well known that, outside epilepsy, almost 50% of adult patients with mood and anxiety disorders have a previous history during childhood. Despite increasing attention to the problem, the additional stigma associated with mental health problems still represents one of the major barriers to prompt diagnosis and treatment. SUMMARY: New studies will focus on the development of shared clinical pathways between neurology and psychiatry for mood disorders and suicide prevention. New global campaigns on the double stigma will support this process in areas where psychiatric comorbidities are still underdiagnosed and undertreated

Cross-cultural impact on the budgeting cycle: a preliminary analysis of Anglo-American and Libyan companies operating in Libyan oil sector

[Abstract]: Globalization is causing the rapid integration of markets, nations, and technology, which facilitates faster contact between people, corporations, and nations. However, there is a failure to notice cultural differences that exist between workforces across nations. Thus all staff needs to have cultural sensitivity, which could be helped by studying cross-cultural differences. Current understanding of how and why specific budget aspects and budgeting processes are different could be attributed to cultural differences. This study utilizes societal cultural dimensions identified by Hofstede to identify differences in budgets and budgeting process between Libyan and Anglo-American companies operating in Libyan oil sector. Some preliminary analysis is discussed

Investigational new drugs for focal epilepsy.

For more than 30 years, antiepileptic drug development has been based on specific assumptions regarding the neurobiology of epilepsy but all marketed drugs have not changed the proportion of drug refractory patients. It is, therefore, evident that new molecular targets need to be identified. Advances in neurobiology and molecular pharmacology are bringing into the epilepsy field new neurochemical functions such as those modulated by cannabinoid, serotonin, melatonin and galanin receptors. Among all the different compounds, the melatonin type 3 receptor agonist beprodone and cannabidiol are those at the more advanced stage of development. Interestingly, despite the structural analogies with tetrahydrocannabinol, the anticonvulsant activity of cannabidiol is not mediated by an interaction with cannabinoid receptors. Neurosteroids represent another remarkable class of drugs, and among them, ganaxolone is at the most advanced stage of development. Furthermore, for the first time, potential disease-modifying agents and techniques are entering the epilepsy market. Rapalogues such as everolimus and the antibiotic minocycline are currently under development for specific epileptic syndromes like tuberous sclerosis or Angelman syndrome. Finally, optogenetics, though still at an early stage of development, represents a futuristic therapeutic strategy for drug-refractory epilepsy

Epilepsy in Dante's poetry.

Dante Alighieri is the greatest Italian poet and one of the most important writers in Western literature. He is best known for the epic poem "Commedia", later named "La Divina Commedia" that has profoundly influenced not only poetic imagination but also all subsequent allegorical creations of imaginary worlds in literature. This paper examines the poetic description of some episodes of loss of consciousness in Dante's poetry discussing how and why typical elements of epileptic seizures have been used. On the 750th anniversary of Dante's birth, his poetry still remains to be an inspiring source of debate and reflection. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity"

Third Generation Antiepileptic Drug Monotherapies In Adults With Epilepsy.

INTRODUCTION: Drugs marketed during the last few years (i.e. Lacosamide, Ruifinamide, Eslicarbazepine acetate, Brivaracetam and Perampanel) are increasingly regarded as third generation AEDs. This paper presents available data about monotherapy with third generation drugs and on-going clinical trials with special attention to the existing debate about monotherapy license in epilepsy. AREAS COVERED: References were identified by searches of Medline/PubMed. In addition, currently active studies for these AEDs were identified in the ClinicalTrials.gov database. Expert commentary: Results of studies on Eslicarbazepine acetate and Lacosamide clearly suggest good efficacy and tolerability. The selective pharmacological profile, the lack of interactions, the good tolerability with low propensity for cognitive side effects and the availability of different pharmacological formulations represent evident advantages. Although third generation monotherapies are quite promising, long-term safety data is needed in order to understand how these compounds will place in the current armamentarium