Hematological Side Effects of Valproate Used for the Treatment of Epilepsy

Aim:Valproate is a commonly used antiepileptic drug with hematologic and non-hematologic side effects at therapeutic doses. The aim of this study was to investigate the relationship between the known hematological side effects of valproate and duration, dose and serum levels of this drug.Materials and Methods:The study population consisted of patients with epilepsy followed by pediatric neurology outpatient clinic, who had been using valproate for at least 3 months. Duration of treatment, valproate doses, hemogram and serum valproate levels of patients were recorded from their files. Patients with other systemic and/or hematological diseases and those who were taking drugs other than valproate were not included in the study.Results:Serum valproate levels and complete blood count results were obtained in 80 of 112 patients who met the criteria. Thirty of them (37.5%) were female. The mean age was 8.2±4.8 years (1-16 years) and the mean duration of treatment was 19.93±16.4 months (3 months-10 years). Valproate use dose ranged from 20 to 60 mg/kg day. At least one hematologic side effect was detected in 34 (42%) patients. These side effects were macrocytosis (18.7%), thrombocytopenia (17.5%), leukopenia (12.5%) and anemia (7.5%). There was no correlation between thrombocytopenia and valproate using time, but a significant correlation was found between dose and serum levels. There was a relationship between macrocytosis and serum valproate level only. No correlation was found between leukopenia and anemia and duration of treatment, dose and serum levels.Conclusion:Hematological side effects of valproate used in the treatment of epilepsy are not uncommon, and these side effects are unpredictable. Therefore, it was concluded that complete blood counts should be sufficient in the follow-up of the patients and families should be informed about the side effects

Epilepsi Tedavisinde Kullanılan Valproatın Hematolojik Yan Etkileri

Amaç: Valproat yaygın olarak kullanılan, tedavi dozlarında hematolojik ve hematolojik olmayan yan etkilere sahip antiepileptik bir ilaçtır. Bu çalışmada; tedavi dozunda kullanılan valproatın bilinen hematolojik yan etkilerinin (trombositopeni, lökopeni, anemi, makrositoz) ilaç kullanım süresi, dozu ve serum seviyesi ile ilişkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Çocuk nöroloji polikliniği tarafından epilepsi tanısı ile takip edilen ve en az 3 aydır valproat kullanmakta olan hastalar çalışmaevrenini oluşturmuştur. Hastaların tedavi alma süreleri, kullandıkları valproat dozları, tam kan sayımı ve serum valproat düzeyleri dosyalarından kaydedilmiştir. Valproat dışında ilaç kullanan, başka bir sistemik ve/veya hematolojik hastalığı olan hastalar çalışmaya dahil edilmemiştir.Bulgular: Çalışma kriterlerini karşılayan 112 hastadan 80’inin serum valproat düzeyi ve hemogram sonuçlarına ulaşılabildi. Hastaların 30’u (%37,5) kız idi. Yaş ortalamaları 8,2±4,8 yıl (1-16 yıl), tedavi süreleri ortalaması 19,93±16,4 ay (3 ay-10 yıl) idi. Valproat kullanım dozu 20-60 mg/kg/gün arasında değişmekte idi. Hastaların 34’ünde (%42) en az bir hematolojik yan etki geliştiği saptandı. Bu yan etkiler makrositoz (%18,7), trombositopeni (%17,5), lökopeni (%12,5) ve anemi (%7,5) idi. Trombositopeni ile valproat kullanım süresi arasında ilişki yok iken, ilaç kullanım dozu ve serum seviyesi ile anlamlı ilişki saptandı. Makrositoz ile sadece serum valproat seviyesi arasında ilişki saptandı. Lökopeni ve anemi ile valproat kullanım süresi, dozu ve serum seviyesi arasında ilişki saptanmadı.Sonuç: Epilepsi tedavisinde kullanılan valproatın hematolojik yan etkilerinin nadir olmadığı, bu yan etkilerin önceden tahmin edilemeyeceği görülmektedir. Bu nedenle hastaların takibinde tam kan sayımının değerlendirilmesinin yeterli olacağı ve yan etkiler açısından ailelerin bilgilendirilmesi gerektiği sonucuna varılmıştır

Deformation of the contact line around spherical particles bound at anisotropic fluid interfaces

When a particle adsorbs at a liquid interface, the 3-phase contact line geometry depends on the shape of the particle and of the liquid interface. The shape of the contact line is the key to controlling capillary forces among particles, and is therefore a useful means to direct assembly of interfacial particles. We measured the shape of the contact line around millimeter-sized PDMS-coated glass spheres at water/air interfaces with anisotropic shapes. We studied the advancing and receding conditions separately. We focused on interfaces with a cylindrical shape, where the predominant deformation of the meniscus and the contact line both have quadrupolar cos(2ϕ) symmetry. We related the measured magnitude of the quadrupolar deformation to the applied vertical force on the sphere and the interface's deviatoric curvature, D0. For modest curvature (D0 < 0.1 × sphere radius), our results agree with the theoretical prediction for free particles. At higher curvature, the measurements exceed the theory. The theory appears to apply even when there is contact-angle hysteresis, as long as the measured contact angle is used rather than the equilibrium (Young-Dupré) angle. The magnitude of the quadrupolar deformation depends on the applied force. Together, these results show the range of validity of the theory

Observation of strongly heterogeneous dynamics at the depinning transition in a colloidal glass

We study experimentally the origin of heterogeneous dynamics in strongly driven glass-forming systems. Thereto, we apply a well-defined force with a laser line trap on individual colloidal polystyrene probe particles seeded in an emulsion glass composed of droplets of the same size. Fluid and glass states can be probed. We monitor the trajectories of the probe and measure displacements and their distributions. Our experiments reveal intermittent dynamics around a depinning transition at a threshold force. For smaller forces, linear response connects mean displacement, and quiescent mean squared displacement. Mode coupling theory calculations rationalize the observations

Diffusing wave microrheology of highly scattering concentrated monodisperse emulsions

Motivated by improvements in diffusing wave spectroscopy (DWS) for nonergodic, highly optically scattering soft matter and by cursory treatment of collective scattering effects in prior DWS microrheology experiments, we investigate the low-frequency plateau elastic shear moduli G′p of concentrated, monodisperse, disordered oil-in- water emulsions as droplets jam. In such experiments, the droplets play dual roles both as optical probes and as the jammed objects that impart shear elasticity. Here, we demonstrate that collective scattering significantly affects DWS mean-square displacements (MSDs) in dense colloidal emulsions. By measuring and analyzing the scattering mean free path as a function of droplet volume fraction φ, we obtain a φ- dependent average structure factor. We use this to correct DWS MSDs by up to a factor of 4 and then calculate G′p predicted by the generalized Stokes–Einstein relation. We show that DWS-microrheological G′p(φ) agrees well with mechanically measured G′p(φ) over about three orders of magnitude when droplets are jammed but only weakly deformed. Moreover, both of these measurements are consistent with predictions of an entropic–electrostatic–interfacial (EEI) model, based on quasi- equilibrium free-energy minimization of disordered, screened-charge–stabilized, deformable droplets, which accurately describes prior mechanical measurements of G′p(φ) made on similar disordered monodisperse emulsions over a wide range of droplet radii and φ. This very good quantitative agreement between DWS microrheology, mechanical rheometry, and the EEI model provides a comprehensive and self-consistent view of weakly jammed emulsions. Extensions of this approach may improve DWS microrheology on other systems of dense, jammed colloids that are highly scattering