Wyniki leczenia topiramatem padaczki u osób w podeszłym wieku

Cele. Ocena skuteczności, tolerancji i jakości życia u starszych pacjentów z padaczką, leczonych topiramatem. Metody. Otwarte, trwające rok badanie kliniczne z elastycznym dawkowaniem. Wyniki. Przebadano 107 pacjentów (średni wiek 69 lat; 53% mężczyzn) przez okres 273 &#177; 141 dni. Średnia dawka, którą osiąga- no ostatecznie w monoterapii, wynosiła 98 mg/dobę - w porównaniu z 153 mg/dobę w ramach leczenia wspomagającego. Średnia skumulowana miesięczna częstość napadów padaczkowych zmniejszyła się z 3,7 &#177; 15 do 1,6 &#177; 7,7 (n = 101; p < 0,0001). U 78% pacjentów z napadami padaczkowymi w momencie rozpoczęcia badania (n = 102) osiągnięto przynajmniej 50-procentową redukcję częstości napadów, 44% nie miało napadów w okresie badania. Całkowita punktacja w skali jakości &#348;ycia osób z padaczką (QOLIE-31) poprawiła się z 57 &#177; 17 na 68 &#177; 18 (n = 64; p < 0,0001). Najczęściej zgłaszanymi zdarzeniami niepożądanymi były drgawki, zawroty głowy i zmęczenie. Wnioski. Pacjenci w starszym wieku leczeni topiramatem osiągali wyraźne zmniejszenie liczby napadów padaczkowych i istotną poprawę w zakresie licznych aspektów jakości życia przy dobrej tolerancji leku

Bibliographie Umwelterziehung

UuStB Koeln(38)-8406009 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLE2., aktualisierte Aufl.DEGerman

Variants in the neuronal nitric oxide synthase (nNOS, NOS1) gene are associated with restless legs syndrome.

Sixty percent of the patients with restless legs syndrome (RLS) report a positive family history. To date five loci have been mapped on chromosome 12q, 14q, 9p, 2q, and 20p (RLS1-5) but no gene has been identified so far. To identify genes related to RLS, we performed a three-stage association study (explorative study, replication study, high-density mapping) in two Caucasian RLS case-control samples of altogether 918 independent cases and controls. In the explorative study (367 cases and controls, respectively), we screened 1536 SNPs in 366 genes in a 21 Mb region encompassing the RLS1 critical region on chromosome 12. Armitage trend test revealed three genomic regions that were significant (P &lt; 0.05). In the replication study (551 cases and controls, respectively) we genotyped the most significant SNPs of Stage 1. After correction for multiple testing, association was observed with SNP rs7977109 (P(nominal) = 0.00175, P(Westfall-Young) = 0.04895, OR = 0.76228, 95% CI = 0.64310-0.90355), which is in the neuronal nitric oxide synthase (NOS1) gene. High-density mapping using altogether 34 tagging and coding SNPs of the NOS1 gene in both case-control samples further confirmed the significant association results to NOS1. Ten more SNPs revealed significance with nominal P-values from 0.0001 to 0.0482 (genotypic test and Armitage test). Altogether, this study provides evidence for an association of variants in the NOS1 gene and RLS, and suggests the involvement of the NO/arginine pathway in the pathogenesis of RLS. Potential usage of NO modulating agents as new treatment options for RLS have become a challenging aspect for future research of this disorder

A Study of the Implementation of ISO 14001 Environmental Management Systems in Hong Kong

The ISO 14001 environmental management system (EMS) standard has been adopted in many parts of the world. In order to evaluate current implementation in Hong Kong, a questionnaire survey was conducted of more than 200 local companies. ISO 14001 EMS adoption is still slow in Hong Kong, particularly for small and medium-sized enterprises (SMEs). The majority of SMEs do not have plans to implement the standard in the near future. However, the EMS standard has brought many advantages to the local ISO 14001 EMS certified companies, including the reduction of operating costs and the improvement of working efficiency. Recommendations are made for EMS standard implementation in local organizations, particularly SMEs.

Genome-wide association study of restless legs syndrome identifies common variants in three genomic regions.

Restless legs syndrome (RLS) is a frequent neurological disorder characterized by an imperative urge to move the legs during night, unpleasant sensation in the lower limbs, disturbed sleep and increased cardiovascular morbidity. In a genome-wide association study we found highly significant associations between RLS and intronic variants in the homeobox gene MEIS1, the BTBD9 gene encoding a BTB(POZ) domain as well as variants in a third locus containing the genes encoding mitogen-activated protein kinase MAP2K5 and the transcription factor LBXCOR1 on chromosomes 2p, 6p and 15q, respectively. Two independent replications confirmed these association signals. Each genetic variant was associated with a more than 50% increase in risk for RLS, with the combined allelic variants conferring more than half of the risk. MEIS1 has been implicated in limb development, raising the possibility that RLS has components of a developmental disorder