Novel Treatment and New Drugs in Epilepsy Treatment.

We now get benefit from more than 20 antiepileptic drugs (AEDs) in the care of people with epilepsy. Newer generation of AED is associated with a more favourable tolerability profile than older generation AEDs which makes them easier to use, despite similar efficacy. In order to define the place of newer generation AEDs in the therapy, we review here the main current guidelines about their use for a special issue concerning antiepileptic drugs in neurosurgical practice. We also discuss how to tailor the treatment with newer generation AEDs according to the patient's needs and comorbid conditions. We review different common setting that may require specific therapeutic considerations, i.e. elderly, pregnancy, HIV infection, tumours and hospital/critical care use. We also discuss the current evidence regarding the use of newer generation AEDs in the neurosurgical practice. We present the most recent commercially available newer AEDs (ezogabine, perampanel, brivacetam, everolimus), describing their mechanism of action, adverse effects and indication according to the type of seizure. We finally describe the promising AEDs that are currently under development or testing. This article is a special issue concerning antiepileptic drugs in neurosurgical practice

Transition en diabétologie [Transition in diabetology].

La transition du patient atteint de diabète de type 1 des soins pédiatriques aux soins adultes pose un réel défi en raison de la complexité de gestion de la maladie dans une phase de la vie caractérisée par de multiples changements physiques, psychologiques et sociaux. Toutes les personnes impliquées dans le suivi de ces jeunes adultes doivent être conscientes du fait que le gain d'autonomie du patient doit s'intégrer aux centres d'intérêts spécifiques du jeune adulte. Le rôle de l'infirmière est primordial dans la coordination et le succès du processus de maintien du lien nécessaire à un suivi de qualité, tout en répondant aux besoins spécifiques des jeunes adultes. For patients with type I diabetes, transition from pediatric to adult care is a challenge due to complex treatment requirements and the physical, psychological and social changes of adolescence. Members of the care team must recognize that while these emerging adults need to develop self-management skills, this may conflict at times with the developmentally appropriate desire for increasing autonomy. The role of nursing in coordinating a successful transition is critical for maintaining continuity of patient-centered care that responds to the specific needs of these young adults