The pattern of female genital hormonal disease in juvenile myoclonic epilepsy

Objective: to reveal and investigate hormonal characteristics in women of childbearing age in juvenile myoclonic epilepsy (JME).Patients and methods. The concentrations of sex steroid and tropic hormones were analyzed in 48 women of childbearing age who suffered from JME and received monotherapy or bitherapy with antiepileptic drugs (AEDs) for more than a year. For comparison of their values, a control group included 15 healthy women who did not take AEDs. Results and discussion. 66.7% of the patients were found to have ovarian hormonal dysfunction characterized by a significant increase in the level of luteinizing hormone and testosterone in the follicular phase of the cycle and a decrease in that of progesterone in the luteal phase compared with the control group. The hormonal deviations were influenced by disease duration and age-related onset in JME. Generalized tonicclonic seizures concurrent with myoclonic ones, bitherapy, and disease onset before menarche and in the period of the menstrual cycle favored the  development of hormonal deviations to a greater extent than myoclonic seizures only, monotherapy, and disease onset after the establishment of the cycle. Valproates were most commonly used in the therapy of JME; however, there were no significant differences in the hormonal deficiencies when different chemical groups of AEDs were administered

The first combined russian experience of using perampanel in children and adolescents with epilepsy in everyday clinical practice

Background. Real world data help to provide more information on the effects and tolerability of therapy. However, data on the use of perampanel in Russian population of children remain limited. aim. To conduct a retrospective analysis of perampanel efficacy and tolerability in children and adolescents with epilepsy in real clinical practice. Materials and methods. A total of 106 children aged 4–18 years receiving perampanel as part of combination therapy for epilepsy were observed at 18 centers. Seizure frequency at 1–3, after 6 and 12 months of treatment, presence and type of adverse events (AEs) were analyzed. The main assessed efficacy parameters were seizure control, significant (≥50 %) decrease in seizure frequency. All other outcomes (<50 % decrease, no change or increased seizure frequency) were considered to be no effect. The assessed safety parameters were the percentage of patients with or without AEs and the percentage of perampanel withdrawals due to AEs. results. We defined 3 age groups for comparison: children 4–6, 7–11 and 12–17 years old. Perampanel efficacy was 69 % (seizure control – 23.6 %, ≥50 % decrease in seizure frequency – 45.3 %). The mean duration of the effect was 7.3 ± 4.1 months. No significant difference in efficacy between age groups was found. However, some greater efficacy of perampanel was noted in adolescents: absence of effect in the form of remission or significant decrease in seizures frequency was noted only in 25.5 %, with 40 % in children 4–11 years old. Among those with inefficacy, 3.8 % reported seizure aggravation. AEs occurred in only 23 % of patients, with the least frequent occurrence in adolescents (11.8 %) and the most frequent in children aged 7–11 years (40 %). The most frequent AEs was sluggishness and/or drowsiness. Discontinuation of perampanel due to AEs was required in 7.6 %. Conclusion. Perampanel has demonstrated high efficacy and good tolerability in real clinical practice among children from 4 years of age and adolescents with partial (focal) and secondary generalized seizures. The AEs that developed were not serious and very rarely led to withdrawal of the therapy. The results are comparable to those of phase III studies and previous real-world data. The usage of perampanel in children with primary generalized seizures should be further investigated. © 2022 ABV-Press Publishing House. All rights reserved.EisaiО.А. Рахманина / O.A. Rakhmanina: https://orcid.org/0000-0001-9218-2531 И.В. Волков / I.V. Volkov: https://orcid.org/0000-0002-7816-7535 О.К. Волкова / O.K. Volkova: https://orcid.org/0000-0003-3314-3895 Ю.А. Александров / Yu.A. Aleksandrov: https://orcid.org/0000-0003-3887-5219 М.В. Бархатов / M.V. Barkhatov: https://orcid.org/0000-0002-6372-4677 И.С. Бахтин / I.S. Bakhtin: https://orcid.org/0000-0003-3600-687X Г.М. Бережная / G.M. Berezhnaya: https://orcid.org/0000-0003-3917-422X А.Ю. Карась / A.Yu. Karas: https://orcid.org/0000-0001-9089-9627 Д.В. Морозов / D.V. Morozov: https://orcid.org/0000-0003-4389-9143 И.С. Бахтин / I.S. Bakhtin: https://orcid.org/0000-0003-3600-687X Т.Р. Томенко / T.R. Tomenko: https://orcid.org/0000-0002-0652-1996 Ж.М. Цоцонава / Zh.M. Tsotsonava: https://orcid.org/0000-0003-3275-5099 Конфликт интересов и финансирование. Публикация подготовлена при финансовой поддержке компании «Эйсай». Авторы несут полную ответственность за содержание статьи и редакционные решения. Conflict of interest and funding. This publication was funded by Eisai. The authors are fully responsible for the content of the article and editorial decisions

Possibilities to optimize pharmacotherapy for epilepsy according to the data of an epidemiological survey in Sterlitamak

The epidemiological survey among the adult population of Sterlitamak identified 587 epileptic patients. This yielded prevalence and incidence rates for epilepsy in Sterlitamak (2.74 per 1000 population and 13.08 per 100.000 population, respectively), which were the same as those in other regions of Russia and relatively low compared to those shown by foreign investigators. Examining the prevalence of epilepsy by sex revealed a slight male preponderance (3.42 per 1000). The greatest proportion of new cases among the men and women was in the age range of 11—20 years. Among the examinees, 51.7% had been epileptic for more than 10 years. Patients with frontal focal lobe epilepsy were prevalent among the adult population. Rational therapy can substantially enhance the control over epileptic seizures

Effectiveness of Epilepsy Therapy in Adults after Correction Performed by an Epileptologist

Objective. To optimize the therapeutic and preventive care for epilepsy patients based on the results of examination and therapy correction performed by an epileptologist. Patients and Methods. Results of clinico-epidemiological examination of 587 adult patients with epilepsy (320 males and 267 females) are presented. The effectiveness of the antiepileptic therapy before and after it had been optimized by an epileptologist was analyzed. Results. The results demonstrated that optimization of antiepileptic drug therapy according to the recommendations of the International League Against Epilepsy (ILAE) allowed 91.87% of patients to achieve positive result: the termination of seizures was observed in 66.61% of cases; a decrease in seizure frequency by over 50% was observed in 25.26% of cases. A total of 6.26% of patients showed clinical improve- ment (seizure frequency was reduced by less than 50%). The therapy turned out to be inefficient in 1.87% of patients

Lechenie katarakty u deteys sakharnym diabetom 1 tipa

Цель. Изучение результатов хирургического лечения диабетической катаракты у детей. Материалы и методы. Проведено обследование и лечение 13 детей (24 глаза) с осложненной катарактой и сахарным диабетом 1 типа. Обследование включало визометрию, биомикроскопию, прямую офтальмоскопию с фоторегистрацией на фундус камере ?Canon?, флуоресцентную ангиографию, электроретинографию, зрительные вызванные корковые потенциалы. Результаты. После удаления катаракты у 2 детей на 2?3-й день после операции мы наблюдали декомпенсацию заболевания. После первичной имплантации (20 глаз) наблюдалось 17 случаев вторичной катаракты (85%). У 2 из 11 оперированных детей (4 глаза) после удаления катаракты с имплантацией ИОЛ выявлена диабетическая ретинопатия (ДР), не диагностированная до операции. Выводы. Для получения достаточно высоких визуальных результатов при экстракции диабетической катаракты необходима взаимосвязанная работа эндокринологов и офтальмологов. Хирургическое лечение катаракты с имплантацией интраокулярных линз у детей с СД 1 типа обеспечивает достаточно высокие функциональные результаты ? оптимальным является применение гибких гидрофобных линз

Epileptic trances – focal motor epileptic seizures: past, present and a little bit of future

This article provides a detailed description of clinical and electroanatomical characteristics of epilepsy in patients suffering from epileptic trances – a rare type of focal motor seizures with ambulatory automatism manifesting as an unplanned travel. We reviewed the currently available data on the nature of psychical seizures in patients with epilepsy and the role of social and legal expertise for this disease. We developed the criteria for differential diagnosis between epileptic trances and other conditions with similar manifestations (for example, epileptic fugues) and identified a diagnostic minimum. We also proposed a hypothesis of ictal spatial migration. We emphasized the efficiency of surgical treatment in the case of compliance with a proper diagnostic algorithm

Strategies to manage hepatitis C virus (HCV) infection disease burden - volume 2

The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries, and the relative impact of two scenarios was considered: (i) increased treatment efficacy while holding the treated population constant and (ii) increased treatment efficacy and increased annual treated population. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. In most countries, the annual treated population had to increase several fold to achieve the largest reductions in HCV-related morbidity and mortality. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. In most of the studied countries, the majority of patients were born between 1945 and 198

Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 2

Chronic hepatitis C virus (HCV) infection is a leading cause of liver related morbidity and mortality. In many countries, there is a lack of comprehensive epidemiological data that are crucial in implementing disease control measures as new treatment options become available. Published literature, unpublished data and expert consensus were used to determine key parameters, including prevalence, viremia, genotype and the number of patients diagnosed and treated. In this study of 15 countries, viremic prevalence ranged from 0.13% in the Netherlands to 2.91% in Russia. The largest viremic populations were in India (8 666 000 cases) and Russia (4 162 000 cases). In most countries, males had a higher rate of infections, likely due to higher rates of injection drug use (IDU). Estimates characterizing the infected population are critical to focus screening and treatment efforts as new therapeutic options become availabl

The present and future disease burden of hepatitis C virus (HCV) infections with today's treatment paradigm - volume 2

Morbidity and mortality attributable to chronic hepatitis C virus (HCV) infection are increasing in many countries as the infected population ages. Models were developed for 15 countries to quantify and characterize the viremic population, as well as estimate the number of new infections and HCV related deaths from 2013 to 2030. Expert consensus was used to determine current treatment levels and outcomes in each country. In most countries, viremic prevalence has already peaked. In every country studied, prevalence begins to decline before 2030, when current treatment levels were held constant. In contrast, cases of advanced liver disease and liver related deaths will continue to increase through 2030 in most countries. The current treatment paradigm is inadequate if large reductions in HCV related morbidity and mortality are to be achieve