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Catalán‐Aguilar J, Hampel KG, Cano‐López I, Garcés M, Lozano‐García A, Tormos‐Pons P, González‐Bono E, Villanueva V. Prospective study of cenobamate on cognition, affectivity, and quality of life in focal epilepsy. Epilepsia Open 2024; 9:223-235. [PMID: 37920923 PMCID: PMC10839366 DOI: 10.1002/epi4.12857] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/27/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE Cenobamate is a recently approved antiseizure medication that proved to be safe and effective in randomized controlled trials. However, little is known about its impact on some areas frequently affected by epilepsy. For this reason, we explored the effects of cenobamate on cognitive performance, as well as on negative affectivity and quality of life in a sample of patients with drug-resistant epilepsy. METHODS Two prospective cohort studies were carried out. In Study 1, 32 patients (22 men and 10 women) underwent a baseline (T0) and a short-term (T1) neuropsychological assessment after 3 months of cenobamate administration. In Study 2, 22 patients (16 men and 6 women) from the T1 sample also underwent a baseline and a follow-up evaluation (T2) 6 months after T0. RESULTS No significant differences were found in cognitive variables, negative affectivity, and quality of life either in Study 1 or Study 2. Similarly, based on the reliable change index, it was found that most patients showed no changes in these variables. SIGNIFICANCE These results suggest that cenobamate is a safe antiseizure medication in terms of cognition, negative affectivity, or quality of life since no adverse events have been found after 3 and 6 months of treatment. PLAIN LANGUAGE SUMMARY Cenobamate is a new antiseizure medication. In patients with epilepsy, cenobamate seems to not affect cognition, anxiety, depression, or quality of life.
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Affiliation(s)
- Judit Catalán‐Aguilar
- Institut d'Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology CenterUniversitat de València. Av. Blasco IbáñezValenciaSpain
| | - Kevin G. Hampel
- Refractory Epilepsy Unit, Neurology Service, Member of ERN EPICAREHospital Universitario y Politécnico La Fe. Av. Fernando Abril MartorellValenciaSpain
| | - Irene Cano‐López
- Institut d'Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology CenterUniversitat de València. Av. Blasco IbáñezValenciaSpain
| | - Mercedes Garcés
- Refractory Epilepsy Unit, Neurology Service, Member of ERN EPICAREHospital Universitario y Politécnico La Fe. Av. Fernando Abril MartorellValenciaSpain
| | - Alejandro Lozano‐García
- Faculty of Health SciencesValencian International UniversityValenciaSpain
- Department of PsychologyUniversidad Europea de ValenciaValenciaSpain
- Faculty of Health SciencesUniversidad Isabel IBurgosSpain
| | - Paula Tormos‐Pons
- Institut d'Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology CenterUniversitat de València. Av. Blasco IbáñezValenciaSpain
| | - Esperanza González‐Bono
- Institut d'Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology CenterUniversitat de València. Av. Blasco IbáñezValenciaSpain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service, Member of ERN EPICAREHospital Universitario y Politécnico La Fe. Av. Fernando Abril MartorellValenciaSpain
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Villanueva V, Rodriguez-Osorio X, Juiz-Fernández Á, Sayas D, Hampel K, Castillo A, Montoya J, Garcés M, Campos D, Rubio-Nazábal E, Fernández-Cabrera A, Gifreu A, Santamarina E, Hernández Pérez G, Falip M, Parejo-Carbonell B, García-Morales I, Martínez AB, Massot M, Asensio M, Giménez J, Guillén V, Ruiz-Giménez J, Chavarria B, Rocamora R, Escalza I. Real-life evidence about the use of intravenous brivaracetam in urgent seizures: The BRIV-IV study. Epilepsy Behav 2023; 147:109384. [PMID: 37634373 DOI: 10.1016/j.yebeh.2023.109384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE Urgent seizures are a medical emergency for which new therapies are still needed. This study evaluated the use of intravenous brivaracetam (IV-BRV) in an emergency setting in clinical practice. METHODS BRIV-IV was a retrospective, multicenter, observational study. It included patients ≥18 years old who were diagnosed with urgent seizures (including status epilepticus (SE), acute repetitive seizures, and high-risk seizures) and who were treated with IV-BRV according to clinical practice in 14 hospital centers. Information was extracted from clinical charts and included in an electronic database. Primary effectiveness endpoints included the rate of IV-BRV responder patients, the rate of patients with a sustained response without seizure relapse in 12 h, and the time between IV-BRV administration and clinical response. Primary safety endpoints were comprised the percentage of patients with adverse events and those with adverse events leading to discontinuation. RESULTS A total of 156 patients were included in this study. The mean age was 57.7 ± 21.5 years old with a prior diagnosis of epilepsy for 57.1% of patients. The most frequent etiologies were brain tumor-related (18.1%) and vascular (11.2%) epilepsy. SE was diagnosed in 55.3% of patients. The median time from urgent seizure onset to IV treatment administration was 60.0 min (range: 15.0-360.0), and the median time from IV treatment to IV-BRV was 90.0 min (range: 30.0-2400.0). Regarding dosage, the mean bolus infusion was 163.0 ± 73.0 mg and the mean daily dosage was 195.0 ± 87.0 mg. A total of 77.6% of patients responded to IV-BRV (66.3% with SE vs. 91% other urgent seizures) with a median response time of 30.0 min (range: 10.0-60.0). A sustained response was achieved in 62.8% of patients. However, adverse events were reported in 14.7%, which were predominantly somnolence and fatigue, with 4.5% leading to discontinuation. Eighty-six percent of patients were discharged with oral brivaracetam. CONCLUSION IV-BRV in emergency settings was effective, and tolerability was good for most patients. However, a larger series is needed to confirm the outcomes.
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Affiliation(s)
- Vicente Villanueva
- Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | | | | | - Debora Sayas
- Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Kevin Hampel
- Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Javier Montoya
- Consorcio Hospital General Universitario, Valencia, Spain
| | - Mercedes Garcés
- Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Dulce Campos
- Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | | | | | | | | | | | - Mercé Falip
- Hospital Universitario Bellvitge, Barcelona, Spain
| | | | | | | | | | | | - Juana Giménez
- Hospital General Universitario Dr Balmis, Alicante, Spain
| | - Virginia Guillén
- Hospital General Universitario Virgen de las Nieves, Granada, Spain
| | | | - Beatriz Chavarria
- Member of ERN EPICARE, Hospital Universitario del Mar, Barcelona, Spain
| | - Rodrigo Rocamora
- Member of ERN EPICARE, Hospital Universitario del Mar, Barcelona, Spain
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Villanueva V, Santos‐Carrasco D, Cabezudo‐García P, Gómez‐Ibáñez A, Garcés M, Serrano‐Castro P, Castro‐Vilanova MD, Sayas D, Lopez‐Gonzalez FJ, Rodríguez‐Osorio X, Torres‐Gaona G, Saiz‐Diaz RA, Hampel KG, Martinez‐Ferri M, Aguilar‐Amat MJ, Mercedes‐Alvarez B, García‐Morales V, del Villar‐Igea A, Massot‐Tarrús A, Rodríguez‐Uranga JJ. Real-world safety and effectiveness of cenobamate in patients with focal onset seizures: Outcomes from an Expanded Access Program. Epilepsia Open 2023; 8:918-929. [PMID: 37149853 PMCID: PMC10472366 DOI: 10.1002/epi4.12757] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/03/2023] [Indexed: 05/09/2023] Open
Abstract
OBJECTIVE This study investigated early, real-world outcomes with cenobamate (CNB) in a large series of patients with highly drug-resistant epilepsy within a Spanish Expanded Access Program (EAP). METHOD This was a multicenter, retrospective, observational study in 14 hospitals. Inclusion criteria were age ≥18 years, focal seizures, and EAP authorization. Data were sourced from patient clinical records. Primary effectiveness endpoints included reductions (100%, ≥90%, ≥75%, and ≥50%) or worsening in seizure frequency at 3-, 6-, and 12-month visits and at the last visit. Safety endpoints included rates of adverse events (AEs) and AEs leading to discontinuation. RESULTS The study included 170 patients. At baseline, median epilepsy duration was 26 years and median number of seizures/month was 11.3. The median number of prior antiseizure medications (ASMs) and concomitant ASMs were 12 and 3, respectively. Mean CNB dosages/day were 176 mg, 200 mg, and 250 mg at 3, 6, and 12 months. Retention rates were 98.2%, 94.5%, and 87% at 3, 6, and 12 months. At last available visit, the rate of seizure freedom was 13.3%; ≥90%, ≥75%, and ≥50% responder rates were 27.9%, 45.5%, and 63%, respectively. There was a significant reduction in the number of seizures per month (mean: 44.6%; median: 66.7%) between baseline and the last visit (P < 0.001). Responses were maintained regardless of the number of prior or concomitant ASMs. The number of concomitant ASMs was reduced in 44.7% of patients. The cumulative percentage of patients with AEs and AEs leading to discontinuation were 68.2% and 3.5% at 3 months, 74.1% and 4.1% at 6 months, and 74.1% and 4.1% at 12 months. The most frequent AEs were somnolence and dizziness. SIGNIFICANCE In this highly refractory population, CNB showed a high response regardless of prior and concomitant ASMs. AEs were frequent but mostly mild-to-moderate, and few led to discontinuation.
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Affiliation(s)
- Vicente Villanueva
- Hospital Universitario y Politécnico La Fe, Member of EPICAREValenciaSpain
| | - Daniel Santos‐Carrasco
- Centro Neurología AvanzadaSevillaSpain
- Departamento de Psicología ExperimentalUniversidad de SevillaSevillaSpain
| | | | | | - Mercedes Garcés
- Hospital Universitario y Politécnico La Fe, Member of EPICAREValenciaSpain
| | | | | | - Débora Sayas
- Hospital Universitario y Politécnico La Fe, Member of EPICAREValenciaSpain
| | | | | | | | | | - Kevin G. Hampel
- Hospital Universitario y Politécnico La Fe, Member of EPICAREValenciaSpain
| | | | - Maria J. Aguilar‐Amat
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz—IdiPAZMadridSpain
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Campo-Caballero D, de la Riva P, de Arce A, Martínez-Zabaleta M, Rodríguez-Antigüedad J, Ekiza J, Iruzubieta P, Purroy F, Fuentes B, de Lera Alfonso M, Krupinski J, Mengual Chirife JJ, Palomeras E, Guisado-Alonso D, Rodríguez-Yáñez M, Ustrell X, Tejada García J, de Felipe Mimbrera A, Paré-Curell M, Tembl J, Cajaraville S, Garcés M, Serena J. Reperfusion therapy in acute ischaemic stroke due to cervical and cerebral artery dissection: Results from a Spanish multicentre study. Neurologia (Engl Ed) 2022:S2173-5808(22)00074-8. [PMID: 35842129 DOI: 10.1016/j.nrleng.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is a rare entity, and few data are available on the use of such reperfusion therapies as intravenous fibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treatments in patients with IS due to CAD and compared them against patients receiving reperfusion treatment for IS of other aetiologies. METHODS We conducted an observational, retrospective, multicentre study of patients with IS due to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology during the period 2011-2019. Comparative analyses were performed between: a) patients with CAD treated and not treated with reperfusion therapies and b) patients treated with reperfusion for IS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiological data, stroke variables, and outcomes at discharge and at 3 months were included in the analysis. RESULTS The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom 68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently in cases of vertebral artery dissection and more frequently in patients with carotid artery occlusion. Compared to patients with IS due to other causes, patients with CAD were younger, more frequently underwent mechanical thrombectomy, and less frequently received intravenous fibrinolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months were similar in both groups. CONCLUSIONS Reperfusion therapy is frequently used in patients with IS due to CAD. The outcomes of these patients demonstrate the efficacy and safety of reperfusion treatments, and are comparable to the outcomes of patients with IS due to other aetiologies.
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Affiliation(s)
- D Campo-Caballero
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, Spain.
| | - P de la Riva
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, Spain
| | - A de Arce
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, Spain
| | - M Martínez-Zabaleta
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, Spain
| | | | - J Ekiza
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, Spain
| | - P Iruzubieta
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, Spain
| | - F Purroy
- Servicio de Neurología, Hospital Arnau de Vilanova de Lleida, Lleida, Spain
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, Spain
| | - M de Lera Alfonso
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J Krupinski
- Servicio de Neurología, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | | | - E Palomeras
- Servicio de Neurología, Hospital de Mataró, Mataró, Spain
| | - D Guisado-Alonso
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - X Ustrell
- Servicio de Neurología, Hospital Universitari Joan XXIII, Tarragona, Spain
| | | | | | - M Paré-Curell
- Servicio de Neurología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - J Tembl
- Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - S Cajaraville
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - M Garcés
- Servicio de Neurología, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - J Serena
- Servicio de Neurología, Hospital Universitari Dr. Josep Trueta, Girona, Spain
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Lemaréchal JD, Jedynak M, Trebaul L, Boyer A, Tadel F, Bhattacharjee M, Deman P, Tuyisenge V, Ayoubian L, Hugues E, Chanteloup-Forêt B, Saubat C, Zouglech R, Reyes Mejia GC, Tourbier S, Hagmann P, Adam C, Barba C, Bartolomei F, Blauwblomme T, Curot J, Dubeau F, Francione S, Garcés M, Hirsch E, Landré E, Liu S, Maillard L, Metsähonkala EL, Mindruta I, Nica A, Pail M, Petrescu AM, Rheims S, Rocamora R, Schulze-Bonhage A, Szurhaj W, Taussig D, Valentin A, Wang H, Kahane P, George N, David O. A brain atlas of axonal and synaptic delays based on modelling of cortico-cortical evoked potentials. Brain 2021; 145:1653-1667. [PMID: 35416942 PMCID: PMC9166555 DOI: 10.1093/brain/awab362] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/03/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
Epilepsy presurgical investigation may include focal intracortical single-pulse electrical stimulations with depth electrodes, which induce cortico-cortical evoked potentials at distant sites because of white matter connectivity. Cortico-cortical evoked potentials provide a unique window on functional brain networks because they contain sufficient information to infer dynamical properties of large-scale brain connectivity, such as preferred directionality and propagation latencies. Here, we developed a biologically informed modelling approach to estimate the neural physiological parameters of brain functional networks from the cortico-cortical evoked potentials recorded in a large multicentric database. Specifically, we considered each cortico-cortical evoked potential as the output of a transient stimulus entering the stimulated region, which directly propagated to the recording region. Both regions were modelled as coupled neural mass models, the parameters of which were estimated from the first cortico-cortical evoked potential component, occurring before 80 ms, using dynamic causal modelling and Bayesian model inversion. This methodology was applied to the data of 780 patients with epilepsy from the F-TRACT database, providing a total of 34 354 bipolar stimulations and 774 445 cortico-cortical evoked potentials. The cortical mapping of the local excitatory and inhibitory synaptic time constants and of the axonal conduction delays between cortical regions was obtained at the population level using anatomy-based averaging procedures, based on the Lausanne2008 and the HCP-MMP1 parcellation schemes, containing 130 and 360 parcels, respectively. To rule out brain maturation effects, a separate analysis was performed for older (>15 years) and younger patients (<15 years). In the group of older subjects, we found that the cortico-cortical axonal conduction delays between parcels were globally short (median = 10.2 ms) and only 16% were larger than 20 ms. This was associated to a median velocity of 3.9 m/s. Although a general lengthening of these delays with the distance between the stimulating and recording contacts was observed across the cortex, some regions were less affected by this rule, such as the insula for which almost all efferent and afferent connections were faster than 10 ms. Synaptic time constants were found to be shorter in the sensorimotor, medial occipital and latero-temporal regions, than in other cortical areas. Finally, we found that axonal conduction delays were significantly larger in the group of subjects younger than 15 years, which corroborates that brain maturation increases the speed of brain dynamics. To our knowledge, this study is the first to provide a local estimation of axonal conduction delays and synaptic time constants across the whole human cortex in vivo, based on intracerebral electrophysiological recordings.
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Affiliation(s)
- Jean-Didier Lemaréchal
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Centre MEG-EEG and Experimental Neurosurgery Team, F-75013 Paris, France.,Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.,Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Maciej Jedynak
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Lena Trebaul
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Anthony Boyer
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - François Tadel
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Manik Bhattacharjee
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Pierre Deman
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Viateur Tuyisenge
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Leila Ayoubian
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Etienne Hugues
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | | | - Carole Saubat
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Raouf Zouglech
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | | | - Sébastien Tourbier
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Claude Adam
- Department of Neurology, Epilepsy Unit, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Carmen Barba
- Neuroscience Department, Children's Hospital Meyer-University of Florence, Florence, Italy
| | - Fabrice Bartolomei
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,Service de Neurophysiologie Clinique, APHM, Hôpitaux de la Timone, Marseille, France
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Université Paris V Descartes, Sorbonne Paris Cité, Paris, France
| | - Jonathan Curot
- Department of Neurophysiological Explorations, CerCo, CNRS, UMR5549, Centre Hospitalier Universitaire de Toulouse and University of Toulouse, Toulouse, France
| | - François Dubeau
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Stefano Francione
- 'Claudio Munari' Centre for Epilepsy Surgery; Neuroscience Department, GOM, Niguarda, Milano, Italy
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Edouard Hirsch
- University Hospital, Department of Neurology, Strasbourg, France
| | | | - Sinclair Liu
- Canton Sanjiu Brain Hospital Epilepsy Center, Jinan University, Guangzhou, China
| | - Louis Maillard
- Centre Hospitalier Universitaire de Nancy, Nancy, France
| | | | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | - Anca Nica
- Neurology Department, CIC 1414, Rennes University Hospital; LTSI, INSERM U 1099, F-35000 Rennes, France
| | - Martin Pail
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | | | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon's Neurosciences Research Center, INSERM U1028/CNRS UMR5292/Lyon 1 University, Lyon, France
| | - Rodrigo Rocamora
- Epilepsy Monitoring Unit, Department of Neurology, Hospital del Mar-IMIM, Barcelona, Spain
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - William Szurhaj
- Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - Delphine Taussig
- Neurophysiology and Epilepsy Unit, Bicêtre Hospital, France.,Service de Neurochirurgie Pédiatrique, Fondation Rothschild, Paris, France
| | - Antonio Valentin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | - Haixiang Wang
- Yuquan Hospital Epilepsy Center, Tsinghua University, Beijing, China
| | - Philippe Kahane
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.,Neurology Department, CHU Grenoble Alpes, Grenoble, France
| | - Nathalie George
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Centre MEG-EEG and Experimental Neurosurgery Team, F-75013 Paris, France
| | - Olivier David
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.,Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
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Campo-Caballero D, de la Riva P, de Arce A, Martínez-Zabaleta M, Rodríguez-Antigüedad J, Ekiza J, Iruzubieta P, Purroy F, Fuentes B, de Lera Alfonso M, Krupinski J, Mengual Chirife JJ, Palomeras E, Guisado-Alonso D, Rodríguez-Yáñez M, Ustrell X, Tejada García J, de Felipe Mimbrera A, Paré-Curell M, Tembl J, Cajaraville S, Garcés M, Serena J. Reperfusion treatment in acute ischaemic stroke due to cervical and cerebral artery dissection: results of a Spanish national multicentre study. Neurologia 2020; 38:S0213-4853(20)30430-8. [PMID: 33358059 DOI: 10.1016/j.nrl.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/14/2020] [Accepted: 10/05/2020] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is a rare entity, and few data are available on the use of such reperfusion therapies as intravenous fibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treatments in patients with IS due to CAD and compared them against patients receiving reperfusion treatment for IS of other aetiologies. METHOD We conducted an observational, retrospective, multicentre study of patients with IS due to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology during the period 2011-2019. Comparative analyses were performed between: a) patients with CAD treated and not treated with reperfusion therapies and b) patients treated with reperfusion for IS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiological data, stroke variables, and outcomes at discharge and at 3 months were included in the analysis. RESULTS The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom 68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently in cases of vertebral artery dissection and more frequently in patients with carotid artery occlusion. Compared to patients with IS due to other causes, patients with CAD were younger, more frequently underwent mechanical thrombectomy, and less frequently received intravenous fibrinolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months were similar in both groups. CONCLUSIONS Reperfusion therapy is frequently used in patients with IS due to CAD. The outcomes of these patients demonstrate the efficacy and safety of reperfusion treatments, and are comparable to the outcomes of patients with IS due to other aetiologies.
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Affiliation(s)
- D Campo-Caballero
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España.
| | - P de la Riva
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España
| | - A de Arce
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España
| | - M Martínez-Zabaleta
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España
| | | | - J Ekiza
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España
| | - P Iruzubieta
- Servicio de Neurología, Hospital Universitario Donostia, Sant Sebastián, España
| | - F Purroy
- Servicio de Neurología, Hospital Arnau de Vilanova de Lleida, Lleida, España
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, España
| | - M de Lera Alfonso
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - J Krupinski
- Servicio de Neurología, Hospital Universitari Mútua de Terrassa, Terrassa, España
| | | | - E Palomeras
- Servicio de Neurología, Hospital de Mataró, Mataró, España
| | - D Guisado-Alonso
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - X Ustrell
- Servicio de Neurología, Hospital Universitari Joan XXIII, Tarragona, España
| | | | | | - M Paré-Curell
- Servicio de Neurología, Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - J Tembl
- Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Valencia, España
| | - S Cajaraville
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
| | - M Garcés
- Servicio de Neurología, Hospital Clínico Lozano Blesa, Zaragoza, España
| | - J Serena
- Servicio de Neurología, Hospital Universitari Dr. Josep Trueta, Girona, España
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Roselló Keränen S, Pizzo C, Huerta M, Muñoz E, Alfaro-Cervello C, Aliaga R, Vera A, Jordá E, Garcés M, Roda D, Tarazona N, Dorcaratto D, Guijarro J, Sánchiz V, Fleitas T, Lluch P, Pascual I, Ferrandez A, Cervantes A, Sabater L. 1565P Clinical outcome after perioperative treatment on locally advanced and borderline pancreatic cancer: Experience of a single academic center. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Villanueva V, Bermejo P, Montoya J, Massot-Tarrús A, Galiano ML, Toledo M, Rodriguez-Uranga JJ, Bertol V, Mauri JÁ, Poza JJ, Bonet M, Castro-Vilanova MD, Ruiz-Giménez J, López-González FJ, Rodríguez-Osorio X, Tortosa-Conesa D, Ojeda J, Giner P, Garcés M, Alvarez BM, Quiroga-Subirana P, Esteve P, Baiges JJ, Hampel K. MONOZEB: Long-term observational study of eslicarbazepine acetate monotherapy. Epilepsy Behav 2019; 97:51-59. [PMID: 31181429 DOI: 10.1016/j.yebeh.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/26/2019] [Accepted: 05/08/2019] [Indexed: 10/26/2022]
Abstract
AIM The aim of the study was to evaluate the effectiveness and tolerability of eslicarbazepine acetate (ESL) when used as monotherapy for 1 year or more in routine clinical use in patients with focal seizures in epilepsy clinics in Spain. METHODS This is a retrospective, observational, noninterventional study. Eligible patients were aged ≥18 years, had focal seizures, and started on ESL ≥1 year before database closure. Primary endpoint was the following: proportion seizure-free for ≥6 months at 1 and 2 years. Secondary endpoints included retention on ESL monotherapy at 1 and 2 years, seizure frequency change, seizure worsening, and side effects. Other analyses included seizure freedom from baseline to 1 and 2 years and outcomes in special populations. RESULTS Four hundred thirty-five patients were included (127 on first-line monotherapy and 308 converting to ESL monotherapy): median daily dose was 800 mg at all time points; 63.2% were seizure-free at 1 year, 65.1% at 2 years, and 50.3% for the entire follow-up. Mean duration of ESL monotherapy was 66.7 months; retention was 88.0% at 1 year and 81.9% at 2 years. Mean reduction in seizure frequency was 75.5% at last visit. Over the entire follow-up, seizure worsening was seen in 22 patients (5.1%), side effects in 28.0%, considered severe in 1.8%, and leading to discontinuation in 5.7%. Dizziness, hyponatremia (sodium <135 mEq/l), and somnolence were the most frequent side effects. Outcomes in special populations (patients aged ≥65 years and those with psychiatric history or learning difficulty) were consistent with the overall population. CONCLUSIONS Patients with focal seizures taking ESL monotherapy had excellent retention, high seizure-free rates, and good tolerability up to 2 years.
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Affiliation(s)
| | - Pedro Bermejo
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | | | | | - Manuel Toledo
- Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - Pau Giner
- Hospital Universitario Doctor Peset, Valencia, Spain
| | | | | | | | | | | | - Kevin Hampel
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Cano-López I, Hidalgo V, Hampel KG, Garcés M, Salvador A, González-Bono E, Villanueva V. Cortisol and trait anxiety as relevant factors involved in memory performance in people with drug-resistant epilepsy. Epilepsy Behav 2019; 92:125-134. [PMID: 30658320 DOI: 10.1016/j.yebeh.2018.12.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/19/2018] [Accepted: 12/22/2018] [Indexed: 11/15/2022]
Abstract
People with drug-resistant epilepsy are exposed to unpredictable and uncontrollable seizures, which can be considered as a chronic stress condition. Additionally, these patients present memory deficits and a high prevalence of depression and anxiety. Cortisol, the main stress hormone, has a modulatory role on memory in healthy individuals and patients with emotional disorders, but its role in memory and emotional processes remains unclear in people with epilepsy. This study analyzes the differences in cortisol levels in people with epilepsy with high and low memory performance, and the relationships among cortisol levels, epilepsy-related factors, memory, anxiety, and depression. Fifty-two adults with drug-resistant epilepsy underwent a neuropsychological evaluation, in which nine saliva samples were collected to analyze the ability of the hypothalamic-pituitary-adrenal axis to descend in accordance with the circadian rhythm. Cortisol area under the curve (AUC) was computed to study the global cortisol changes. Patients with low immediate and delayed memory performance and left-hemisphere focus showed higher cortisol levels. Additionally, patients with low memory scores had higher cortisol AUC, and therefore slower declining levels in the afternoon. Memory performance was negatively related to the cortisol AUC and trait anxiety, being both reliable predictors of memory performance, especially in patients with left-hemisphere focus. These results suggest that memory deficits in people with drug-resistant epilepsy may be influenced by exposure to cortisol derived from chronic stress. Additionally, trait anxiety could contribute to increasing the vulnerability to stress.
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Affiliation(s)
- Irene Cano-López
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain.
| | - Vanesa Hidalgo
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain; Department of Psychology and Sociology, Area of Psychobiology, Social and Human Sciences Center, University of Zaragoza, Campus Ciudad Escolar, 44003, Teruel, Spain
| | - Kevin G Hampel
- Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026, Valencia, Spain
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026, Valencia, Spain
| | - Alicia Salvador
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain
| | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain
| | - Vicente Villanueva
- Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026, Valencia, Spain
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Cano-López I, Hampel KG, Garcés M, Villanueva V, González-Bono E. Quality of life in drug-resistant epilepsy: relationships with negative affectivity, memory, somatic symptoms and social support. J Psychosom Res 2018; 114:31-37. [PMID: 30314576 DOI: 10.1016/j.jpsychores.2018.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the relative contribution of factors non-directly related to seizures such as negative affectivity, social support, somatic symptoms and memory performance on quality of life (QOL) in patients with drug-resistant epilepsy. METHODS This is a cross-sectional study. Seventy patients with drug-resistant epilepsy were consecutively recruited from the inpatient Epilepsy Unit, Hospital Universitario y Politécnico La Fe, between April 2015 and October 2017. Medical history provided demographic characteristics of the patients (sex, age, and educational level), and clinical data (age at epilepsy onset, duration of epilepsy in years, frequency of seizures per month, type of seizures and number of AEDs). Pre-surgical assessment included diagnosis of the type of epilepsy and the lateralization of the epileptogenic area. All the patients underwent a neuropsychological assessment in which QOL (QOLIE-31), negative affectivity, social support, somatic symptoms, and memory were evaluated. RESULTS Negative affectivity (including anxiety-trait and depression), social support, neurosensory symptoms, and long-term verbal memory were significantly related to QOL composite score (for all, p < .009), subscales of QOL showing different sensitivities to them. Even after controlling for negative affectivity, neurosensory symptoms and long-term verbal memory significantly contribute to QOL composite score (p = .0001). CONCLUSION Results suggest that clinical management of patients with drug-resistant epilepsy should consider the treatment of verbal memory impairments at an early stage. Recognition of negative affectivity, poor social support and high somatic symptoms would also lead health professionals to develop different strategies to improve the QOL of patients with drug-resistant epilepsy.
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Affiliation(s)
- Irene Cano-López
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain.
| | - Kevin G Hampel
- Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026, Valencia, Spain
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026, Valencia, Spain
| | - Vicente Villanueva
- Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026, Valencia, Spain
| | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain
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Villanueva V, Montoya J, Castillo A, Mauri-Llerda JÁ, Giner P, López-González FJ, Piera A, Villanueva-Hernández P, Bertol V, Garcia-Escrivá A, Garcia-Peñas JJ, Garamendi I, Esteve-Belloch P, Baiges-Octavio JJ, Miró J, Falip M, Garcés M, Gómez A, Gil-López FJ, Carreño M, Rodriguez-Uranga JJ, Campos D, Bonet M, Querol R, Molins A, Tortosa D, Salas-Puig J. Perampanel in routine clinical use in idiopathic generalized epilepsy: The 12-month GENERAL study. Epilepsia 2018; 59:1740-1752. [PMID: 30062784 DOI: 10.1111/epi.14522] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/02/2018] [Accepted: 07/06/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To analyze the effectiveness and tolerability of perampanel across different seizure types in routine clinical care of patients with idiopathic generalized epilepsy (IGE). METHODS This multicenter, retrospective, 1-year observational study collected data from patient records at 21 specialist epilepsy units in Spain. All patients who were aged ≥12 years, prescribed perampanel before December 2016, and had a confirmed diagnosis of IGE were included. RESULTS The population comprised 149 patients with IGE (60 with juvenile myoclonic epilepsy, 51 generalized tonic-clonic seizures [GTCS] only, 21 juvenile absence epilepsy, 10 childhood absence epilepsy, 6 adulthood absence epilepsy, and one Jeavons syndrome). Mean age was 36 years. The retention rate at 12 months was 83% (124/149), and 4 mg was the most common dose. At 12 months, the seizure-free rate was 59% for all seizures (88/149); 63% for GTCS (72/115), 65% for myoclonic seizures (31/48), and 51% for absence seizures (24/47). Seizure frequency was reduced significantly at 12 months relative to baseline for GTCS (78%), myoclonic (65%), and absence seizures (48%). Increase from baseline seizure frequency was seen in 5.2% of patients with GTCS seizures, 6.3% with myoclonic, and 4.3% with absence seizures. Perampanel was effective regardless of epilepsy syndrome, concomitant antiepileptic drugs (AEDs), and prior AEDs, but retention and seizure freedom were significantly higher when used as early add-on (after ≤2 prior AEDs) than late (≥3 prior AEDs). Adverse events were reported in 50% of patients over 12 months, mostly mild or moderate, and irritability (23%), somnolence (15%), and dizziness (14%) were most frequent. SIGNIFICANCE In routine clinical care of patients with IGE, perampanel improved seizure outcomes for GTCS, myoclonic seizures, and absence seizures, with few discontinuations due to adverse events. This is the first real-world evidence with perampanel across different seizure types in IGE.
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Affiliation(s)
| | - Javier Montoya
- Lluis Alcanyis Hospital, Xátiva, Spain.,General University Hospital Valencia, Valencia, Spain
| | | | | | - Pau Giner
- University Hospital Dr Peset, Valencia, Spain
| | | | - Anna Piera
- University Hospital Clinic Valencia, Valencia, Spain
| | | | | | | | | | | | | | | | - Júlia Miró
- University Hospital Bellvitge, Barcelona, Spain
| | - Mercè Falip
- University Hospital Bellvitge, Barcelona, Spain
| | | | - Asier Gómez
- University Hospital and Polytechnic La Fe, Valencia, Spain
| | | | | | | | | | | | - Rosa Querol
- University Complex Infanta Cristina, Badajoz, Spain
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Trebaul L, Deman P, Tuyisenge V, Jedynak M, Hugues E, Rudrauf D, Bhattacharjee M, Tadel F, Chanteloup-Foret B, Saubat C, Reyes Mejia GC, Adam C, Nica A, Pail M, Dubeau F, Rheims S, Trébuchon A, Wang H, Liu S, Blauwblomme T, Garcés M, De Palma L, Valentin A, Metsähonkala EL, Petrescu AM, Landré E, Szurhaj W, Hirsch E, Valton L, Rocamora R, Schulze-Bonhage A, Mindruta I, Francione S, Maillard L, Taussig D, Kahane P, David O. Probabilistic functional tractography of the human cortex revisited. Neuroimage 2018; 181:414-429. [PMID: 30025851 PMCID: PMC6150949 DOI: 10.1016/j.neuroimage.2018.07.039] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/21/2018] [Accepted: 07/15/2018] [Indexed: 12/13/2022] Open
Abstract
In patients with pharmaco-resistant focal epilepsies investigated with intracranial electroencephalography (iEEG), direct electrical stimulations of a cortical region induce cortico-cortical evoked potentials (CCEP) in distant cerebral cortex, which properties can be used to infer large scale brain connectivity. In 2013, we proposed a new probabilistic functional tractography methodology to study human brain connectivity. We have now been revisiting this method in the F-TRACT project (f-tract.eu) by developing a large multicenter CCEP database of several thousand stimulation runs performed in several hundred patients, and associated processing tools to create a probabilistic atlas of human cortico-cortical connections. Here, we wish to present a snapshot of the methods and data of F-TRACT using a pool of 213 epilepsy patients, all studied by stereo-encephalography with intracerebral depth electrodes. The CCEPs were processed using an automated pipeline with the following consecutive steps: detection of each stimulation run from stimulation artifacts in raw intracranial EEG (iEEG) files, bad channels detection with a machine learning approach, model-based stimulation artifact correction, robust averaging over stimulation pulses. Effective connectivity between the stimulated and recording areas is then inferred from the properties of the first CCEP component, i.e. onset and peak latency, amplitude, duration and integral of the significant part. Finally, group statistics of CCEP features are implemented for each brain parcel explored by iEEG electrodes. The localization (coordinates, white/gray matter relative positioning) of electrode contacts were obtained from imaging data (anatomical MRI or CT scans before and after electrodes implantation). The iEEG contacts were repositioned in different brain parcellations from the segmentation of patients' anatomical MRI or from templates in the MNI coordinate system. The F-TRACT database using the first pool of 213 patients provided connectivity probability values for 95% of possible intrahemispheric and 56% of interhemispheric connections and CCEP features for 78% of intrahemisheric and 14% of interhemispheric connections. In this report, we show some examples of anatomo-functional connectivity matrices, and associated directional maps. We also indicate how CCEP features, especially latencies, are related to spatial distances, and allow estimating the velocity distribution of neuronal signals at a large scale. Finally, we describe the impact on the estimated connectivity of the stimulation charge and of the contact localization according to the white or gray matter. The most relevant maps for the scientific community are available for download on f-tract. eu (David et al., 2017) and will be regularly updated during the following months with the addition of more data in the F-TRACT database. This will provide an unprecedented knowledge on the dynamical properties of large fiber tracts in human.
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Affiliation(s)
- Lena Trebaul
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Pierre Deman
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Viateur Tuyisenge
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Maciej Jedynak
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Etienne Hugues
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - David Rudrauf
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Manik Bhattacharjee
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - François Tadel
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Blandine Chanteloup-Foret
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Carole Saubat
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Gina Catalina Reyes Mejia
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Claude Adam
- Epilepsy Unit, Dept of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Anca Nica
- Neurology Department, CHU, Rennes, France
| | - Martin Pail
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - François Dubeau
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France
| | - Agnès Trébuchon
- Service de Neurophysiologie Clinique, APHM, Hôpitaux de la Timone, Marseille, France
| | - Haixiang Wang
- Yuquan Hospital Epilepsy Center, Tsinghua University, Beijing, China
| | - Sinclair Liu
- Canton Sanjiu Brain Hospital Epilepsy Center, Jinan University, Guangzhou, China
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Université Paris V Descartes, Sorbonne Paris Cité, Paris, France
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Luca De Palma
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Rome, Italy
| | - Antonio Valentin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | | | | | | | - William Szurhaj
- Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - Edouard Hirsch
- University Hospital, Department of Neurology, Strasbourg, France
| | - Luc Valton
- University Hospital, Department of Neurology, Toulouse, France
| | - Rodrigo Rocamora
- Epilepsy Monitoring Unit, Department of Neurology, Hospital del Mar-IMIM, Barcelona, Spain
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | | | - Louis Maillard
- Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Delphine Taussig
- Service de neurochirurgie pédiatrique, Fondation Rothschild, Paris, France
| | - Philippe Kahane
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France; CHU Grenoble Alpes, Neurology Department, Grenoble, France
| | - Olivier David
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France.
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Garcés M, Ulloa M, Miranda A, Bravo LA. Physiological and ultrastructural characterisation of a desiccation-tolerant filmy fern, Hymenophyllum caudiculatum: Influence of translational regulation and ABA on recovery. Plant Biol (Stuttg) 2018; 20:288-295. [PMID: 29105969 DOI: 10.1111/plb.12660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/27/2017] [Indexed: 06/07/2023]
Abstract
The filmy fern Hymenophyllum caudiculatum can lose 60% of its relative water content, remain dry for some time and recover 88% of photochemical efficiency after 30 min of rehydration. Little is known about the protective strategies and regulation of the cellular rehydration process in this filmy fern species. The aim of this study was to characterise the filmy fern ultrastructure during a desiccation-rehydration cycle, and measure the physiological effects of transcription/translation inhibitors and ABA during desiccation recovery. Confocal and transmission electron microscopy were used to compare changes in structure during fast or slow desiccation. Transcription (actinomycin D) and translation (cycloheximide) inhibitors and ABA were used to compare photochemical efficiency during desiccation recovery. Cell structure was conserved during slow desiccation and rehydration, constitutive properties of the cell wall, allowing invagination and folding of the membranes and an important change in chloroplast size. The use of a translational inhibitor impeded recovery of photochemical efficiency during the first 80 min of rehydration, but the transcriptional inhibitor had no effect. Exogenous ABA delayed photochemical inactivation, and endogenous ABA levels decreased during desiccation and rehydration. Frond curling and chloroplast movements are possible strategies to avoid photodamage. Constitutive membrane plasticity and rapid cellular repair can be adaptations evolved to tolerate a rapid recovery during rehydration. Further research is required to explore the importance of existing mRNAs during the first minutes of recovery, and ABA function during desiccation of H. caudiculatum.
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Affiliation(s)
- M Garcés
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Bioren, Universidad de La Frontera, Temuco, Chile
- Departamento de Ciencias Agronómicas y Recursos Naturales, Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco, Chile
| | - M Ulloa
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Bioren, Universidad de La Frontera, Temuco, Chile
| | - A Miranda
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Bioren, Universidad de La Frontera, Temuco, Chile
| | - L A Bravo
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Bioren, Universidad de La Frontera, Temuco, Chile
- Departamento de Ciencias Agronómicas y Recursos Naturales, Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco, Chile
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14
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Iranzo-Tatay C, Rubio-Granero T, Gutierrez A, Garcés M, Conde R, Gómez-Ibáñez A, Arques-Egea S, Sancho-Miñana L, Hervas-Marín D, Villanueva V. Reply to letter to the editor: "The psychiatric risks of temporal epilepsy surgery. What should patients be told?" by Bengi Kansu. Epilepsy Behav 2018; 78:313-314. [PMID: 29102304 DOI: 10.1016/j.yebeh.2017.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 09/04/2017] [Indexed: 11/24/2022]
Affiliation(s)
| | - Teresa Rubio-Granero
- Department of Psychiatry, "La Fe" Hospital, Valencia, Spain; Multidisciplinary Epilepsy Unit of "La Fe" Hospital, Valencia, Spain
| | - Antonio Gutierrez
- Multidisciplinary Epilepsy Unit of "La Fe" Hospital, Valencia, Spain; Department of Neurosurgery, "La Fe" Hospital, Valencia, Spain
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit of "La Fe" Hospital, Valencia, Spain; Department of Neurology, "La Fe" Hospital, Valencia, Spain
| | - Rebeca Conde
- Multidisciplinary Epilepsy Unit of "La Fe" Hospital, Valencia, Spain; Department of Neurosurgery, "La Fe" Hospital, Valencia, Spain
| | - Asier Gómez-Ibáñez
- Multidisciplinary Epilepsy Unit of "La Fe" Hospital, Valencia, Spain; Department of Neurology, "La Fe" Hospital, Valencia, Spain
| | | | | | | | - Vicente Villanueva
- Multidisciplinary Epilepsy Unit of "La Fe" Hospital, Valencia, Spain; Department of Neurology, "La Fe" Hospital, Valencia, Spain
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15
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Villanueva V, Gómez A, Garcés M, Bermejo P, Montoya J, Toledo M, López-González FJ, Rodriguez X, Campos D, Martínez P, Giner P, Zurita J, Rodríguez-Uranga J, Ojeda J, Mauri JA, Ruiz-Giménez J, Poza JJ, Massot A, Bonet M. PO042 Early-esli study: from early add-on to monotherapy with eslicarbazepine acetate. J Neurol Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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16
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Villanueva V, Bermejo P, Montoya J, Toledo M, Gómez-Ibáñez A, Garcés M, Vilella L, López-González FJ, Rodriguez-Osorio X, Campos D, Martínez P, Giner P, Zurita J, Rodríguez-Uranga J, Ojeda J, Mauri JA, Camacho JL, Ruiz-Giménez J, Poza JJ, Massot-Tarrús A, Galiano ML, Bonet M. EARLY-ESLI study: Long-term experience with eslicarbazepine acetate after first monotherapy failure. Acta Neurol Scand 2017; 136:254-264. [PMID: 27935017 DOI: 10.1111/ane.12720] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 02/01/2023]
Abstract
PURPOSE Evaluate real-life experience with eslicarbazepine acetate (ESL) after first monotherapy failure in a large series of patients with focal epilepsy. METHOD Multicentre, retrospective, 1-year, observational study in patients older than 18 years, with focal epilepsy, who had failed first antiepileptic drug monotherapy and who received ESL. Data from clinical records were analysed at baseline, 3, 6 and 12 months to assess effectiveness and tolerability. RESULTS Eslicarbazepine acetate was initiated in 253 patients. The 1-year retention rate was 92.9%, and the final median dose of ESL was 800 mg. At 12 months, 62.3% of patients had been seizure free for 6 months; 37.3% had been seizure free for 1 year. During follow-up, 31.6% of the patients reported ESL-related adverse events (AEs), most commonly somnolence (8.7%) and dizziness (5.1%), and 3.6% discontinued due to AEs. Hyponatraemia was observed in seven patients (2.8%). After starting ESL, 137 patients (54.2%) withdrew the prior monotherapy and converted to ESL monotherapy; 75.9% were seizure free, 87.6% were responders, 4.4% worsened, and 23.4% reported ESL-related AEs. CONCLUSION Use of ESL after first monotherapy failure was associated with an optimal seizure control and tolerability profile. Over half of patients were converted to ESL monotherapy during follow-up.
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Affiliation(s)
- V. Villanueva
- Hospital Universitario y Politécnico La Fe; Valencia Spain
| | - P. Bermejo
- Hospital Universitario Puerta Hierro; Madrid Spain
| | | | - M. Toledo
- Hospital Universitario Vall d′Hebron; Barcelona Spain
| | | | - M. Garcés
- Hospital Universitario y Politécnico La Fe; Valencia Spain
| | - L. Vilella
- Hospital Universitario Vall d′Hebron; Barcelona Spain
| | | | | | - D. Campos
- Hospital Clínico Universitario; Valladolid Spain
| | - P. Martínez
- Hospital Universitario Virgen del Rocio; Sevilla Spain
| | - P. Giner
- Hospital Universitario Dr. Peset; Valencia Spain
| | - J. Zurita
- Hospital Universitario Infanta Leonor; Madrid Spain
| | - J. Rodríguez-Uranga
- Clínica Sagrado Corazón; Instituto de Especialidades Neurológicas; Sevilla Spain
| | - J. Ojeda
- Hospital Universitario Infanta Sofía; Madrid Spain
| | - J. A. Mauri
- Hospital Clinico Universitario Lozano Blesa; Zaragoza Spain
| | - J. L. Camacho
- Hospital Clinico Universitario Lozano Blesa; Zaragoza Spain
| | | | - J. J. Poza
- Hospital Universitario Donosti; San Sebastian Spain
| | | | - M. L. Galiano
- Hospital Universitario Gregorio Marañon; Madrid Spain
| | - M. Bonet
- Hospital Arnau de Vilanova; Valencia Spain
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17
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Cano-López I, Vázquez JF, Campos A, Gutiérrez A, Garcés M, Gómez-Ibáñez A, Conde R, González-Bono E, Villanueva V. Age at surgery as a predictor of cognitive improvements in patients with drug-resistant temporal epilepsy. Epilepsy Behav 2017; 70:10-17. [PMID: 28407524 DOI: 10.1016/j.yebeh.2017.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/16/2016] [Accepted: 03/04/2017] [Indexed: 10/19/2022]
Abstract
Temporal lobe epilepsy (TLE) surgery is an effective procedure that can produce cognitive changes. However, the prognostic factors related with cognitive outcomes need to be better understood. The aim of the present study is to know if age at surgery is a reliable predictor of verbal memory competence and considering factors such as: hemisphere; type of surgery; pre-surgical seizure frequency; and epilepsy duration. Sixty-one typically dominant patients with drug-resistant TLE (34 with left TLE [L-TLE] and 27 with right TLE [R-TLE]) underwent a neuropsychological assessment before and a year after surgery. Results showed that R-TLE patients had better evolution in short- and long-term verbal memory and naming than L-TLE patients (for all, p >.04). L-TLE patients also more frequently showed a strong and reliable decline in these functions than R-TLE patients. No effects for gender or type of surgery were found. From a multivariate approach, patients with improvements in verbal competence underwent surgery at earlier ages and suffered epilepsy for less time (for all, p <0.4). The relevance of age at surgery was confirmed as a predictor of long-term verbal memory changes, although the frequency of partial seizures also explains, at least partially, these changes. In addition, the frequency of partial seizures explains short-term verbal memory changes. These results emphasize the importance of early intervention, independently of the resected hemisphere, in order to minimize the cognitive side-effects of epilepsy treatment, as well the need to consider cognitive functions as related processes and network dependent.
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Affiliation(s)
- Irene Cano-López
- Department of Psychobiology/IDOCAL, University of Valencia, Spain; Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Juan Francisco Vázquez
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Anabel Campos
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Antonio Gutiérrez
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Asier Gómez-Ibáñez
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Rebeca Conde
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | | | - Vicente Villanueva
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain.
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18
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Gómez-Ibáñez A, Serratosa J, Guillamón E, Garcés M, Giráldez B, Toledo M, Salas-Puig J, López-González F, Rodríguez-Uranga J, Castillo A, Mauri J, Camacho J, López-Gomáriz E, Giner P, Torres N, Palau J, Molins A, Villanueva V. Efficacy and safety of eslicarbazepine-acetate in elderly patients with focal epilepsy: Case series. Seizure 2017; 48:53-56. [DOI: 10.1016/j.seizure.2017.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/15/2017] [Accepted: 04/06/2017] [Indexed: 12/01/2022] Open
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19
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Abilleira S, Ribera A, Cardona P, Rubiera M, López-Cancio E, Amaro S, Rodríguez-Campello A, Camps-Renom P, Cánovas D, de Miquel MA, Tomasello A, Remollo S, López-Rueda A, Vivas E, Perendreu J, Gallofré M, Martí-Fàbregas J, Delgado-Mederos R, Martínez-Domeño A, Marín R, Roquer J, Ois Á, Jiménez-Conde J, Guimaraens L, Chamorro Á, Obach V, Urra X, Macho J, Blasco J, San Roman L, Martínez-Yélamos A, Quesada H, Lara B, Cayuela N, Aja L, Mora P, Molina C, Ribó M, Pagola J, Rodríguez-Luna D, Muchada M, Coscojuela P, Dávalos A, Millán M, Pérez de la Ossa N, Gomis M, Dorado L, Castaño C, Garcia M, Estela J, Krupinski J, Huertas-Folch S, Nicolás-Herrerias M, Gómez-Choco M, García S, Martínez R, Sanahuja J, Purroy F, Serena J, Castellanos M, Silva Y, Marés R, Pellisé A, Ustrell X, Baiges J, Garcés M, Saura J, Soler-Insa J, Aragonés J, Cocho D, Palomeras E. Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different. Stroke 2017; 48:375-378. [DOI: 10.1161/strokeaha.116.015857] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 10/24/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients.
Methods—
Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel–Haenszel test statistic.
Results—
We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74–1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74–1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25–1.27).
Conclusions—
This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care.
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Affiliation(s)
- Sònia Abilleira
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Aida Ribera
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Pedro Cardona
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Marta Rubiera
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Elena López-Cancio
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Sergi Amaro
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Ana Rodríguez-Campello
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Pol Camps-Renom
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - David Cánovas
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Maria Angels de Miquel
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Alejandro Tomasello
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Sebastian Remollo
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Antonio López-Rueda
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Elio Vivas
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Joan Perendreu
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Miquel Gallofré
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
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20
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Villanueva V, Garcés M, López-González FJ, Rodriguez-Osorio X, Toledo M, Salas-Puig J, González-Cuevas M, Campos D, Serratosa JM, González-Giráldez B, Mauri JA, Camacho JL, Suller A, Carreño M, Gómez JB, Montoya J, Rodríguez-Uranga J, Saiz-Diaz R, González-de la Aleja J, Castillo A, López-Trigo J, Poza JJ, Flores J, Querol R, Ojeda J, Giner P, Molins A, Esteve P, Baigesr JJ. Erratum to "Safety, efficacy and outcome-related factors of perampanel over 12months in a real-world setting: The FYDATA study" [Epilepsy Res. 126 (2016) 201-210]. Epilepsy Res 2016; 129:174-175. [PMID: 28017504 DOI: 10.1016/j.eplepsyres.2016.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- V Villanueva
- Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - M Garcés
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - M Toledo
- Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J Salas-Puig
- Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - D Campos
- Hospital Clínico Universitario, Valladolid, Spain
| | | | | | - J A Mauri
- Hospital Clínico Universitario, Zaragoza, Spain
| | - J L Camacho
- Hospital Clínico Universitario, Zaragoza, Spain
| | - A Suller
- Hospital Clínico Universitario, Zaragoza, Spain
| | - M Carreño
- Hospital Clinic Universitari, Barcelona, Spain
| | - J B Gómez
- Hospital Clinic Universitari, Barcelona, Spain
| | - J Montoya
- Hospital Lluis Alcanyis, Xátiva, Spain
| | | | - R Saiz-Diaz
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - A Castillo
- Consorcio Hospital General Universitario, Valencia, Spain
| | - J López-Trigo
- Consorcio Hospital General Universitario, Valencia, Spain
| | - J J Poza
- Hospital Universitario Donosti, Spain
| | - J Flores
- Hospital Nuestra Sẽnora Candelaria, Tenerife, Spain
| | - R Querol
- Hospital Universitario Infanta Cristina, Badajoz, Spain
| | - J Ojeda
- Hospital Universitario Infanta Sofia, Madrid, Spain
| | - P Giner
- Hospital Universitario Dr Peset, Valencia, Spain
| | - A Molins
- Hospital Universitario Josep Trueta, Girona, Spain
| | - P Esteve
- Hospital Verge de la Cinta, Tortosa, Spain
| | - J J Baigesr
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Villanueva V, Saiz-Diaz R, Toledo M, Piera A, Mauri JA, Rodriguez-Uranga JJ, López-González FJ, Gómez-Ibáñez A, Garcés M, González de la Aleja J, Rodríguez-Osorio X, Palao-Duarte S, Castillo A, Bonet M, Ruiz-Giménez J, Palau J, Arcediano A, Toledo M, Gago A. NEOPLASM study: Real-life use of lacosamide in patients with brain tumor-related epilepsy. Epilepsy Behav 2016; 65:25-32. [PMID: 27863278 DOI: 10.1016/j.yebeh.2016.09.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/02/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND The choice of antiepileptic drug (AED) therapy in patients with brain tumor-related epilepsy (BTRE) is complicated, and there are a lack of robust clinical trial data to date. METHODS The NEOPLASM (Neuroncologic Patients treated with LAcoSaMide) study was a 6-month, multicenter, retrospective, observational study in patients with BTRE treated with lacosamide. Patients were started on lacosamide because of a lack of efficacy or adverse events (AEs) with prior AEDs or suitability versus other AEDs, according to clinical practice. The primary efficacy variable was the seizure-free rate at 6months. Safety variables included the proportion of patients with an AE and the proportion with an AE that led to discontinuation. RESULTS Overall, 105 patients from 14 hospital centers were included in the analysis. Treatment with lacosamide for 6months resulted in a 30.8% seizure-free rate, and 66.3% of patients had a ≥50% seizure reduction (responders). In the subset of patients included because of a lack of efficacy with prior AEDs, seizure-free rates were 28.0%, and 66.7% of patients were responders. No statistically significant differences in efficacy were observed according to the mechanism of action or enzyme-inducing properties of concomitant AEDs. Adverse events were reported by 41.9% of patients at 6months, and 4.7% of them led to discontinuation. The most common AEs were somnolence/fatigue and dizziness. Notably, 57.1% of the patients who were switched to lacosamide because of AEs with their previous therapy did not report any AE at 6-month follow-up. CONCLUSIONS In this open-label, observational study, lacosamide appeared to be effective and well tolerated in a large population of patients with BTRE. Lacosamide may therefore be a promising option for the treatment of patients with BTRE.
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Affiliation(s)
- Vicente Villanueva
- Hospital Universitario y Politécnico La Fe, Bulevard Sur, s/n, Carretera de Malilla, 46026 Valencia, Spain.
| | - Rosana Saiz-Diaz
- Hospital Universitario 12 de Octubre, Avda de Córdoba, s/n, 28041 Madrid, Spain
| | - Manuel Toledo
- Hospital Universitario Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - Ana Piera
- Hospital Clínico Universitario Valencia, Spain
| | - Jose Angel Mauri
- Hospital Clínico Universitario Lozano Blesa, Calle de San Juan Bosco, 15, 50009 Zaragoza, Spain
| | | | | | - Asier Gómez-Ibáñez
- Hospital Universitario y Politécnico La Fe, Bulevard Sur, s/n, Carretera de Malilla, 46026 Valencia, Spain
| | - Mercedes Garcés
- Hospital Universitario y Politécnico La Fe, Bulevard Sur, s/n, Carretera de Malilla, 46026 Valencia, Spain
| | | | | | | | - Ascensión Castillo
- Consorcio Hospital General Universitario de Valencia, Av Tres Cruces, 2, 46014, Valencia, Spain
| | - Macarena Bonet
- Hospital Arnau de Vilanova, Calle San Clemente, 12, 46015, Valencia, Spain
| | - Jesús Ruiz-Giménez
- Hospital Universitario Virgen de las Nieves, Avenida de las Fuerzas Armadas, 2, 18014 Granada, Spain
| | - Juan Palau
- Hospital Manises Avenidad Generalitat Valenciana, 46940 Manises, Spain
| | | | - Maria Toledo
- Hospital Universitario La Princesa Madrid, Calle Diego de León, Madrid, Spain
| | - Ana Gago
- Hospital Universitario La Princesa Madrid, Calle Diego de León, Madrid, Spain
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22
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Abilleira S, Ribera A, Quesada H, Rubiera M, Castellanos M, Vargas M, Gomis M, Krupinski J, Delgado-Mederos R, Gómez-Choco M, Giralt-Steinhauer E, Garcia M, Pellisé A, Purroy F, Garcés M, Gallofré M. Applicability of the SPAN-100 index in a prospective and contemporary cohort of patients treated with intravenous rtPA in Catalonia. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2014.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Villanueva V, Garcés M, López-González F, Rodriguez-Osorio X, Toledo M, Salas-Puig J, González-Cuevas M, Campos D, Serratosa J, González-Giráldez B, Mauri J, Camacho J, Suller A, Carreño M, Gómez J, Montoya J, Rodríguez-Uranga J, Saiz-Diaz R, González-de la Aleja J, Castillo A, López-Trigo J, Poza J, Flores J, Querol R, Ojeda J, Giner P, Molins A, Esteve P, Baiges J. Safety, efficacy and outcome-related factors of perampanel over 12 months in a real-world setting: The FYDATA study. Epilepsy Res 2016; 126:201-10. [DOI: 10.1016/j.eplepsyres.2016.08.001] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 07/18/2016] [Accepted: 08/03/2016] [Indexed: 01/05/2023]
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Garcés M, Chávez J, Villalobos-Labra R, Westermeier F, Sáez P, Salas-Pérez F, Cautivo K, Busso D, Varas J, San Martin S, Sobrevia L, Farías-Jofré M. High fat diet in mice induces endoplasmic reticulum stress in livers of their offspring. Placenta 2015. [DOI: 10.1016/j.placenta.2015.01.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Villanueva V, Garcés M, López-Gomáriz E, Serratosa JM, González-Giráldez B, Parra J, Rodríguez-Uranga J, Toledo M, López González FJ, Bermejo P, Giner P, Castillo A, Molins A, Campos D, Mauri JÁ, Muñoz R, Bonet M, Serrano-Castro P, del Villar A, Saiz-Díaz RA. Early Add-on Lacosamide in a Real-Life Setting: Results of the REALLY Study. Clin Drug Investig 2014; 35:121-31. [PMID: 25488477 DOI: 10.1007/s40261-014-0255-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Vicente Villanueva
- Hospital Universitario y Politécnico La Fe, Bulevard Sur, s/n, Carretera de Malilla, 46026, Valencia, Spain,
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Pedrosa M, Prieto-García A, Sala-Cunill A, Baeza ML, Cabañas R, Campos A, Cimbollek S, Gómez-Traseira C, González Quevedo T, Guilarte M, Jurado-Palomo J, Lobera T, López-Serrano MC, Marcos C, Piñero-Saavedra M, Prior N, Sáenz de San Pedro B, Ferrer M, Barceló JM, Daschner A, Echechipía M, Garcés M, Iriarte P, Jáuregui I, Lázaro M, Quiñones M, Veleiro B, Villareal O. Management of angioedema without urticaria in the emergency department. Ann Med 2014; 46:607-18. [PMID: 25580506 DOI: 10.3109/07853890.2014.949300] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Angioedema refers to a localized, transient swelling of the deep skin layers or the upper respiratory or gastrointestinal mucosa. It develops as a result of mainly two different vasoactive peptides, histamine or bradykinin. Pathophysiology, as well as treatment, is different in each case; nevertheless, the resulting signs and symptoms may be similar and difficult to distinguish. Angioedema may occur at any location. When the affected area involves the upper respiratory tract, both forms of angioedema can lead to an imminent upper airway obstruction and a life-threatening emergency. Emergency physicians must have a basic understanding of the pathophysiology underlying this process. Angioedema evaluation in the emergency department (ED) should aim to distinguish between histamine- and bradykinin-induced angioedema, in order to provide appropriate treatment to patients. However, diagnostic methods are not available at the ED setting, neither to confirm one mechanism or the other, nor to identify a cause. For this reason, the management of angioedema should rely on clinical data depending on the particular features of the episode and the patient in each case. The history-taking should be addressed to identify a possible etiology or triggering agent, recording complete information for an ulterior diagnostic study in the outpatient clinic. It is mandatory quickly to recognize and treat a potential life-threatening upper airway obstruction or anaphylaxis. This review focuses on the underlying mechanisms and management of histamine- and bradykinin-induced angioedema at the emergency department and provides an update on the currently available treatments.
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Affiliation(s)
- Maria Pedrosa
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
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Abugattas J, Llacuachaqui M, Allende YS, Velásquez AA, Velarde R, Cotrina J, Garcés M, León M, Calderón G, de la Cruz M, Mora P, Royer R, Herzog J, Weitzel JN, Narod SA. Prevalence of BRCA1 and BRCA2 mutations in unselected breast cancer patients from Peru. Clin Genet 2014; 88:371-5. [PMID: 25256238 DOI: 10.1111/cge.12505] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/17/2014] [Accepted: 09/17/2014] [Indexed: 01/14/2023]
Abstract
The prevalence of BRCA1 and BRCA2 mutations among breast cancer patients in Peru has not yet been explored. We enrolled 266 women with breast cancer from a National cancer hospital in Lima, Peru, unselected for age or family history. DNA was screened with a panel of 114 recurrent Hispanic BRCA mutations (HISPANEL). Among the 266 cases, 13 deleterious mutations were identified (11 in BRCA1 and 2 in BRCA2), representing 5% of the total. The average age of breast cancer in the mutation-positive cases was 44 years. BRCA1 185delAG represented 7 of 11 mutations in BRCA1. Other mutations detected in BRCA1 included: two 2080delA, one 943ins10, and one 3878delTA. The BRCA2 3036del4 mutation was seen in two patients. Given the relatively low cost of the HISPANEL test, one should consider offering this test to all Peruvian women with breast or ovarian cancer.
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Affiliation(s)
- J Abugattas
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - M Llacuachaqui
- Familial Breast Cancer Research Unit, Women's College Research Institute, Toronto, ON, Canada
| | - Y Sullcahuaman Allende
- Unidad de Genética y Biología Molecular, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.,Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - A Arias Velásquez
- Unidad de Genética y Biología Molecular, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - R Velarde
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - J Cotrina
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - M Garcés
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - M León
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - G Calderón
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - M de la Cruz
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - P Mora
- Departamento de Mamas, Partes Blandas y Piel, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - R Royer
- Familial Breast Cancer Research Unit, Women's College Research Institute, Toronto, ON, Canada
| | - J Herzog
- City of Hope Comprehensive Cancer Center and Beckman Research Institute, Division of Clinical Cancer Genetics, Duarte, CA, USA
| | - J N Weitzel
- City of Hope Comprehensive Cancer Center and Beckman Research Institute, Division of Clinical Cancer Genetics, Duarte, CA, USA
| | - S A Narod
- Familial Breast Cancer Research Unit, Women's College Research Institute, Toronto, ON, Canada
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Garcés M, Villanueva V, Mauri JA, Suller A, García C, López González FJ, Rodríguez Osorio X, Fernández Pajarín G, Piera A, Guillamón E, Santafé C, Castillo A, Giner P, Torres N, Escalza I, Del Villar A, García de Casasola MC, Bonet M, Noé E, Olmedilla N. Factors influencing response to intravenous lacosamide in emergency situations: LACO-IV study. Epilepsy Behav 2014; 36:144-52. [PMID: 24922617 DOI: 10.1016/j.yebeh.2014.05.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 04/14/2014] [Accepted: 05/18/2014] [Indexed: 01/13/2023]
Abstract
Status epilepticus (SE) and acute repetitive seizures (ARSs) frequently result in emergency visits. Wide variations in response are seen with standard antiepileptic drugs (AEDs). Oral and intravenous (IV) formulations of lacosamide are approved as adjunctive therapy in the treatment of partial-onset seizures in adults and adolescents. The aim of the retrospective multicenter observational study (LACO-IV) was to analyze data from a large cohort of patients with SE or ARSs of varying severity and etiology, who received IV lacosamide in the emergency setting. Patient clinical data were entered into a database; lacosamide use and efficacy and tolerability variables were analyzed. In SE, IV lacosamide tended to be used mainly in nonconvulsive status epilepticus as second- or third-line treatment. The proportion of patients with no seizures when IV lacosamide was the last drug administered was 76.5% (70.9% SE and 83.7% ARSs). The rate of seizure cessation ≤ 24 h after IV lacosamide administration was 57.1% (49.1% SE and 67.4% ARSs). Of the factors analyzed, a shorter latency from seizure onset to IV lacosamide infusion influenced treatment response significantly. A nonsignificant tendency towards a higher response was seen with lacosamide dose >200mg versus ≤ 200 mg. Analysis of response according to mechanism of action showed no significant differences in response to IV lacosamide in patients receiving prior sodium channel blocker (SCB) or non-SCB AEDs in the overall or SE population; however, in ARSs, a tendency towards a higher response was observed in those receiving non-SCB AEDs. The frequency and nature of adverse events observed were in line with those reported in other studies (somnolence being the most frequent). In the absence of randomized prospective controlled studies of IV lacosamide, our observations suggest that IV lacosamide may be a potential alternative for treatment of SE/ARSs when seizures fail to improve with standard AEDs or when AEDs are contraindicated or not recommended.
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Affiliation(s)
- Mercedes Garcés
- Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | | | | | - Ana Suller
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
| | - Carolina García
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
| | | | | | | | - Anna Piera
- Hospital Clínico Universitario, Valencia, Spain.
| | | | | | | | - Pau Giner
- Hospital Universitario Dr. Peset, Valencia, Spain.
| | - Nerea Torres
- Hospital Universitario Dr. Peset, Valencia, Spain.
| | | | | | | | - Macarena Bonet
- Hospital Universitario Arnau de Vilanova, Valencia, Spain.
| | - Enrique Noé
- Hospital NISA Valencia al Mar, Valencia, Spain.
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29
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Bernad M, Garcés M, Martín Mola E. SAT0483 Denosumab Compared with Alendronate in Osteoporotic Postmenopausal Women Previously Treated with Alendronate. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Villanueva V, Serratosa JM, Guillamón E, Garcés M, Giráldez BG, Toledo M, Salas-Puig J, López González FJ, Flores J, Rodríguez-Uranga J, Castillo A, Mauri JA, Camacho JL, López-Gomáriz E, Giner P, Torres N, Palau J, Molins A. Long-term safety and efficacy of eslicarbazepine acetate in patients with focal seizures: results of the 1-year ESLIBASE retrospective study. Epilepsy Res 2014; 108:1243-52. [PMID: 24908564 DOI: 10.1016/j.eplepsyres.2014.04.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/28/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Eslicarbazepine acetate (ESL) is a new antiepileptic drug (AED) licensed as adjunctive therapy in adults with partial-onset or focal seizures. OBJECTIVE To evaluate in a clinical practice setting the long-term efficacy and safety of ESL in patients with focal seizures. METHODS ESLIBASE was a retrospective study that included all patients with focal seizures who started ESL between January 2010 and July 2012 at 12 hospitals. ESL was prescribed individually according to real-life practice. Efficacy and safety were evaluated over 1 year. Switching from carbamazepine (CBZ) and oxcarbazepine (OXC) was assessed. RESULTS Three hundred and twenty-seven patients were included; 78% of patients were taking ≥2 other AEDs at baseline. Most (87%) began ESL because of poor seizure control and 13% because of adverse events (AEs) with CBZ or OXC. After 1 year, 237 patients (72.4%) remained on ESL. At 3, 6 and 12 months, the responder rate was 46.3%, 57.9%, and 52.5%, and 21.0%, 28.0%, and 25.3% of patients were seizure free. The responder rate significantly increased when ESL was combined with a non-sodium channel-targeting drug (non-SC drug) (66.7%) versus an SC drug (47.7%; p<0.001). At 12 months, 40.7% of patients had ≥1 AE; AEs led to treatment discontinuation in 16.2%. Dizziness, nausea, and somnolence were the most common AEs. The tolerability profile improved in >50% of the patients who switched from CBZ or OXC to ESL because of AEs. CONCLUSIONS ESL was well tolerated and effective in a real-world setting over 1 year. Side-effect profile improved when OXC and CBZ recipients were switched to ESL.
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Affiliation(s)
- V Villanueva
- Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - J M Serratosa
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - E Guillamón
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Garcés
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - B G Giráldez
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M Toledo
- Hospital Universitario Vall d́Hebron, Barcelona, Spain
| | - J Salas-Puig
- Hospital Universitario Vall d́Hebron, Barcelona, Spain
| | - F J López González
- Complejo Hospitalario Universitario Santiago, Santiago de Compostela, Spain
| | - J Flores
- Hospital Universitario Nuestra Señora Candelaria, Tenerife, Spain
| | - J Rodríguez-Uranga
- Instituto de Especialidades Neurológicas (IENSA), Clinica Sagrado Corazón, Sevilla, Spain
| | - A Castillo
- Consorcio Hospital General Universitario Valencia, Valencia, Spain
| | - J A Mauri
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - J L Camacho
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - P Giner
- Hospital Universitario, Dr. Peset, Valencia, Spain
| | - N Torres
- Hospital Universitario, Dr. Peset, Valencia, Spain
| | - J Palau
- Hospital de Manises, Manises, Spain
| | - A Molins
- Hospital Universitario Dr. JosepTrueta, Girona, Spain
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Montiel-Eulefi E, Jara F, Toro C, Garcés M, Leal P. Cytotoxic Effect of Double Emulsion (W/O/W) CuSO4 Loaded PLA Nanoparticles on MKN-45 Gastric Adenocarcinoma Cell Line. INT J MORPHOL 2014. [DOI: 10.4067/s0717-95022014000100011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Guillamón E, Miró J, Gutiérrez A, Conde R, Falip M, Jaraba S, Plans G, Garcés M, Villanueva V. Combination of corpus callosotomy and vagus nerve stimulation in the treatment of refractory epilepsy. Eur Neurol 2013; 71:65-74. [PMID: 24334999 DOI: 10.1159/000353979] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 06/23/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Palliative techniques such as partial corpus callosotomy (CC) and vagus nerve stimulation (VNS) may be effective for adequate control of seizures in pharmacoresistant patients who are not candidates for resective surgery. OBJECTIVE The objective of this study was to analyze the efficacy of the combination of these two techniques in patients where the first surgery had not achieved adequate control. MATERIALS AND METHODS This is a retrospective review of 6 patients with refractory epilepsy in which both types of surgery were performed, CC and VNS. We analyzed variables such as age, sex, age at onset of epilepsy, seizure types, electroencephalogram and magnetic resonance imaging results, and number of pre- and postoperative seizures. RESULTS Three patients first underwent VNS and then CC, and 3 patients were treated in reverse order. All patients had some improvement after the first surgery, but they continued to experience persistent falls, so a second palliative technique was used. The mean improvement after both surgeries was 89% (90% in patients first receiving CC and 87% in patients who first underwent VNS). CONCLUSIONS In adequately studied patients who are not optimal candidates for resective surgery, palliative surgery is a choice. The combination of VNS and CC shows good results in our series, although the right order to perform both procedures has not been defined. These results should be confirmed in a larger group of patients.
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Affiliation(s)
- E Guillamón
- Servicio de Neurología y Neurocirugía, Unidad Multidisciplinar de Epilepsia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Colás C, Montoiro R, Fraj J, Garcés M, Cubero JL, Caballero T. Nonhistaminergic idiopathic angioedema: clinical response to icatibant. J Investig Allergol Clin Immunol 2012; 22:520-521. [PMID: 23397675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- C Colás
- Allergy Department, Hospital Clínico Universitario "Lozano Blesa," Zaragoza, Spain.
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Le Pichon A, Ceranna L, Garcés M, Drob D, Millet C. On using infrasound from interacting ocean swells for global continuous measurements of winds and temperature in the stratosphere. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005jd006690] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Garcés M, Caron P, Hetzer C, Le Pichon A, Bass H, Drob D, Bhattacharyya J. Deep infrasound radiated by the Sumatra earthquake and tsunami. ACTA ACUST UNITED AC 2005. [DOI: 10.1029/2005eo350002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Baquero M, Blasco R, Campos-García A, Garcés M, Fages EM, Andreu-Català M. [Descriptive study of behavioural disorders in mild cognitive impairment]. Rev Neurol 2004; 38:323-6. [PMID: 14997455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is defined as an abnormality in cognitive function not provoking a noticeable disability in activities of daily living in the affected person. In a group of patients with MCI, we propose to observe and to quantify the presence of behavioral disorders, using the neuropsychiatric inventory (NPI). PATIENTS AND METHODS NPI is a known instrument in evaluation of this kind of disorders in patients with dementia, and it is a semi structured interview with a relevant informer or relative to the patient. NPI was applied to a series of 100 cases (61 women and 39 men) of MCI, diagnosed as usual in our settings. Mean age was 74.3 +/- 10 years, and mean MEC (Spanish modified version of MMSE) 25.57 +/- 4.2 (over a maximum of 35 points). RESULTS Most prevalent disorder was depression, in 36 % of cases, and other frequent findings were irritability (35%), anxiety (24%) and apathy (19%). In some cases, agitation (4%), abnormal motor behavior (3%) and delusions (1%) were detected. Hallucination, disinhibition and euphoria or elation were not detected in this series. CONCLUSION Data show a certain similarity with occidental culture environment, globally considered. The presence of behavioral and psychological disorders in patients with MCI could be a marker for later development of dementia. NPI can be a usable tool when detection and evaluation of these symptoms is required.
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Affiliation(s)
- M Baquero
- Unidad de Neuropsicología y Demencias, Servicio de Neurología, Hospital Universitario La Fe, Valencia, España.
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Affiliation(s)
- Douglas P. Drob
- E. O. Hulburt Center for Space Research; Naval Research Laboratory; Washington, DC USA
| | - J. M. Picone
- E. O. Hulburt Center for Space Research; Naval Research Laboratory; Washington, DC USA
| | - M. Garcés
- Infrasound Laboratory; University of Hawaii, Manoa; Kailua-Kona Hawaii USA
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Abstract
The Vallesian Crisis involved the extinction of most of the hominoids that settled successfully in Europe during the middle and early Late Miocene, including Dryopithecus, Ankarapithecus and Graecopithecus. This event has been dated at 9.6 Ma, predating by more than one million years the spread of the C4 grasses and the retreat of forests over large parts of the globe at 7-8 Ma. The finding of macrofloral remains in the Terrassa section (Vallès-Penedès Basin) sheds new light on the nature of vegetational change associated with the hominoid extinction. This section presents an abundant late Vallesian vertebrate fauna and has been accurately dated at 9.2 - 9 Ma by paleomagnetism. Therefore, it provides the best indication of the kind of vegetation that occupied the area after the Vallesian Crisis. It is suggested that the extinction of the late Miocene Western European hominoids was not related to the spread of grasses, but to a significant increase of a floral association dominated by deciduous trees.
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Affiliation(s)
- J Agustí
- Institute of Paleontology M. Crusafont (D. Barcelona-Unidad Asociada CSIC), E-08201 Sabadell, Spain.
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Fernández T, Ríos C, Santos S, Casadevall T, Tejero C, López-García E, Fabre O, Garcés M, Mauri JA, Iñíguez C, Pascual LF. ["Household items" : an alternative task to "animals" in the assessment of semantic verbal fluency: a validation study]. Rev Neurol 2002; 35:520-3. [PMID: 12389167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
INTRODUCTION The semantic verbal fluency (SVF) is usually evaluated with the task animals in 1 minute . This is a test widely applied in the screening of cognitive impairment. In our best knowledge there are not other alternatives categories for this task validated in our environment (Spanish as mother tongue, Spain). OBJECTIVE To validate the category households items as an alternative parallel task to animals in the assessment of SVF. PATIENTS AND METHODS Prospective assessment of two categories (animals and household items) in two groups: normal controls and patients with Alzheimer s disease (AD). RESULTS CONTROL GROUP n= 22 (13 M, 9 W); age: 73 5 years, education: 12 5 years; MMSE MEC 35: 30 4; Animals : 15 4. Percentile distribution 10th: 11; 50th: 15; 90th: 20; household items : 17 4. Percentile distribution: 10th: 12; 50th: 17; 90th: 22. AD group: n= 24 (9 M, 15 W); age: 74 5 years; education: 11 5 years; MMSE MEC 35: 17 8; Animals : 6 3. Percentile distribution: 10th: 2; 50th: 6; 90th: 9; household items : 6 4. Percentile distribution: 10th: 1; 50th: 6; 90th: 11. It is observed a positive correlation between the two categories (Spearman s Rho: 0.83, p< 0.0001). CONCLUSIONS Both SVF categories had a similar distribution and a high correlation. This findings demonstrated the validity of the household items as an alternative and parallel form to animals in the assessment of SVF in patients with cognitive impairment or dementia.
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Affiliation(s)
- T Fernández
- Hospital Clinico Universitario, Zaragoza, España.
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García F, Blanco JG, Garcés M, Juste S, Fuentes M, Herrero D. Freezing protects against allergy to Anisakis simplex. J Investig Allergol Clin Immunol 2002; 11:49-52. [PMID: 11436972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Allergic reactions to Anisakis simplex have been described following ingestion of fish and were thought to be possible even if seafood is frozen or well-cooked. OBJECTIVE This study aimed to confirm, by challenge test, that dead A. simplex larvae are not able to trigger allergic reactions in patients with proven hypersensitivity to this parasite. METHODS Simple-blind, placebo-controlled, oral challenge tests with frozen A. simplex larvae were performed in 12 patients who had suffered severe anaphylactic reactions after ingestion of seafood and diagnosed of A. simplex hypersensitivity by skin prick test and specific IgE. If no reaction appeared, they were told to eat frozen seafood. 63 patients who had suffered urticaria or urticaria/angioedema by demonstratred hypersensitivity to A. simplex were also advised to eat frozen seafood. All of them were reevaluated 6 months later. RESULTS All patients tolerated the dead larvae challenge test. After eating previously frozen seafood at least two times per week, all patients, including those who had suffered anaphylactic reactions and those who had only presented cutaneous manifestations, remained asymptomatic. CONCLUSIONS Anisakis simplex-allergic patients tolerate ingestion of dead larvae. It is probable that these patients can eat frozen fish and that a seafood-free diet is not necessary.
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Affiliation(s)
- F García
- Section of Allergy, Hospital General Yagüe, Burgos, Spain.
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Villanueva-Haba VE, Garcés M, de Vera A, Valero C, Burguera JA. [Descriptive study of a serie of patients affected by progressive supranuclear palsy]. Rev Neurol 2001; 32:1027-30. [PMID: 11562823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Progressive supranuclear palsy is a neurodegenerative disorder affecting diverse neurologic systems. The actual treatment response is poor in most patients. OBJECTIVE review of a long series of patients affected by PSP in several aspects. PATIENTS AND METHODS A series of patients was reviewed by means of the register questionnaire of PSP in Spain (from PSP Disabling Rating Scale and Staging System). This is carried out on the patients when the diagnostic is done. It was achieved a descriptive of the patients, in several aspects, and an evaluation of the treatment in relation to the dose and the duration. RESULTS In general, the age of diagnostic is 66 years, there is not neurological illness in the family, falls and disorders of gait are the most representative parameters. The neuroimage shows fronto temporal atrophy. The treatment response is poor, despite the dose and the duration. CONCLUSIONS Our series confirms the typical dates of the illness an the poor response to treatment with L Dopa.
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Affiliation(s)
- V E Villanueva-Haba
- Servicio de Neurología; Hospital Universitario La Fe, Valencia, 46009, España
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42
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Affiliation(s)
- F García
- Sección de Alergología, Hospital General Yagüe, Burgos, Spain
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Alonso O, Martinez M, Mut F, Delgado L, Lago G, De Boni D, Bazzano C, Núñez M, Garcés M, Muse IM, Roca R, Touya E, Espasandín J, Priario J. Detection of recurrent malignant melanoma with 99mTc-MIBI scintigraphy. Melanoma Res 1998; 8:355-60. [PMID: 9764811 DOI: 10.1097/00008390-199808000-00009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Initial reports suggest that 99mTc-methoxyisobutylisonitrile (MIBI) scanning may be of clinical value in staging patients with malignant melanoma. We carried out a study to evaluate the potential of this technique in the detection of recurrent disease. Whole-body 99mTC-MIBI scans were performed in 81 patients with a history of a surgically excised MM: 28 with known recurrent lesions and 53 during follow-up without evidence of disease. Images started 10 min post-injection, using a dose of 740 MBq. Diagnoses were confirmed by cytological/histological examination or at least one conventional imaging modality. Blinded interpretations of the MIBI scans were performed. Whole-body MIBI scanning correctly detected 68 (92%) of 74 metastatic lesions in the following sites: regional lymph nodes (n=23), non-regional lymph nodes (n=10), skin (n=16), brain/cerebellum (n=6), lung (n=8), bone (n=4) and breast (n=1). The technique failed to detect three subcutaneous regressive lesions (< 1 cm), one liver metastasis, one spleen metastasis and a case of multiple small lesions of the duodenal mucous membrane. In 14 patients the procedure detected previously unknown metastatic lesions. These results suggest that 99mTc-MIBI scanning is an effective imaging modality for whole-body screening of metastatic disease in malignant melanoma patients with the potential to influence treatment planning.
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Affiliation(s)
- O Alonso
- Nuclear Medicine Centre, Clinical Hospital of the University of Uruguay, Montevideo.
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Perea R, Bassas E, Lepe JA, Lombardo M, Garcés M. [Prevalence of antibodies to Entamoeba histolytica in the Northern area of the Province of Huelva]. Med Clin (Barc) 1998; 110:275. [PMID: 9562953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Affiliation(s)
- F García
- Sección de Alergología, Hospital General Yagüe, Burgos, Spain
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Hagerty M, Schwartz SY, Protti M, Garcés M, Dixon T. Observations at Costa Rican volcano offer clues to causes of eruptions. ACTA ACUST UNITED AC 1997. [DOI: 10.1029/97eo00337] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- R Pérez
- Sección de Alergología Hospital General Yague, Burgos, Spain
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Affiliation(s)
- P Rodriguez
- Sección Alergología, Hospital General Yagüe, Burgos, Spain
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49
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Affiliation(s)
- S Juste
- Seccion de Alergología, Hospital General Yagüe, Burgos, Spain
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Affiliation(s)
- J Jerez
- Seccion Allergologia, Hospital Nacional Marques de Valdecilla, Santander, Spain
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