RESUMO
Objective To observe the long-term efficacy and safety of topiramate in the treatment of symptomatic epilepsy in infants.Methods Fifty infants with symptomatic epilepsy were collected.The monotherapy was started with topiramate from April 2012 to April 2013,including 26 males and 24 females.The effective rate,retention rate and adverse effects after using the medication at 1 year,2 years,3 years,4 years were evaluated.Kaplan -Meier and Cox proportional hazards regression model were used to calculate the retention rate and analyze the risk factors for retention rate.Results From the beginning of using the medicine,the effective rate was 66.00％ at 1 year,61.90％ at 2 years,58.33％ at 3 years,and 53.33％ at 4 years,respectively.The rates of complete remission were 44.00％,42.86％,41.67％,36.67％ at 1 year,2 years,3 years,4 years,respectively.The main adverse effects of topiramate were drowsiness,hypodynamia,weight loss,anepithymia,vomit,diarrhea,hypohidrosis,slowly thinking active,attention disorders,etc.The retention rate was 84.00％ at 1 year,72.00％ at 2 years,60.00％ at 3 years,and 48.00％ at 4 years.The main causes of stopping medication were lower curative effect of topiramate monotherapy and side effects.Conclusion Topiramate in the treatment of infants with symptomatic epilepsy has good effect and safety,with higher retention rate in a long-term follow-up.The major factors that affect the retention rate are lower curative effect and adverse reactions.Slowly add quantity and low dose treatment can reduce adverse drug reactions,improve compliance and increase retention rate.
RESUMO
Objective To evaluate the diagnostic value of the common test parameters in acute fever without obvious infection focus and sick appearance in children under 5 years.Methods The hospitalized children with fever duration less than 7 days, anal temperature higher than or equal to 38°C, age younger than or equal to 5 years, and without obvious infection focus and sick appearance were recruited, we investigated the diagnosis value of common test parameters including C-reactive protein (CRP), procalcitonin (PCT), the white blood cell count (WBC), and neutrophil percentage (N%) , according to the ifnal diagnostic.Results Of 228 children, 42 children (18.42%) had serious diseases, the difference of CRP, PCT between serious diseases group and non-serious diseases group were statistically signiifcant (P<0.001). The diagnostic cut-off point of CRP was 67.1 mg/L by speciifcity of 0.810 and sensitivity of 0.715, that of PCT was 0.505 ng/L by speciifcity 0.762 and sensitivity 0.672. The speciifcity and sensitivity combining CRP with PCT was respectively 0.918 and 0.617. Of 228 children, 32 children had viral infections, 40 children had bacterial infections, 15 children had mycoplasma infections. The difference of CRP, PCT, WBC, and N% among three groups were statistically signiifcant (P<0.01).The cut-off point of CRP was 38 mg/L by sensitivity 0.900 and spec-iifcity 0.813, that of PCT was 0.450 ng/L by sensitivity 0.700 and speciifcity 0.812, and the speciifcity and sensitivity combining CRP with PCT was respectively 0.965 and 0.630, to distinguish bacterial infections from viral infections. The diagnostic cut-off point of CRP was 80.75 mg/L by sensitivity 0.700 and speciifcity 0.933 distinguishing bacterial infections from mycoplasma infections.Conclusions The parameters CRP and PCT have the diagnostic value for the children with the acute fever and age younger than or equal to 5 years and without obvious infection focus and sick appearance in etiology and serious diseases, espe-cially the value of combining CRP with PCT is better.
RESUMO
0.05). The 2 cases in Carbamazepine group appeared severe complications.Conclusions There are significant curative effects of single drug treatment with Oxcarbazepine and Carbamazepine on new diagnostic children with partial epilepse,and the adverse reaction and tolerance are similar. The severe complication is not appeared in Oxcarbazepine group.