Characteristics Of Cognitive Status Of Epilepsy Patients Treated With Monotherapy Of First-Generation Antiepileptic Drugs

@#Epilepsy is one of the main health problems in neurology that can lead to cognitive decline. Generally, the epilepsy-associated cognitive decline is influenced by demographic, clinical, and treatment characteristics. This study aimed to determine the characteristics of cognitive status of epilepsy patients who received monotherapy using first-generation antiepileptic drugs (AEDs), namely phenytoin, carbamazepine, and valproic acid. It involved 93 epilepsy patients of Mutiara Sukma Mental Hospital (n=38) and Mataram General Hospital (n=55). Besides, 93 healthy patients were assigned as healthy control group (HC) subjects (n=93). Demographic characteristics collected from epilepsy and HC groups were age, gender, and years of education. Clinical characteristics taken from both groups were MoCA-Ina score. Clinical characteristics taken from epilepsy group were age at epilepsy onset, type of seizure (partial vs generalized), etiology (idiopathic vs structural), first-generation AED used, years of treatment, and cognitive status. The result of the study revealed that there were no significant different between the two groups in the means of age and years of education as well as the frequency of male gender (p>0.05). The mean of MoCA-Ina score of epilepsy group was significantly lower compared with HC group (p<0.05). The frequency of cognitive decline among epilepsy patients was 75.3%. The cognitive functions of epilepsy patients using monotherapy with carbamazepine, phenytoin, or valproic acid was significantly lower compared with healthy subjects. We conclude that there was high prevalence of epilepsy-associated cognitive impairment which was associated with male gender.

History and Future of Antipsychotic Drugs / 신경정신의학

After the discovery of antipsychotic drugs, the nature of clinical practice entered a period of inexorable transition. The advances of psychopharmacotherapy have interacted in complex ways with clinical practice, and the economics and policy of mental health care systems. The study of the mechanisms of action of these drugs has guided the development of hopefully improved treatment, and stimulated biological research on the pathophysiology of severe mental disorders. Despite the considerable effort to modify and change existing antipsychotic drugs, progress has been modest. This review describes the history of antipsychotic drugs and their impact on clinical practice and the study of psychiatric disorders, and offer prospects for future developments. Although finding new knowledge and methodologies to bring innovative discovery is imperative, as of now, it is important to provide comprehensive care, including the optimal use of existing antipsychotic drugs.

First-generation epithelial growth factor receptor tyrosine kinase inhibitor in the first-line treatment of advanced non-small cell lung cancer: 166 cases analysis of progression-free survival / 中国实用内科杂志

OBJECTIVE: Explore the clinical benefit factors of progression-free survival(PFS) in sensitive epithelial growth factor receptor(EGFR) gene mutated advanced non-small cell lung cancer patients treated with first-generation of EGFR tyrosine kinase inhibitor(TKI).METHODS: The clinical data of 166 patients who received first-line treatment with first-generation EGFR-TKI were retrospectively collected in 2016-2017 from Xiangya Hospital, Central South University. The patients were divided into three groups: PFS≤3 m,3 m

Effects of different doses of T-2 toxin on organs and bones of BALB/c pregnant mice and their offspring mice / 中华地方病学杂志

Objective To study the effects of different doses of T-2 toxin on organs and bones of BALB/c pregnant mice and their offspring mice.Methods Sixty female SPF BALB/c mice at the age of 6-weeks were mated with 30 6-week-old male SPF BALB/c mice.Female mice were divided into control,low dose,medium dose and high dose groups according to body weight via the random digital table method,with 15 mice in each group.After mating with male mice,the pregnant mice in each group were 14,10,9 and 15,respectively.Nutritional interventions (feed:the doses of T-2 toxin were 0,600,1 200 and 2 400 ng/g,respectively) were initiated from the gestation day 0 until the first generation mice were grown up (6-weeks-old).The growth status and organ coefficient (heart,liver,kidney,thymus,spleen and brain) of the two generations in each period were recorded.Skeletal X-ray photographs of the two generations were taken by digital radiography.The histopathological changes in the organs (liver,thymus,spleen and epiphyseal cartilage) of the two generations were observed under light microscope.Results Among the pregnant mice,there were no significant differences in organ coefficients (P ＞ 0.05).No abnormalities were observed in each group of skeletal X-ray photographs.In the female generation mice,there were no significant differences in the coefficients of heart,liver and kidney (F =0.233,2.196,0.430,P ＞ 0.05),while there were significant differences in the coefficients of thymus,spleen and brain (F=3.683,3.148,4.498,P ＜ 0.05),and the thymus coefficient of medium dose group was higher than that of control group;the thymus coefficient of high dose group was lower than that of other three groups;the spleen coefficients of the three dose groups were higher than that of control group;the brain coefficients of the three dose groups were lower than that of control group (P ＜ 0.05).In the male generation mice,there were no significant differences in the coefficients of thymus and brain (F =2.447,1.620,P ＞ 0.05),while there were significant differences in the coefficients of heart,liver,kidney and spleen (F =5.339,2.738,11.435,2.872,P ＜ 0.05),and the heart coefficient of high dose group was lower than that of control group and low dose group;the coefficients of liver and kidney in medium dose and high dose groups were lower than those in control and low dose groups;the spleen coefficients of the three dose groups were higher than that of control group (P ＜ 0.05).The pathological changes of liver,thymus,spleen and epiphyseal cartilage were found in dose exposure groups;epiphyseal hyperplasia was found in the skeletal X-ray photographs of medium and high dose groups.Conclusion T-2 toxin has no significant effects on pregnant mice,but it could cause damage to the organs and epiphyseal plate cartilage of the first generation,and the location of the injury is related to gender.

Comparison of Efficacy and Safety between First- and Second-Generation Drug-Eluting Stents in Patients with Acute Coronary Syndrome / 中华医学杂志(英文版)

Background@#It remains undetermined whether second-generation drug-eluting stents (G2-DESs) outperform first-generation DESs (G1-DESs) in patients with acute coronary syndrome (ACS). We aimed to compare the efficacy and safety of G1-DES and G2-DES in ACS patients in a high-volume cardiovascular center.@*Methods@#In 2013, 10,724 consecutive patients underwent percutaneous coronary intervention in our institution. We included 4037 patients with ACS who underwent exclusively G1-DES or G2-DES implantation (n = 364 and n = 3673, respectively). We used propensity score matching to minimize the imbalance between the G1-DES and G2-DES groups and followed patients for 2 years. The efficacy endpoints were major adverse cardiac events (MACEs) and its components including target vessel-related myocardial infarction (TV-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), and cardiac death. The safety endpoint was stent thrombosis. Continuous variables were compared by Mann-Whitney U-test, and categorical variables were compared using Pearson's Chi-square or Fisher's exact test. Kaplan-Meier curves were constructed to compare the event-free survival rates, and multivariate Cox proportional hazards regression analysis was used to assess whether stent type was an independent risk factor for the efficacy and safety endpoints.@*Results@#At the 2-year follow-up, the results for MACE and it components, as well as stent thrombosis, were similar for G1-DES and G2-DES (MACE, 5.2% vs. 4.3%, χ = 0.514, P = 0.474; TV-MI, 0.8% vs. 0.4%, P = 0.407; TVR, 4.9% vs. 3.7%, χ = 0.939, P = 0.333; TLR, 3.8% vs. 2.5%, χ = 1.610, P = 0.205; cardiac death, 0.3% vs. 0.5%, P = 0.670; and stent thrombosis, 0.5% vs. 0.4%, P > 0.999). Kaplan-Meier analysis indicated similar event-free survival rates between G1-DES and G2-DES after propensity score matching (all: log-rank P > 0.05). Multivariate analysis demonstrated that stent type was not an independent risk factor for the efficacy and safety endpoints (MACE, hazard ratio [HR] = 0.805, 95% confidence interval [CI]: 0.455-1.424, P = 0.456; TV-MI, HR = 0.500, 95% CI: 0.101-2.475, P = 0.395; TVR, HR = 0.732, 95% CI: 0.403-1.330, P = 0.306; TLR, HR = 0.629, 95% CI: 0.313-1.264, P = 0.193; cardiac death, HR = 1.991, 95% CI: 0.223-17.814, P = 0.538; and stent thrombosis, HR = 0.746, 95% CI: 0.125-4.467, P = 0.749).@*Conclusion@#G1-DES and G2-DES have similar efficacy and safety profiles in ACS patients at the 2-year follow-up.

Segmentación y exclusión en Chile: el caso de los jóvenes primera generación en educación superior / Segmentation and exclusion in Chile: the case of first generation young people in higher education / Segmentation and exclusion in Chile: the case of first generation young people in higher

Haciendo uso de bases de datos históricas del Proceso de Admisión a la Educación Superior en Chile, mediante un análisis estadístico inferencial y comparativo, este artículo tiene como objetivo analizar a estudiantes “Primera Generación” y sus elecciones profesionales, contrastándolo con el estudiante “Continuista”. Los principales hallazgos informan sobre la existencia de atributos y comportamientos diferenciales del estudiante “Primera Generación” respecto del alumno “Continuista”, dando cuenta de la persistencia de procesos de exclusión y segregación que se manifiestan en una elección profesional fuertemente condicionada por el habitus que reproduce desigualdades y limita las aspiraciones a un conjunto restringido de opciones. Este escenario pone en cuestión el real ejercicio de la opción vocacional así como la mayor democratización e inclusión de un sistema de educación superior masificado y diversificado.

Using historical databases that contain statistics on higher educationadmissions in Chile, this article uses an inferential and comparative statistical analysis to analyze“first generation” university students” and their career choices, contrasting with “continuousgeneration” students, whose parents and/or grandparents also went to university. The main findingsof this report the existence of differential attributes and behaviors of “first generation” studentscompared to the “continuous generation” students, demonstrating the persistence of exclusion andsegregation processes that manifest themselves in professional choices that are highly conditioned by the habitus that reproduces inequalities and limits aspirations to a restricted set of options. Thisscenario calls into question the actual exercise of making vocational choices and the increaseddemocratization and inclusion of a mass and diversified higher education system.

Usando bases de dados históricos de admissão ao ensino superior noChile por meio de uma análise estatística inferencial e comparativa, este artigo tem por objetivoanalisar os alunos de primeira geração e suas escolhas de carreira, contrastando com os alunosveteranos.As principais conclusões do relatório informam a existência de atributos e comportamentosdiferentes do estudante “Primeira Geração” em relação ao aluno veterano, percebendo a persistênciade processos de exclusão e segregação que se manifestam em uma escolha de profissionais altamentecondicionada pelo habitus que reproduz as desigualdades e aspirações limitadas a um conjuntorestrito de opções. Este cenário põe em questão o real exercício da escolha profissional assim comoda maior democratização e inclusão de um sistema de ensino superior massificado e diversificado.

A clinical study on dystonia manifested as parkinsonism( report of 1 next-generation sequencing attached case) / 临床神经病学杂志

Objective To discuss the clinical features of dystonia manifested as Parkinsonism ( PKS) . Methods Clinical materials of a patient with dystonia manifested as PKS were analyzed retrospectively. Results The onset age of the young women was 31 years old, who was started asymmetrically with symptoms of claudication and tremor of the right foot. Levodopa had a short-term effect. The results of dopamine transporter ( DAT) PET showed that DAT in retrolentiform part were decreased significantly. Atypical Parkinson's disease was considered and she was treated as PKS long-termly. Subsequently, heterozygous mutation of c. 268-4T>A (NM_018105) in DYT6 gene was found through the next-generation sequencing, which was a kind of splicing mutation and confirmed by the first-generation sequencing. Conclusions Patients with dystonia might share similar clinical manifestations with PKS. Particularly, they should be differentiated with young-onset Parkinson's disease combined with focal dystonia. Clinical observation and genetic testing are important approaches to differentiate them.

Update on Medications in Schizophrenia

Antipsychotics are a pharmacologically heterogeneous group of compounds, but all act as D2 dopamine receptor antagonists, an action linked to their antipsychotic effect. Today, sixty years on since 1952, we have the FGAs and the SGAs. These medications continue to be useful, and continue to have some troubling adverse effects. As a class, the FGAs are more likely to be associated with EPS but this is primarily true of medications that bind tightly with D2 neuroreceptors, such as haloperidol, and less true of medications that bind weakly, such as chlorpromazine. Anticholinergic effects are especially prominent with weaker-binding FGAs, as well as with the SGA clozapine. As a class, the SGAs, especially clozapine and olanzapine generally tend to cause more problems relating to the metabolic syndrome, such as obesity and type 2 diabetes mellitus. All antipsychotic medications are associated with an increased likelihood of sedation, sexual dysfunction, postural hypotension, prolonged QT interval and sudden death. Primary care physicians need to be familiar with the individual adverse effect profiles of these medications.

Expresionismo y revolución: el abismo de la realidad / Expressionism and revolution: the abism of the reality / Expressionismo e revolução: o abismo da realidade

En este estudio se plantea el paso de la conciencia expresionista a la conciencia crítica; es decir, la evolución del Expresionismo artístico hacia la creación de la Teoría Crítica sociológica en la Alemania de la República de Weimar. De este modo, se repasan los procesos sociales y culturales que dieron lugar a un tipo de Arte en el que se reflejaban las profundas y dramáticas contradicciones de las primeras décadas del siglo XX, subrayándose por tanto como la Escuela de Frankfurt en su primera Generación (Adorno, Horkheimer, Benjamín) significó el punto de inflexión fundamental para analizar y entender filosófica y sociológicamente estas complejas y profundas contradicciones colectivas, así como sus consecuencias históricas posteriores.

This study emerges from the expressionist consciousness about the critical consciousness; in other words, the evolution of the artistic expresionism toward the creation of the critical Theory in the Germany of the Republic of Weimar. In this way, the social and cultural processes that gave place to a type of Art in which there were reflected the deep and dramatic contradictions of the first decades of the XXth century are revised, being underlined, therefore, that the School of Frankfurt in his First Generation (Adorno, Horkheimer, Benjamin) is the point of fundamental inflection to analyse and to understand philosophical and sociologically these complex and deep collective contradictions, as well as its subsequent and later historical consequences.

Neste estudo expõe o a passagem da consciência expressionista para consciência crítica; isto é, a evolução do Expressionismo artístico até a criação da Teoria Crítica sociológica na Alemanha na República de Weimar. O texto faz uma revisão dos processos sociais e culturais que deram lugar a um tipo de Arte na qual se reflete as profundas e dramáticas contradições das primeiras décadas do século XX, destacando-se como a Escola de Frankfurt, em sua primeira Geração (Adorno, Horkheimer, Bejamin), significou o ponto de inflexão fundamental para analisar e endender filosófica e sociologicamente estas complexas e profundas contradições coletivas, assim como suas consequências históricas posteriores.

Health Care Status of First Generation Korean Immigrants in New Zealand / 간호학회지

The purpose of this study is to describe the health care status of Korean Immigrants in New Zealand. The sample consisted of 155 Koreans who were randomly selected from the Korean Immigrants telephone book in Auckland, N.Z. They had health problems that required health management both physically(50.3%) and psychologically(70.3%). During the previous year, the average rate of medical contact with a general practitioner was 1+/-1.29 times. Korean immigrants who had health problems first attempted to resolve the problem through self medication rather than utilize health care services. They would only visit a general practitioner if they had severe subjective symptoms or no relief from self medication. Even if they think they need to visit the health care service, 41.9% of the subjects did not go back for follow-up care. Generally, the person who demonstrated positive health care behaviors was male, a college level graduate or higher, lived in N.Z. longer than 2 years, had a high score on health status by self assessment, and he placed few demands on health care services. Barriers to a healthy lifestyle are communication difficulties in expressing subjective symptoms, understanding the physician's treatment and medication plans, difficulty in accessing the appointment system, ant the high cost of service.

Health Care Status of First Generation Korean Immigrants in New Zealand / 간호학회지

The purpose of this study is to describe the health care status of Korean Immigrants in New Zealand. The sample consisted of 155 Koreans who were randomly selected from the Korean Immigrants telephone book in Auckland, N.Z. They had health problems that required health management both physically(50.3%) and psychologically(70.3%). During the previous year, the average rate of medical contact with a general practitioner was 1+/-1.29 times. Korean immigrants who had health problems first attempted to resolve the problem through self medication rather than utilize health care services. They would only visit a general practitioner if they had severe subjective symptoms or no relief from self medication. Even if they think they need to visit the health care service, 41.9% of the subjects did not go back for follow-up care. Generally, the person who demonstrated positive health care behaviors was male, a college level graduate or higher, lived in N.Z. longer than 2 years, had a high score on health status by self assessment, and he placed few demands on health care services. Barriers to a healthy lifestyle are communication difficulties in expressing subjective symptoms, understanding the physician's treatment and medication plans, difficulty in accessing the appointment system, ant the high cost of service.