Características clínicas de pacientes con epilepsia atendidos en la atención primaria / Clinical characteristics of patients with epilepsy attending primary health care

Objetivo: Este estudio tuvo como objetivo llenar el vacío de conocimiento actual en la bibliografía mediante la identificación de las características demográficas y clínicas de los pacientes con epilepsia que asisten a la atención primaria de salud. Pacientes y métodos: Éste fue un estudio transversal que involucró a adultos (18 años o mayores) con epilepsia que asistieron a atención primaria de salud de un país en desarrollo entre 2015 y 2019. Se recopilaron información demográfica y datos relacionados con la epilepsia. Resultados: Se evaluó a un total de 140 pacientes –51,4%, varones; edad media (± desviación estándar), 44,9 ± 17,8 años–. La edad media de inicio de las crisis fue de 29,9 ± 22,9 años, con una evolución media de 14,3 ± 15,4 años. Las crisis focales presentes en el 88,57% de los casos y evolucionaron a crisis tonicoclónicas bilaterales (45,16%). De las generalizadas, las crisis motoras predominaron con el 81,82%; las ausencias, el 9,09%; y las motoras + ausencias, el 9,09%. Entre las crisis motoras de inicio generalizado, predominó la tonicoclónica, con un 55,56%. Entre los tipos, predominó la epilepsia focal (88,57%). Las etiologías primarias fueron desconocidas (62,14%), causas estructurales (27,85%) e infecciosas (9,28%). Los pacientes en monoterapia representaron el 66,1%, con control de la epilepsia en el 92,4%. Los fármacos antiepilépticos más utilizados fueron la carbamacepina (33,1%), el ácido valproico (28,2%) y el fenobarbital (10,4%). Conclusiones: Predominaron el sexo masculino, las convulsiones y la epilepsia focal. La resonancia magnética fue más útil que la tomografía computarizada. La mayoría de las etiologías se desconocían; sin embargo, la esclerosis temporal mesial y la neurocisticercosis fueron las causas conocidas más prevalentes. La mayoría de los pacientes se controlaron con un régimen de monoterapia. La implementación de las clasificaciones y definiciones de la Liga Internacional contra la Epilepsia fue factible y útil.(AU)

Objective: This study aimed to fill the current knowledge gap in the literature by identifying the demographic and clinical characteristics of patients with epilepsy attending primary health care (PHC). Patients and methods: This was a cross-sectional study involving adults (≥ 18 years of age) with epilepsy attending PHC from a developing country between 2015 and 2019. Demographic information and epilepsy-related data were collected. Results: A total of 140 patients (51.4% male; mean [± SD] age 44.9 ± 17.8 years) were evaluated. The mean age at onset of seizures was 29.9 ± 22.9 years, with a mean evolution of 14.3±15.4 years. Focal seizures accounted for 88.57% of cases and evolved into bilateral tonic-clonic attack (45.16%). Of those that were generalized, motor seizures accounted for 81.82%, absence 9.09%, and motor + absence 9.09%. Among generalized onset motor seizures, tonic-clonic was predominant, accounting for 55.56%. Among types, focal epilepsy predominated (88.57%). The primary etiologies were unknown (62.14%), structural causes (27.85%) and infectious (9.28%). Patients undergoing monotherapy accounted for 66.1%, with epilepsy control in 92.4%. The most commonly used antiepileptic drugs were carbamazepine (33.1%), valproic acid (28.2%), and phenobarbital (10.4%). Conclusions: Male sex, seizures, and focal epilepsy were prevalent. Magnetic resonance imaging was more useful than computed tomography. Most etiologies were unknown; however, mesial temporal sclerosis and neurocysticercosis were the most prevalent known causes. Most patients were controlled using a monotherapy regimen. The implementation of International League Against Epilepsy classifications and definitions was feasible and useful.(AU)

Clinical characteristics of patients with epilepsy attending primary health care. / Características clínicas de pacientes con epilepsia atendidos en la atención primaria.

OBJECTIVE: This study aimed to fill the current knowledge gap in the literature by identifying the demographic and clinical characteristics of patients with epilepsy attending primary health care (PHC). PATIENTS AND METHODS: This was a cross-sectional study involving adults (= 18 years of age) with epilepsy attending PHC from a developing country between 2015 and 2019. Demographic information and epilepsy-related data were collected. RESULTS: A total of 140 patients (51.4% male; mean [± SD] age 44.9 ± 17.8 years) were evaluated. The mean age at onset of seizures was 29.9 ± 22.9 years, with a mean evolution of 14.3±15.4 years. Focal seizures accounted for 88.57% of cases and evolved into bilateral tonic-clonic attack (45.16%). Of those that were generalized, motor seizures accounted for 81.82%, absence 9.09%, and motor + absence 9.09%. Among generalized onset motor seizures, tonic-clonic was predominant, accounting for 55.56%. Among types, focal epilepsy predominated (88.57%). The primary etiologies were unknown (62.14%), structural causes (27.85%) and infectious (9.28%). Patients undergoing monotherapy accounted for 66.1%, with epilepsy control in 92.4%. The most commonly used antiepileptic drugs were carbamazepine (33.1%), valproic acid (28.2%), and phenobarbital (10.4%). CONCLUSIONS: Male sex, seizures, and focal epilepsy were prevalent. Magnetic resonance imaging was more useful than computed tomography. Most etiologies were unknown; however, mesial temporal sclerosis and neurocysticercosis were the most prevalent known causes. Most patients were controlled using a monotherapy regimen. The implementation of International League Against Epilepsy classifications and definitions was feasible and useful.

TITLE: Características clínicas de pacientes con epilepsia atendidos en la atención primaria.Objetivo. Este estudio tuvo como objetivo llenar el vacío de conocimiento actual en la bibliografía mediante la identificación de las características demográficas y clínicas de los pacientes con epilepsia que asisten a la atención primaria de salud. Pacientes y métodos. Éste fue un estudio transversal que involucró a adultos (18 años o mayores) con epilepsia que asistieron a atención primaria de salud de un país en desarrollo entre 2015 y 2019. Se recopilaron información demográfica y datos relacionados con la epilepsia. Resultados. Se evaluó a un total de 140 pacientes ­51,4%, varones; edad media (± desviación estándar), 44,9 ± 17,8 años­. La edad media de inicio de las crisis fue de 29,9 ± 22,9 años, con una evolución media de 14,3 ± 15,4 años. Las crisis focales presentes en el 88,57% de los casos y evolucionaron a crisis tonicoclónicas bilaterales (45,16%). De las generalizadas, las crisis motoras predominaron con el 81,82%; las ausencias, el 9,09%; y las motoras + ausencias, el 9,09%. Entre las crisis motoras de inicio generalizado, predominó la tonicoclónica, con un 55,56%. Entre los tipos, predominó la epilepsia focal (88,57%). Las etiologías primarias fueron desconocidas (62,14%), causas estructurales (27,85%) e infecciosas (9,28%). Los pacientes en monoterapia representaron el 66,1%, con control de la epilepsia en el 92,4%. Los fármacos antiepilépticos más utilizados fueron la carbamacepina (33,1%), el ácido valproico (28,2%) y el fenobarbital (10,4%). Conclusiones. Predominaron el sexo masculino, las convulsiones y la epilepsia focal. La resonancia magnética fue más útil que la tomografía computarizada. La mayoría de las etiologías se desconocían; sin embargo, la esclerosis temporal mesial y la neurocisticercosis fueron las causas conocidas más prevalentes. La mayoría de los pacientes se controlaron con un régimen de monoterapia. La implementación de las clasificaciones y definiciones de la Liga Internacional contra la Epilepsia fue factible y útil.

The effect of protease and Bacillus licheniformis on nutritional value of pea, faba bean, yellow lupin and narrow-leaved lupin in broiler chicken diets.

1. This study investigated the nutritional value (digestibility of ileal crude protein and amino acids (AAs)) and the AMEN value of legumes (pea, faba bean, yellow lupin, and narrow-leaved lupin) with or without protease. 2. Two hundred, one-day-old, male Ross 308 broiler chickens were randomly allocated to ten groups. Each group received one of five different protein raw materials - either peas, faba beans, yellow lupins or narrow-leaved lupins, with or without protease produced from Bacillus licheniformis. The birds were kept in individual cages. Nutrient digestibility was calculated using the difference method. The total duration of the study was 23 d, and the study involved two phases - accommodation phase (d 1-18) and experimental phase (d 18-23). 3. The effect of protease on response traits was not consistent between the legumes. The enzyme increased the digestibility of some AAs in the pea (arginine, leucine, phenylalanine, histidine, tyrosine, alanine, and proline), faba bean (lysine, arginine, glycine, and asparagine), and yellow lupin diets (lysine, valine, and serine), but this effect was not observed in the narrow-leaved lupin diet. The change in AMEN values due to protease addition was only statistically significant for the pea diet (P < 0.05), whereas in the case of other legume species, the difference was insignificant (P > 0.05). 4. Exogenous protease increased the digestibility of AAs present in pea, faba bean, and yellow lupin seeds but not in narrow-leaved lupin diets. The AMEN value of peas increased with protease supplementation, but no effect of protease was found for the AMEN values of faba bean and both the lupin diets.

The effect of faba bean extrusion on the growth performance, nutrient utilization, metabolizable energy, excretion of sialic acids and meat quality of broiler chickens.

Soybean meal in broiler chicken diets can partly be replaced by faba bean seeds. Unfortunately, high levels of antinutritional factors and resistant starch found in these seeds can have a detrimental impact on both broiler chickens' performance and nutrient digestibility. It is, however, possible to increase the usefulness of faba bean for broiler nutrition by a technological process known as extrusion. In this study, the authors made and attempt to investigate the effect of different forms of faba bean seeds (raw or extruded) on broiler chicken performance, nitrogen-corrected apparent metabolizable energy values (AMEN), nutrient utilization and meat quality, as well as on the excretion of total and free sialic acids. In the trial, the total of 160 1-day-old male broiler chicks of the Ross 308 strain were used. Experimental birds were randomly assigned to two dietary treatments, each containing 10 replication (floor pens); one replication included nine birds. The first group contained 300 g/kg diet of raw faba bean seeds, whereas the second group - 300 g/kg diet of extruded faba bean seeds. The applied extrusion process was found to exert a positive impact and led to a decrease in phytic phosphorus, H, NDF, ADF and resistant starch content in studied faba bean seeds. Experimental birds fed diets containing extruded faba bean seeds were characterized by a lower feed intake (2299 g) and feed conversion ratios (FCRs) (1.52 g/g) in comparison with the other group (feed intake 2466 g; FCR 1.61 g/g). Extrusion of faba bean seeds improved dry matter retention, dietary AMEN value, apparent ileal digestibility of dry matter and starch, as well as most amino acids. In addition, the above-mentioned process resulted in a decrease in the excretion of total and free sialic acids. Extruded faba bean seeds failed to have a significant impact on broiler meat quality. It was concluded that application of extrusion can increase the use of faba bean seeds in broiler chicken nutrition.

Influence of graded inclusion of white lupin (Lupinus albus) meal on performance, nutrient digestibility and ileal viscosity of laying hens.

1. The aim of this study was to investigate the effect of white lupin (Lupinus albus) meal (WLM) addition on the intestinal viscosity, bird performance and nutrient utilisation of laying hens. 2. The experiment was conducted with 360 laying hens aged 21 weeks fed one of 6 treatments, including a corn-soybean meal control diet (CON) and 5 experimental diets containing 60, 120, 180, 240 and 300 g/kg WLM. 3. A linear increase in feed intake (p < 0.001) was observed with higher levels of WLM from 0 to 300 g/kg. Laying rate decreased quadratically (p < 0.05) and egg weight (at 6th, 12th and 18th weeks of the trial) decreased linearly with WLM inclusion from 0 to 300 g/kg. Birds fed 60 g/kg or more of WLM laid lighter eggs (p < 0.05) than CON hens. When 240 g/kg or more WLM was included into the diet, laying rate was affected negatively (p < 0.05). 4. As WLM increased from 0 to 300 g/kg, apparent metabolisable energy and pre-caecal digestibility of dry matter and crude protein decreased quadratically (p < 0.05). When 300 g/kg of WLM was used, there was a tendency (p < 0.1) to decrease pre-caecal starch digestibility. WLM dose exerted a quadratic effect (p < 0.05) on total sialic acid excretion. As WLM increased, the viscosity of ileal digesta linearly increased (p < 0.05). 5. In the 6th and 12th weeks of the experiment (p < 0.05), eggshell thickness decreased linearly when 240 g/kg of WLM was added. At the 6th, 12th and 18th weeks, a linear decrease in eggshell content was observed (p < 0.05) after WLM addition. 6. In conclusion, the graded inclusion of WLM into laying hens' diets resulted in depressed performance, AMEN and eggshell quality.

Influence of graded inclusion of white lupin (Lupinus albus) meal on performance, nutrient digestibility and intestinal morphology of broiler chickens.

The aim of this study was to investigate the effect of white lupin (Lupinus albus) meal (WLM) addition on the intestinal viscosity, bird performance, nutrient utilisation and villi morphology of growing broiler chicks. The experiment was conducted with 480 broiler chicks divided into 6 dietary treatments, including a maize-soybean meal control diet (CON) and 5 experimental diets containing 100, 150, 200, 250 and 300 g/kg WLM. During the period from d 0 to 35, birds fed on 200 or higher WLM/kg were characterised by lower body weight gain and feed intake than CON. The use of 150 g of WLM/kg increased feed conversion ratio (FCR) compared to CON treatment. Apparent metabolisable energy corrected to zero N balance (AMEN) and apparent ileal digestibility of dry matter, ether extract, crude protein and starch, linearly decreased as WLM increased from 0 to 300 g/kg. There was a quadratic effect of WLM dose on sialic acid excretion. A strong negative linear correlation was found between the excretion of sialic acid and AMEN. The viscosity of ileal digesta was linearly increased as WLM increased. The effect of WLM dose on ileum villus height (VH) was linear, while that on ileum villus area (VA) was quadratic. Both parameters decreased as WLM increased from 0 to 300 g/kg. In conclusion, the use of over 150 g/kg of WLM in broiler diets depressed performance results. However, depression of nutrient utilisation was only observed when 250 or 300 g/kg of WLM was used.

Biotechnological preparation of the elaiophylin.

Sporulation conditions (sporulation period and the sporulation broth) of the elaiophylin producer Streptomyces melanosporofaciens were optimized. The best culture sporulation was on agar broths with dextrin or hydrolyzed corn starch as carbon sources.