What Is the Effect of Topiramate Use on Growth in Children With Epilepsy?

Objective The literature related to weight loss as a side effect of using topiramate (TPM) in pediatric patients is inconsistent. The aim of this study was to assess the effect of TPM on the growth of pediatric epileptic patients. Methods The electronic medical files of 50 pediatric epileptic patients who were prescribed TPM over 5 years were retrospectively reviewed. Cases treated with other antiepileptic drugs were the control group (n=60). Results Height growth was similar in both groups. At the 6-12-month follow-up, there was a decrease in the average BMI in the TPM group of -0.81 kg/m2 (p=0.019) and an increase in the control group of +0.46 kg/m2 (p=0.023). Weight loss was noted in 21/50 (42%) of the TPM group as compared with 13/60 (22%) in the control group (p=0.02). More weight loss was observed in the overweight TPM group in 7/16 (44%) compared to none in the nine cases in the control group (p=0.03). After the one-year follow-up, the average change in weight was +1.73 kg (p=0.0001) and +3.53 kg (p=0.0001) in the TPM and control groups, respectively. In patients with normal initial BMI, the weight increased by +1.3 kg on average, compared to the group with a high initial BMI, which decreased by -2.55 kg. Conclusion Topiramate use has no negative effect on height growth in pediatric patients with epilepsy. While mild weight loss occurs frequently in the first year of treatment, weight gain resumes after the first year except in patients with a high initial BMI.

Thirty-day readmission rates and associated risk factors after coronary artery bypass grafting.

OBJECTIVES: Coronary artery bypass grafting (CABG) is among the most frequently performed cardiac surgical procedures. However, it is associated with high readmission rates for a plethora of causes, which can substantially increase healthcare costs. This study aimed to assess the rates and associated risk factors of 30-day readmissions for CABG patients. METHODS: We conducted this retrospective cohort study at King Abdulaziz Medical City. The study targeted adult patients who underwent CABG between January 1, 2016, and January 31, 2019. Data were extracted from the BEST Care system. Frequencies and percentages were generated for categorical variables. Mean and standard deviation were calculated for quantitative variables. Bivariable and multivariable logistic regressions were used to detect readmission risk factors. RESULTS: Among 534 adult patients, the overall 30-day readmission rate was 16.1% (n = 86). The multivariable logistic regression analysis showed that diabetes mellitus (P = .002), amiodarone use (P = .04), statin use (P = .04), amlodipine use (P = .006), asthma (P < .001), and hyperlipidemia (P = .04) were significantly correlated with 30-day readmission. CONCLUSIONS: Our study showed an estimated 16.1% 30-day readmission rate after CABG. Diabetes mellitus, asthma, hyperlipidemia, and use of medications such as amiodarone, statins, and amlodipine were associated with readmission. Further studies are needed to develop tailored and practical strategies to reduce CABG readmissions and mitigate patient and health care facility burdens.