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The behaviour and the effects of xenobiotics including pharmaceuticals and fragrances in the environment are widely unknown. In order to improve our knowledge, field investigations and modelling approaches for the entire area of the city of Halle/Saale, Germany, were performed. The distribution of the concentration values and mass fluxes are exemplified using indicators such as Bisphenol A, t-Nonylphenol, Carbamacepine, Galaxolide, Tonalide, Gadolinium and isotopes. Concentrations at a magnitude of ng/L to microg/L were found ubiquitously in the ground and surface waters. Using the concentration values, the impact of the city concerning the indicators was not always evident. Only the assessment of the mass fluxes shows significant urban impacts along the city passage. The calculation of the mass fluxes shows increasing values for all investigated xenobiotics during the city passage; only Bisphenol A stagnates. A balance model of water and indicator mass fluxes was built up for the entire city area.
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Characteristics and treatment patterns of neuropathic pain at Siriraj Pain Clinic are similar to those seen in other pain clinics elsewhere in the world. The high prevalence of neuropathic pain in the clinic indicates that this type of pain syndrome is increasingly critical to our clinical practice. More educational programs on neuropathic pain and management are needed for Thai healthcare professionals.
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Carbamazepine (CBZ) is a well-established drug in the therapy of temporal lobe epilepsy (TLE). The anticonvulsant action of CBZ has been explained mainly by use-dependent effects on voltage-dependent Na+ channels in various nonhuman cell type. However, it is unclear whether Na+ currents in neurons within the focal epileptogenic area of patients with medically intractable TLE show similar characteristics.
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Carbamazepine showed high efficacy in therapy of moderate persistent or severe bronchial asthma. Antiasthmatic activity of carbamazepine can be considered as influence on neurogenic mechanisms of asthma. We suppose that it is possible to use carbamazepine for therapy of bronchial asthma in clinical practice.
Paroxysmal pain in a 64-year-old woman diagnosed with trigeminal neuralgia disappeared with the administration of carbamazepine, but carbamazepine had to be discontinued because of intolerable lassitude and liver dysfunction. Afterward, the paroxysmal pain reoccurred, and depressive symptoms appeared. Milnacipran was then administered at a dosage of 50 mg/d for 2 months, and the paroxysmal pain and depression disappeared completely. Carbamazepine is the drug of first choice for trigeminal neuralgia, but the present results suggest that milnacipran is worth investigating for patients who do not respond to carbamazepine, who cannot stay on carbamazepine because of side effects, and who exhibit depressive symptoms.
Brivaracetam and CBZ reduced IN a in N1E-115 cells (30% and 40%, respectively) and primary cortical neurons (21% and 47%, respectively) by modulating the fast-inactivated state of VGSCs. BRV, in contrast to CBZ, did not affect I(Na) in CA1 neurons and SRF in cortical and CA1 neurons. CBZ consistently inhibited neuronal SRF by 75-93%.
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The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with newly diagnosed epilepsy and identify those seizure types and syndromes where more evidence is necessary.
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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.
Subjective cognitive side effects (CSEs) are common in patients taking antiepileptic drugs (AEDs). The objective of this study was to predict which patients are at risk for CSEs, and compare the CSE profiles of all commonly used AEDs. In this nonrandomized retrospective study, medical records of 1694 adult outpatients with epilepsy seen at our center over a 5-year period who had taken one or more AEDs were examined. Non-AED predictors of CSEs were investigated, and rates of AED-related CSEs were compared in 1189 patients (546 on monotherapy) newly started on an AED at our center. The average rate of AED-related intolerable CSEs (leading to dosage change or discontinuation) was 12.8%. On multivariate analysis, no significant non-AED predictors of CSEs were found. Significantly more intolerable CSEs were attributed to topiramate (21.5% of 130 patients) than to most other AEDs, including carbamazepine (9.9%), gabapentin (7.3%), levetiracetam (10.4%), lamotrigine (8.9%), oxcarbazepine (11.6%), and valproate (8.3%). CSE rates with zonisamide (14.9%) were significantly higher than those for gabapentin and lamotrigine. After exclusion of CSEs during the first 8 weeks of therapy, rates of CSEs were lower, but relative differences remained unchanged. In monotherapy, significantly more intolerable CSEs occurred with topiramate (11.1% of 18 patients) than with carbamazepine or valproate, and both phenytoin and zonisamide were associated with more CSEs than valproate. From this study, it can be concluded that intolerable patient-reported CSEs are most common with topiramate, followed by zonisamide, phenytoin, and oxcarbazepine. They are least likely to be reported with gabapentin, valproate, lamotrigine, carbamazepine, and levetiracetam.
Additional administration of lithium, but not adjunctive carbamazepine significantly augmented the antidepressant efficacy of mirtazapine in the unipolar depressed patients. Moreover, carbamazepine but not lithium significantly lowered the serum concentrations of mirtazapine.
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This article summarizes a three-year experience of treating 34 patients with carbamazepine (CMZ) retard with partial epilepsy who had previously been treated with a standard form of CMZ. The following steps were taken in order to optimize the therapy: the usage of monotherapy with CMZ, an increase of CMZ dose if it was necessary, usage of CMZ retard-form. Increase of the dose (more than 1400 mg) resulted in adverse reactions in 6 patients, which regressed when the patients started to be treated with CMZ retard form. On the whole, optimization of therapy provided the following effects: 18 patients (53%) did not experience any seizures, in 11 patients (32%) a frequency of the seizures was considerably decreased (by 50% and more as compared with the baseline level). Individual analysis of the seizures frequency showed that in patients treated with CMZ retard-form the maximal decrease of this frequency was observed for sleep seizures. A frequency of seizures decreased by 63% at night and by 34% in day hours.
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ALAC exerts significant protective activity against seizures in animal models, the effect being especially prominent against audiogenic seizures in GEPR-9 rats, seizures induced by low-dose pilocarpine in mice, and spontaneous seizures in mice exposed to pilocarpine-induced SE. This action is likely to be mediated by increased availability of TRP in the brain, with a consequent increase in 5-HT mediated transmission.
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Psoriasis was resolved when lithium was replaced with carbamazepine and valproic acid. These medication shave different pharmacodynamic effects than lithium.
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We present the clinical and electroencephalographic data of 20 patients with exclusively sleep-induced epileptic crises, evaluating not only the type of crises and the diagnosis of the particular syndrome, but also the response to treatment and prognosis. The patients studied were over 17 years old, had only nocturnal crises and were followed up for a period of three years. An EEG done during sleep and cerebral CT scan were available in all cases and a cranial MR was available in two cases. Diagnosis was made using clinical data and the sleep EEG.
This was an individual participant data (IPD) review. Outcomes were time to (a) treatment withdrawal (b) 12-month remission (c) six-month remission and (d) first seizure post randomisation. Cox proportional hazards regression models were used to obtain study-specific estimates of hazard ratios (HRs) with 95% confidence intervals (CIs) with the generic inverse variance method used to obtain the overall pooled estimate of HRs and 95% CIs.
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Anti-HHV-6 IgG titres increased in 62 of 100 patients, 14-28 days after the onset of symptoms. These patients suffered from severe organ involvement and a prolonged course compared with 38 patients showing no reactivation of HHV-6. Significant amounts of HHV-6 DNA were detected in serum samples from 18 of the 62 patients. Flaring of symptoms such as fever and hepatitis was closely related to HHV-6 reactivation in these 18 patients. It should be emphasized that all five patients with fatal outcome and 10 patients with renal failure were in the HHV-6 reactivation group.
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Video-EEG monitoring with outstretched arm tests were carried out in 17 patients, and 9 of them were examined with simultaneous electromyography (EMG). The ENM manifestations, electrophysiologic features and responses to antiepileptic drugs (AED) were analyzed.
Intractable neuropathic dynamic allodynia remains one of the major symptoms of human trigeminal neuropathy and is commonly accepted to be the most excruciatingly painful condition known to humankind. At present, a validated animal model of this disorder is necessary for efficient and effective development of novel drug treatments. Intracisternal strychnine in rats has been shown to result in localized trigeminal dynamic allodynia, thus representing a possible model of trigeminal neuralgia. The purpose of this study was to validate a mouse model of trigeminal glycinergic inhibitory dysfunction using established positive (carbamazepine epoxide) and negative (morphine) controls.
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23 of 52 PWE (44%) used LEV monotherapy and 16/23 (70%) had 'therapeutic' LEV with 13/16 (81%) seizure-free. 29 of 52 (56%) used polytherapy and 16/29 (55%) had 'therapeutic' LEV with 7/16 (44%) seizure-free. 11 of 29 (38%) used CBZ: 4/11 (36%) had therapeutic mean LEV levels and 7/11 (64%) were seizure-free. Fourteen (48%) used VPA: 9/14 (64%) had therapeutic mean LEV levels and 8/14 (57%) were seizure-free. 13 of 29 (45%) used LTG: 8/13 (62%) had therapeutic mean LEV levels and 5/13 (38%) were seizure-free. LEV did not alter CBZ, but CBZ affected LEV. LEV elevated VPA free levels but not VPA total levels. Dosage/concentration was lowered with polytherapy.
Sixty-five patients were enrolled consecutively and the postoperative hyperammonemia was found in 46 patients (70.77%), and 45 (97.83%) were asymptomatic. A total of 80.95% of the patients using valproate developed hyperammonemia, and the postoperative blood ammonia concentration continued to rise in 61.90% of these patients. Additionally, valproate had the least impact on liver enzymes. The synthetic function of the liver in patients with higher concentrations of preoperative blood ammonia was more seriously damaged than that in patients with normal postoperative ammonia concentrations.