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Biomedical subjects

C Tudor

Publications and source records attributed to C Tudor.

At least 19 recordsLinked to original sources
PubMed2001

Lamotrigine therapy of epilepsy in tuberous sclerosis.

PURPOSE: Lamotrigine (LTG), a newer antiepileptic drug (AED), has activity against both partial-onset and generalized seizures. Its reported benefits for behavior, and its effectiveness in Lennox-Gastaut syndrome and other forms of refractory epilepsy, make it a logical choice for treatment of epilepsy in tuberous sclerosis complex (TSC). We present our experience with LTG therapy of epilepsy in 57 patients with TSC. METHODS: Patients fulfilled the diagnostic criteria for clinically definite TSC. LTG was initiated and increased until improvement in seizure frequency was noted, intolerable side effects occurred, or maximal doses were reached. Seizure frequency and behavioral changes were recorded during LTG therapy and compared with those prior to the introduction of LTG. RESULTS: Twenty-four (42%) were seizure free, and 21 (37%) had a >50% reduction in seizure frequency. Eighteen (32%) had subjectively improved behavior and/or alertness with daily activities. Thirty-eight (67%) had no change in this regard, whereas one (2%) became worse. Responders were more likely to not have a history of infantile spasms, and to have experienced only partial seizures (p < 0.05). Otherwise no phenotypic correlations with response were apparent. CONCLUSIONS: Among patients with TSC and epilepsy, LTG was effective and well tolerated, including as initial monotherapy. Improved alertness and behavior were apparent in many patients. The incidence of side effects is similar to that reported for other pediatric populations with symptomatic partial epilepsy. The usefulness of LTG in TSC may relate to an underlying defect of glutamatergic neurotransmission in partial epilepsy.

Adolescent↗
PubMed2000

Topiramate therapy of epilepsy associated with Angelman's syndrome.

Angelman's syndrome, a genetic disorder involving a defect in the DNA coding for subunits of the gamma-aminobutyric acid (GABA) type A receptor, often is associated with intractable epilepsy. Topiramate is a novel anticonvulsant that enhances GABAergic neurotransmission. Five children with Angelman's syndrome and epilepsy were treated with topiramate for clinical indications. The drug was effective and well tolerated, possibly because of its GABAergic properties. Further studies are necessary to confirm and elucidate this observation.

Angelman Syndrome↗
PubMed1999

Medicare, managed care, and cancer.

The Medicare program has undergone phenomenal changes during the last decade. Many of the changes relate to the growth of Medicare managed care. Changes in Medicare will continue as the Health Care Financing Administration implements the provisions of the Balanced Budget Act of 1997. As a result, Medicare should be open to more types of delivery systems that are organized in different ways than traditional health maintenance organizations. Payments should be improved so that these organizations can enroll sicker people and can be paid for accepting and treating those people. Beneficiaries should be provided with enough information that they have the necessary data to select plans based on quality, not just cost.

Health Care Costs↗
PubMed1997

[Quantitative trabeculectomy].

The outcomes of the trabeculectomy which finally establish one normal ocular pressure are presented. The surgery method is adjustment of the thickness of the sclera, fragment depending on the initial ocular pressure. The evacuation of the aqueous humor after trabeculectomy is indirect proportionally with the thickness of the scleral fragment. The method was used in 36 eyes with different patterns of glaucoma. At this patients the initial ocular pressure was until 50 mm Hg. In 72.2% from cases was necessary only one surgery intervention for maintain the ocular pressure, without auxiliary drugs; two eyes underwent still one surgical intervention and in seven eyes was necessary auxiliary hypotensor drugs. The outcomes were good in 97.2% from cases. One failure was obtained in one eye with closed angle glaucoma where the trabeculectomy was complicated with malignant glaucoma. Complications were hypema, atalamy with or without choroidal detachment and high ocular pressure. All complications were improved after conservative treatment excepting the case with malignant glaucoma.

Glaucoma↗
PubMed1996

Health status of Medicare enrollees in HMOs and fee-for-service in 1994.

We compared the health status of 863 health maintenance organization (HMO) enrollees with that of 4,576 non-enrollees, controlling for demographics and area of residence, using 1994 data from the Medicare Current Beneficiary Survey (MCBS). HMO respondents were less likely to report fair or poor health, functional impairment, or heart disease. Average predicted costs based on various health-status measures were substantially lower for HMO respondents than for respondents in fee-for-service (FFS) arrangements. The Medicare payment formula for HMOs does not adequately adjust for the better health and consequent lower expected costs of HMO enrollees. The addition of health-status measures would improvement payment accuracy and reduce average HMO payments significantly below current levels.

Activities of Daily Living↗
PubMed1994

Cervical root compression by a loop of the vertebral artery: case report.

A case of an abnormal loop of the extracranial vertebral artery enlarging the intervertebral foramen at C5-C6 and the transverse foramen at C5 is reported. This occurrence is rare and was associated with cervicobrachial neuralgia caused by neurovascular compression of the C6 root. The patient was cured by microvascular decompression.

Adult↗
PubMed1994

[Anterior osteosynthesis of the cervical spine by phusiline bioresorbable screws and plates. Initial results apropos of 5 cases].

The authors have designed a biocompatible and bioresorbable plate (1) in Phusilines* for anterior cervical interbody stabilization. Phusilines* are polymer of alpha hydroxyacid (poly lactic acid), and their in vivo degradation (in lactic acid and via the Krebs circle, in water and carbon dioxide), is complete within 18 months. Screws are available in the same material. Phusilines* are radiotransparent and do not interfere with MRI. The size and shape of the plate have been determined with three dimensional computed tomography, their thickness and their molecular weight and chemical structure have been determined to obtain the best compromise in mechanical properties and time of resorption. Biomechanical studies have been performed in cadaver, and have showed a good quality of the osteosynthesis. Five patients with anterior cervical disco-ligamental instability were operated on according the french law of bioethic (Huriet Law). In these five cases the operation was performed via antero lateral approach, and it consisted in a interbody xenograft with Surgibone (2) and interbody osteosynthesis with a plate and four screws of 16 mm of length and 4 mm of diameter. Clinical and radiological examinations were realised during 18 months. In all cases, clinical results in rachialgia and neurological signs were excellent, in four case the tolerance was excellent, in a case inflammatory phenomens were observed the 8th and the 14th month successfully treated with non steroid anti-inflammatories. Anatomical results were excellent in two cases, good in two cases and incomplete in one case. Reasons of these incomplete results are discussed. These preliminary results are sufficient to continue these implantations.

Adult↗
PubMed1991

[The early detection of diabetes mellitus and the active dispensary care of 1200 subjects with a genetic predisposition].

Diabetes mellitus (DM) is a metabolic disease with a long-lasting chronic course, attending during its development by complications which affect the state of health and require additional measures from the social and economic point of view. The current strategy consists in the earliest possible detection of disease in groups of population selected according to the existent risk of developing a DM. This action is followed by an active dispensary care and by lessons of health education, aimed at preventing metabolic decompensations and the early occurrence of degenerative chronic complications. Taking into account these considerations in the present paper, authors analyse the possibility of detection of DM in 1,200 subjects genetically predisposed, a special stress being laid on the means of prevention, on the role of active dispensary care and on the place of health education in the therapy of DM and in the prevention of complications of this disease with an invalidating potential.

Adult↗
PubMed1988

Career plans and debt levels of graduating U.S. medical students, 1981-1986.

Trends in students' responses to the annual graduation questionnaire of the Association of American Medical Colleges from 1981 to 1986 were examined. Since 1981 the percentage of students choosing primary care specialties dropped from 43.6 percent to 36.6 percent. The decline of interest in primary care specialties occurred mainly in general internal medicine. Changes in career activity since 1981 reflected increasing interest by the students in full-time academic appointments and decreasing interest in solo, private practices. Changes in the size of a city in which students planned to practice reflected an increasing interest in large cities or suburbs. The students' preferences for certain geographic regions of the country for practice locations changed very little. Finally, total postsecondary educational debt increased from an average of +19,697 in 1981 to an average of +33,499 in 1986. This difference represents a 70 percent increase as measured by 1987 dollars and a 37 percent increase in constant dollars.

Career Choice↗
PubMed1978

[Not Available].

Explore the source record for details and available documents.

History, Modern 1601-↗
PubMedDate not supplied

Traumatic intracerebral hematoma. A report of 50 cases.

The study presents an analysis of demographic, clinical and paraclinical characteristics of 50 cases as well as the surgical treatment results of 50 cases with traumatic intracerebral hematoma (TIH) out of 70 admitted. The men showed the greatest incidence, the male/female ratio was 5:1. Age mean was 55.3 yrs. Hematomas were caused in one third of the cases by traffic collisions, followed by severe cranial traumata associated or not with other traumatic lesions and/or preceding diseases. The most frequent location was anterior in the frontal (30%) and temporal lobes (26%). Diagnosis was confirmed by arteriography and tomography. Specific paraclinical aspects of TIH were discussed together with those of the primary intracerebral hematoma (PIH). All patients were operated on under general anesthesia. A minimum craniectomy was carried out aimed at the lesion. Surgery was planned after a full neurological examination. Postoperative mortality was increased (42%) due to the severity of trauma (88%) in patients with a Glasgow coma scale assessment under 8, to age (50% of the patients were over 50 yrs), to hematoma size (84-100% in patients with a diameter of the hematoma between 50 and 100 cu cm, and over 100 cu cm, respectively) and to the location (66% in the frontal hematomas compared to 33% in temporal ones).

Adolescent↗
PubMedDate not supplied

Contribution to the early diagnosis of diabetes mellitus.

The authors present the results of an investigation for diabetes mellitus (DM), in a selected group of 9,901 persons at high risk for the disease, using oral glucose tolerance test (OGTT). In the group investigated they included 4,753 diabetic blood relatives, 4,123 obese patients and 935 women who delivered big babies. The percentage of diagnosed DM was 30.58 for the entire group, with variations between: 39.47 in the obese, 27.27 in women with macrosomia, and 23.35% in the diabetic blood relatives. The results showed the value of OGTT as a diagnostic tool, the importance of early diagnosis and the necessity of careful long time follow-up of the newly diagnosed diabetics.

Adolescent↗