PubMed Health⌕ Search

Biomedical subjects

V Bertol

Publications and source records attributed to V Bertol.

29 records · Page 2Linked to original sources
PubMed1991

[Primary intraventricular hemorrhage in the adult].

Forty two instances of primary intraventricular hemorrhage (PIVH) out of overall 592 cases of intracerebral hemorrhages diagnosed by CT in 1980-1989, to evaluate the general prognosis attributable to PIVH and its factors. The mortality rate was 23.8%, and persistent residual disability was small or absent in 59.5% of patients. The prognosis was influenced by the clinical status at admission and the magnitude of ventricular bleeding. We conclude that PIVH is comparatively benign.

Adolescent↗
PubMedDate not supplied

[Electro-clinical and neuroimaging studies in epilepsy in elderly patients].

INTRODUCTION: Due to the aging population in developed countries, epidemiological studies show an increasing tendency to the prevalence of epilepsy in the elderly. PATIENTS AND METHODS: During 54 months, we have studied the electroclinical and neuroimaging features in outpatients older than 60, with active epilepsy. Every patient was interviewed by one of the authors. Then, we have reviewed the medical records about the clinical features, EEG and neuroimaging (NI) studies and seizures frequency (SF) outcome. Differences in crude proportions were assessed by chi 2 test for independence by 2 x 2 tables. RESULTS: The study was been performed in 78 patients with 70.3 +/- 7.3 years of mean age at review. Partial seizures were significantly related with an higher SF at onset and, in the series of complex partial seizures was more frequent a temporal EEG topography. There was predominance of men, NI abnormal, symptomatic etiology and SF at onset > or = 1 by day in that patients who started their epilepsy after 60 years. A 51.3% was seizures-free in the last year and in 80% the SF was improved a 50% or more from the beginning. CONCLUSION: A significantly greater percentage of patients remained with seizures in four cases: in those with a SF at onset greater than 1 every day, in those suffering complex partial seizures, in women and in patients with temporal EEG topography.

Aged↗
PubMedDate not supplied

[Therapeutic benefits of monotherapy with lamotrigine].

OBJECTIVE: To analyze the overall therapeutic benefit (effect on seizures and quality of life) in 100 patients, aged 14-89 years, treated with lamotrigine (LTG) as primary (25) or secondary (75) monotherapy, followed up for between one and six years. PATIENTS AND METHODS: The patients were selected for treatment, under open observation, and not randomized at all. Thirty patients suffered from generalized seizures and 70 from partial crises, with progression to generalized tonic-clonic crises in 36 cases. The usual LTG serum level when bi-therapy was used was 2 to 4 mg and was similar with monotherapy. The predominant dosage of LTG (100 to 200 mg) was similar for monotherapy and for bi-therapy in those treated with valproate, as compared with 200-400 mg in most of those in whom the associated drug was carbamazepine (24), phenobarbital (14), phenytoin (6) or other drug, with a considerable reduction in dose (of 100 mg to 250 mg) when they were treated by monotherapy instead. RESULTS: Overall therapeutic benefit was obtained in 79 cases, partly due to suppression or reduction of the seisures, or maintenance free of them, but mainly due to correction of the side-effects, especially somnolence, attention disorders, obesity, tremor, ataxia, reduced global productivity, hyperlipidaemia and liver enzyme changes. CONCLUSION: Lamotrigine was more effective and better tolerated in smaller doses as monotherapy, and better than other drugs in reference to quality of life, especially by the supression of side-effects, demonstrating that it is valuable in obtaining overall improvement of the disease and its consequences.

Adolescent↗
PubMedDate not supplied

[Cerebral ischemia and epilepsy].

INTRODUCTION: We review the characteristics and evolution of epileptic crises (EC) related to non-hemorrhagic ictus. Patients and methods. Since June 1994 we have studied patients with EC both at the time of the ictus (acute symptomatic crises, ASC) and later (remote symptomatic crises RSC). One hundred and fifteen fulfilled the criteria and were followed-up until recurrence of EC, death or the end of the study (30.06.98). There were 66 men and 49 women (average age at the time of ictus = 67.4 +/- 12 years). RESULTS: Ninety one patients had RSC; reversible ischemic neurological deficit (DNIR) (50%), atherothrombotic pathology (58.5%) and anterior territory (70%) predominated. There was a similar proportion of partial and generalized crises (51.5% compared with 48.5%). Fifteen patients had presented with ASC. Thirty-nine patients presented with ASC, with predominance of established ictus (48.5%), atherothrombotic pathology (56.5%), anterior territory (82%) and generalized crises (59%). There was recurrence in 50.5% of those with RSC (follow-up 18.5 +/- 24 months). STATISTICAL ANALYSIS: there was a predominance of ASC in patients with established ictus and RSC in the case of DNIR. In cases of abnormal EEG there was a greater proportion of patients with a history of ASC. In patients over 60 years old, CSR was commoner. In those with atherothrombosis there was a predominance of one crisis and in patients with embolisms two or more crises. There were more recurrences in patients with no previous history of ASC (p = 0.001), those with all the anterior territory affected (p = 0.002), those < 59 years old (p = 0.01), those previously untreated (p = 0.04) and those with abnormal EEG (p = 0.03). There was an increased RR in the abnormal EEG, involvement of the entire anterior territory and age < 59 years. Multivariate analysis showed that the probability of recurrence increased 1.23 times when there was a previous history of ASC; 14.73 times if the EEG was abnormal, and 18.12 times when both these factors were present.

Acute Disease↗
PubMedDate not supplied

[Preventive prophylactic treatment in posttraumatic epilepsy].

Posttraumatic epilepsy (PTE) represents about 2 3% of all the etiologies of epilepsy. The so called early seizures , which appear in the first week after the traumatic brain injury (TBI), are related to the severity of the injury; they do not have an strictly epileptic mechanism, but they become a risk factor to the development of PTE. PTE appears in 5% of all the patients suffering from all TBI, and in 15 20% of the patients suffering from a severe TBI. However, the endpoint uses to be to use antiepileptic drugs (AEDs) as prophylactic treatment in all well established PTE. The efficacy of classic antiepileptic drugs (Phenobarbital, Phenytoin, Carbamazepine, Valproate acid) to control the kindling effect has not been confirmed yet as a prophylactic treatment for PTE. Prophylactic efficacy of other drugs, like lipid peroxidation inhibitors, neuroprotectors (especially antioxidants), glutamic receptor blockers, NMDA receptor blockers, and drugs that modulate apoptosis via caspasas inhibition; however, they constitute new ways of therapeutic investigation with a strong experimental basis. Our recommended therapeutic strategy is not to administrate AEDs indiscriminately, but analyzing risk factors, designing a careful prevention for late seizures using AEDs with proven efficacy in partial seizures and with the best achievable tolerability; being also attentive to the possible use of new drugs in the future, like lipid peroxidation inhibitors, and drugs designed to inhibit other excitotoxic, ionic or oxidative processes.

Anticonvulsants↗
PubMedDate not supplied

[The evaluation of cognitive deterioration in transient ischemic attacks].

We compared the degree of dementia in a group of 41 patients who, four years previously, had presented a first TIA with that of 31 healthy controls of similar age. For pathogenic diagnosis the Hachinski and Gustafson-Nilsson scales were applied, while mental state was evaluated by the Folstein, Blessed, GDS and CDR tests. We performed in all cases cerebral CT and several MR. The findings associated with dementia were the presence of multi-infarctions, leucoaraiosis or lacunes in the cerebral CT and the presentation of new ischemic episodes, sphincterian or gait disturbances and focal deficits. There were no differences with the control group in the cases only presenting one TIA. Polyglobulia was the only factor significantly associated with vascular dementia in these patients.

Age Factors↗