The Authors present and discuss the results obtained by assaying plasma DPH and PB in 123 patients chronically treated with antiepileptic drugs. The subjects examined were considered resistant to medical therapy and were all at their first laboratory control. The data obtained show: 1) the very poor correlation existing between the doses of drugs administered and their actual plasma levels; 2) the very high percentage of patients with DPH and PB plasma levels not in the therapeutic range of these drugs. The Authors discuss some of the most frequent errors in planning chronic therapy with DPH and barbiturates due to the lack of knowledge of drug blood levels.

Adolescent↗

PubMedDate not supplied

[Otolaryngological aspects of Camurati-Engelmann disease (progressive diaphyseal dysplasia): review of literature and report of one case].

Camurati-Engelmann's disease (progressive diaphyseal dysplasia) is a rare hereditary condition characterized by symmetrical hyperostosis of the long bones and the skull-base, myopathies and neurological disturbances. So far, little more than one hundred cases have been reported. The diagnosis is based on radiological imaging (traditional X rays and CT scan) and family history. Our patient (a 15-year-old male) had high-grade skull-base hyperostosis producing audiological signs, such as progressive deafness, persistent otorrhea and otalgia with progressive stenosis of the external acoustic meatus.

Adolescent↗

PubMedDate not supplied

Neuro- and ototoxicity of high-dose carboplatin treatment in poor prognosis ovarian cancer patients.

BACKGROUND: Hematopoietic toxicity of high-dose carboplatin (HD-CBDCA) chemotherapy can be managed effectively with autologous blood cell support, but no conclusive data are available on its neuro- and ototoxicity. PATIENTS AND METHODS: We determined the neuro- and ototoxicity of HD-CBDCA in 10 patients affected by advanced ovarian cancer. HD-CBDCA was delivered as 24-hour continuous infusion or as 5-day schedules. Each patient underwent an extended clinical and instrumental neurological and otological evaluation before, during and after treatment. RESULTS: After HD-CBDCA only 1 patient had a clinically-evident peripheral neuropathy, while 3 additional patients had only distal paresthesias. Neurophysiological examination evidenced mild, although diffuse, sensory nerve impairment. Motor nerve impairment was also occasionally observed. All the sensory and motor pathological changes had a favorable course during the follow-up period. Ototoxicity was more severe than neurotoxicity and, in one case it was dose-limiting and audiologic impairment tended to remain constant also in the follow-up period. CONCLUSIONS: HD-CBDCA treatment can be tolerated by most of the patients, but careful monitoring of neuro- and, especially, ototoxicity should be planned.

Adult↗