Biomedical subjects

J Sivenius

Publications and source records attributed to J Sivenius.

102 records · Page 6Linked to original sources

PubMed1982

Treatment of osteomalacia in institutionalized epileptic patients on long-term anticonvulsant therapy.

The efficacy of vitamin D2 in the dose of 2000 IU daily in reversing anticonvulsant osteomalacia was studied in nine epileptic inpatients. The treatment with vitamin D2 was associated with increased serum 25-hydroxycalciferol and 24,25-dihydroxyvitamin D concentrations and partial healing of osteomalacic changes in the cancellous bone of the iliac crest. But it was concluded that the dose of vitamin D2, 2000 IU daily, was too small and that calcium supplementation may be needed in addition to vitamin D therapy.

24,25-Dihydroxyvitamin D 3↗

PubMed1982

Anticonvulsant osteomalacia in epileptic outpatients.

The occurrence of anticonvulsant osteomalacia was studied in 23 epileptic outpatients, and in age and sex matched controls. Hypocalcaemia was observed in 10, hypophosphataemia in 1, and increased serum alkaline phosphatase in 8 of the patients. The serum 25-hydroxyvitamin D concentration was significantly lower In the patients than in the controls, but no difference was found in the serum 24,25-dihydroxyvitamin D concentration between the patients and the controls. There was no difference in bone mineral density between the patients and the healthy controls. In the histomorphometric study, no differences were found in the amount of trabecular bone or osteoid between the patients and the controls, but the patients had a slightly more extensive trabecular resorption surfaces. Histological osteomalacia was found in two of the 23 cases (9%). We conclude that epileptic outpatients on long-term anticonvulsant therapy have vitamin D deficiency and may develop osteomalacia.

Adult↗

PubMed1981

Osteomalacia in institutionalized epileptic patients on long-term anticonvulsant therapy.

The occurrence of anticonvulsant osteomalacia was studied in 31 epileptic inpatients, 16 women and 15 men. Disturbances in biochemical parameters indicating osteomalacia were frequent. Thirty two per cent of the patients were hypocalcemic, 55% had an increase in S-ALP and 26% in U-HOP, and dU-Ca was decrease in 55%. The S-25OHD3 concentrations were significantly lower in the patients compared with healthy controls. BMD was decreased in females but not in males compared wih the controls. Histomorphometric analysis revealed an increase in the amount of osteoid, but the amount of trabecular bone was no lower than in the controls. The amount of resorption surfaces was increased in the females, but not in the males. The patients who took less physical activity had a pronounced decrease in BMD. The conclusion drawn was that osteomalacia is a frequent complication of long-term anticonvulsant medication, especially among institutionalized patients.

Adult↗

PubMed1979

[Myositis].

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Bacterial Infections↗

PubMedDate not supplied

Reduction of dosing frequency of carbamazepine with a slow-release preparation.

The occurrence of side effects and epileptic seizures and the pharmacokinetics of carbamazepine (CBZ) and carbamazepine-10,11-epoxide were studied using a slow-release CBZ preparation, Neurotol slow, and a conventional CBZ preparation, Tegretol. The study was an open, randomized cross-over trial, with a 2 week study period for each preparation. Tegretol was given 3 times and Neurotol slow twice a day. The earlier CBZ dose was kept unchanged. The initial sample consisted of 24 adult epileptic patients receiving CBZ treatment of whom 20 patients were evaluable. The fluctuation in serum CBZ concentrations did not differ significantly between the 2 treatment periods, even though the interdose interval of Neurotol slow was 4 h longer than that of Tegretol. The switch-over from conventional CBZ to the slow-release formulation did not seem to alter the efficacy and side effects of CBZ. By using Neurotol slow instead of a conventional CBZ preparation, Tegretol, it is evidently possible to reduce the dosing frequency from 3 times a day to twice daily administrations.

Adolescent↗

PubMedDate not supplied

Clinical trial with an experimental taurine derivative, taltrimide, in epileptic patients.

The antiepileptic effect, effects on EEG, and tolerability of taltrimide, a new taurine derivative, were studied in this open clinical trial in 27 patients with severe epilepsy resistant to conventional drugs. After the 2-week control phase, taltrimide was given in gradually increasing doses up to 4.0 g/day--this dose used for 12 days. Taltrimide was given over 4 weeks and it was gradually withdrawn over 2 weeks. The frequency of seizures increased statistically significantly during the trial with increasing dose of taltrimide and decreased again in the withdrawal phase of the trial. Of six dropouts, one had status epilepticus, and in two patients increased number or severity of seizures necessitated withdrawal of taltrimide. There were no changes in EEG recordings or in laboratory data for safety evaluation. Taltrimide penetrated well through the blood-brain barrier, with the concentration of its main metabolite, phthalimidoethanesulphonamide, in cerebrospinal fluid, about half that in serum. The concentration of phenytoin increased statistically significantly, and there was a significant decrease in serum carbamazepine concentration during the taltrimide treatment. The anticonvulsive effect of taltrimide observed in animal experiments could not be confirmed in this study; in contrast, the seizures increased statistically significantly during taltrimide treatment. The reason for this remains obscure. The doses used, the significant drug interactions, or the patient material seemingly do not explain totally the noticed increase in seizure frequency. One explanation may be that taltrimide has proconvulsive properties in humans.

Adult↗

PubMedDate not supplied

Electrophysiologic effects of gamma-vinyl GABA and carbamazepine.

The effects of gamma-vinyl GABA (GVG) and carbamazepine (CBZ) monotherapy on somatosensory (SEP) and visual (VEP) evoked potentials and spectral quantitative EEG (QEEG) were studied in 17 patients with complex partial seizures using a cross-over double-blind study design. CBZ was associated with statistically significant prolongation of SEP latencies. When the drug was switched to GVG, shortening of the peak latencies was observed. Prolonged pattern-VEP peaks were observed both during CBZ and GVG monotherapies. A similar but more subtle tendency of the peaks was observed in P100 latencies. Spectral EEG revealed a slowing of the occipital rhythm with CBZ. No QEEG changes related to GVG were found. The use of multimodal evoked potentials and QEEG should be considered in studying the effects of new antiepileptic drugs (AEDs).

Adult↗

PubMedDate not supplied

Double-blind study of Gabapentin in the treatment of partial seizures.

Forty-three patients completed a double-blind, placebo-controlled study of Gabapentin (GBP) as add-on therapy in partial and secondarily generalized seizures. All patients were followed for an initial 3-month baseline period, after which they were randomly allocated to receive either a placebo or 900 or 1,200 mg/day GBP for 3 months. A statistically significant difference in seizure frequency from the baseline to the treatment phase was noted between patients receiving placebo and GBP 1,200 mg, in whom seizure frequency decreased 57%. The GBP dosage of 900 mg appeared to be ineffective. A close relationship was observed between the serum GBP concentrations and the GBP dosage based on the seizure frequency. Serum GBP concentrations greater than 2 micrograms/ml resulted in a lower frequency of seizures. The adverse effects were minor and consisted mainly of transient drowsiness. GBP appears to be effective in the treatment of partial epileptic seizures in a dosage-related manner.

Acetates↗

PubMedDate not supplied

Gamma-vinyl GABA (vigabatrin) in epilepsy: clinical, neurochemical, and neurophysiologic monitoring in epileptic patients.

We report long-term clinical, neurochemical, and electrophysiologic data of gamma-vinyl GABA (GVG, vigabatrin) in three groups of patients. GVG was started as add-on therapy for 75 patients with refractory complex partial seizures (group A) and for 36 mentally handicapped patients with severe epilepsy (group B). The third group (C) consisted of 20 patients with carbamazepine (CBZ) monotherapy, in half of whom GVG monotherapy was substituted. After 3 months, 55% of patients in group A and 42% in group B were responders (reduction in seizure frequency greater than 50%). After 6 (group A) and 3 years (group B) of follow-up, 27 and 33% of the patients, respectively, still had good response to GVG. Neurochemical measurements showed a twofold increase in CSF GABA concentrations and minimal or no changes in other neurotransmitter-related parameters. In group C, substitution of GVG as medication tended to normalize the lengthened latencies in somatosensory evoked potentials (SEPs) observed during CBZ treatment.

Adult↗

PubMedDate not supplied

Vigabatrin (gamma-vinyl-GABA): neuropathologic evaluation in five patients.

We performed neuropathologic examination of cerebral cortex specimens from 4 patients who underwent epilepsy surgery and the brain of 1 patient who died suddenly. All had severe epilepsy and had received gamma-vinyl-GABA (GVG, vigabatrin) for 3-5.5 years. Neither the surgically resected temporal lobe specimens nor the frontal and temporal lobes autopsy specimens showed abnormal white matter vacuolation.

Adult↗

PubMedDate not supplied

The incidence of stroke in the Kuopio area of East Finland.

During a 20-month study period there were 373 strokes in a geographically defined population (235/100,000/year). When age and sex were adjusted to the mean population of Finland in 1979, the annual incidence of stroke was 270/100,000 persons. The distribution of incident cases by diagnostic category was as follows: cerebral infarction 80%, ICH 9%, SAH 8% and NOS 3%. Case fatality of stroke within one year was 37%. The recurrence rate was 6% during the first year after any stroke.

Adolescent↗

PubMedDate not supplied

The significance of intensity of rehabilitation of stroke--a controlled trial.

Of the 373 stroke patients 95 were admitted to the feasibility study of stroke rehabilitation. The patients were divided into two groups, an intensive and a normal treatment group. In this study, the functional recovery of stroke, measured by ADL and motor function was significantly better in the intensive treatment group. There was no difference in institutionalization or incidence of death between the groups. The gain of ADL and motor function was greatest during the first three months after stroke in the intensive treatment group. The conclusion is that intensified physiotherapy seems to improve the functional recovery of stroke patients.

Activities of Daily Living↗