No abstract

SUMMARY The therapeutic effects of sodium valproate and ethosuximide were compared in a prospective, randomised study of 28 children whose absense attacks were associated with 3‐per‐second spike and wave activity in the EEG. The two drugs were equally effective in the control of absence attacks. When patients failed to respond to the initial drug prescribed, a response occurred with the alternative drug in all but one child. Complete or partial remission with sodium valproate was associated with serum levels ranging from 312 to 849mol/1 and to ethosuximide with levels from 106 to 614mol/l. Acute pancreatitis occurred in one patient on sodium valproate, whose serum levels exceeded 800mol/l. RÉSUMÉ Etude comparative entre l'ethosuximide et le valproate de sodium dans le traitement des absences petit mal typiques L'action thérapeutique du valproate de sodium et de l'ethosuximide a été comparée au cours d'une étude prospective randomisée de 28 enfants dont les absences critiques étaient associées à des pointes‐ondes de fréquence 3 par seconde à l'EEG. Les deux médications se sont révélées d'action égale dans le contrôle des absences. Une réponse positive avec la seconde médication est survenue chez tous les enfants sauf un lorsque la première médication prescrite était inefficace. Les réponses excellentes ou bonnes au valproate de sodium étaient associées avec des taux sériques allant de 312 à 849mol/litre, pour l'ethosuximide avec des taux de 106 à 614mol/litre. Une pancréatite aigue est survenue chez un malade traité au valproate de sodium dont les taux sériques dépassaient 800mol/litre. ZUSAMMENFASSUNG Eine vergleichende Studie von Ethosuximid und Sodium Valproat bei der Behandlung typischer Absencen (Petit Mal) Die therapeutische Wirkung von Sodium Valproat und Ethosuximid wurde in einer prospektiven randomisierten Studie bei 28 Kindern verglichen, deren Absencen mit 3/sec Spike‐Wave Aktivität im EEG einhergingen. Beide Medikamente waren bei der Behandlung der Absencen gleich wirksam. Wenn Patienten auf das zuerst verschriebene Medikament nicht ansprachen, dann wurde bis auf eine Ausnahme bei allen ein Erfolg mit dem anderen Medikament erzielt. Ein hervorragender bis guter Erfolg wurde beim Sodium Valproat mit Spiegeln von 312–849mol/l und beim Ethosuximid von 106–614mol/l erreicht. Bei einem Patienten trat unter Sodium Valproat mit einem Spiegel über 800mol/l eine akute Pankreatitis auf. RESUMEN Estudio comparativo entre la etosuccimida y el valproato sódico en el tratamiento de las crisis de ausencia tipicas (pequeño mal) Los efectos terapéuticos del valproato sódico y la etosuccimida fueron comparados en un estudio prospectivo al azar en 28 niños cuyas crisis de ausencia iban asociadas con una actividad en el EEG de punta‐onda de 3 por segundo. Ambas medicaciones eran igualmente efectivas en el control de las crisis de ausencia. Cuando los pacientes no respondian a la medicacion inicial, se obtenia respuesta con el otro fármaco en todos los casos excepto uno. Una respuesta excelente o buena al valproato sódico...

Introduction Mucosal melanoma (MM) is a rare condition with a poor prognosis. Surgery is the corner stone of treatment, however, radiotherapy has been commonly employed as a treatment strategy and recent studies suggesting that survival outcomes may be improving are emerging. Methods A systematic review and meta‐analysis comparing risk ratios of radiotherapy and surgery and radiotherapy (SRT) with surgery for 5‐year overall survival, local recurrence and distant metastasis in head and neck mucosal melanoma (HNMM). Results SRT has a lower risk of death compared to surgery [RR 0.93 [95% CI = 0.87, 0.98] (P = .01)] and a reduced risk of local recurrence [RR 0.63 [95% CI = 0.48, 0.82] (P = .005)]. SRT has no effect on distant metastasis. Radiotherapy has worse survival when compared to surgery [RR 1.2 [95% CI = 1.03, 1.33] (P = .0006)]. Conclusions SRT confers a moderate survival advantage in HNMM compared to surgery. This is most likely secondary to reduced local recurrence.

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The first trials using progenitor cells to improve burn wound healing are beginning. However, there remains a paucity of data on patients' opinions of the source of stem cells. In this study, 279 patients attending plastic surgery/burns outpatient and medical outpatient clinics were questioned to assess willingness to accept a tissue-engineered skin product derived from a variety of sources. Levels of acceptance for the use of progenitor cells derived from these sources for treatment across a range of disease states (burns, Parkinson's disease, diabetes, and for cosmetic use) were also assessed. Overall, 80% of those questioned would accept a tissue-engineered product. Autologous cells were the preferred choice of cells (acute burns 94%, diabetes 95%, Parkinson's 93.9%). Allogeneic cells were still widely accepted (acute burns 67%, diabetes 66.7%, Parkinson's 69.2%). There was no difference observed between plastic surgical patients and medical patients in acceptance of cell therapy for burns, Parkinson's disease, or diabetes. There is good potential acceptance for the use of both autologous and allogeneic cells for the treatment of acute burns and burns' scarring as well as in diabetes and Parkinson's disease. Disease state does not appear to influence overall acceptability and choice of cells.