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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Climate change and epilepsy: Insights from clinical and basic science studies(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2021-01-01) Gulcebi I, Medine; Bartolini, Emanuele; Lee, Omay; Lisgaras, Christos Panagiotis; Onat, Filiz; Mifsud, Janet; Striano, Pasquale; Vezzani, Annamaria; Hildebrand, Michael S.; Jimenez-Jimenez, Diego; Junck, Larry; Lewis-Smith, David; Scheffer, Ingrid E.; Thijs, Roland D.; Zuberi, Sameer M.; Blenkinsop, Stephen; Fowler, Hayley J.; Foley, Aideen; Sisodiya, Sanjay M.; Balestrini, Simona; Berkovic, Samuel; Cavalleri, Gianpiero; Correa, Daniel Jose; Custodio, Helena Martins; Galovic, Marian; Guerrini, Renzo; Henshall, David; Howard, Olga; Hughes, Kelvin; Katsarou, Anna; Koeleman, Bobby P. C.; Krause, Roland; Lowenstein, Daniel; Mandelenaki, Despoina; Marini, Carla; O'Brien, Terence J.; Pace, Adrian; De Palma, Luca; Perucca, Piero; Pitkanen, Asla; Quinn, Finola; Selmer, Kaja Kristine; Steward, Charles A.; Swanborough, Nicola; Thijs, Roland; Tittensor, Phil; Trivisano, Marina; Weckhuysen, Sarah; Zara, Federico; Consortium, Epilepsy Climate ChangeClimate change is with us. As professionals who place value on evidence-based practice, climate change is something we cannot ignore. The current pandemic of the novel coronavirus, SARS-CoV-2, has demonstrated how global crises can arise suddenly and have a significant impact on public health. Global warming, a chronic process punctuated by acute episodes of extreme weather events, is an insidious global health crisis needing at least as much attention. Many neurological diseases are complex chronic conditions influenced at many levels by changes in the environment. This review aimed to collate and evaluate reports from clinical and basic science about the relationship between climate change and epilepsy. The keywords climate change, seasonal variation, temperature, humidity, thermoregulation, biorhythm, gene, circadian rhythm, heat, and weather were used to search the published evidence. A number of climatic variables are associated with increased seizure frequency in people with epilepsy. Climate change-induced increase in seizure precipitants such as fevers, stress, and sleep deprivation (e.g. as a result of more frequent extreme weather events) or vector-borne infections may trigger or exacerbate seizures, lead to deterioration of seizure control, and affect neurological, cerebrovascular, or cardiovascular comorbidities and risk of sudden unexpected death in epilepsy. Risks are likely to be modified by many factors, ranging from individual genetic variation and temperature-dependent channel function, to housing quality and global supply chains. According to the results of the limited number of experimental studies with animal models of seizures or epilepsy, different seizure types appear to have distinct susceptibility to seasonal influences. Increased body temperature, whether in the context of fever or not, has a critical role in seizure threshold and seizure-related brain damage. Links between climate change and epilepsy are likely to be multifactorial, complex, and often indirect, which makes predictions difficult. We need more data on possible climate-driven altered risks for seizures, epilepsy, and epileptogenesis, to identify underlying mechanisms at systems, cellular, and molecular levels for better understanding of the impact of climate change on epilepsy. Further focussed data would help us to develop evidence for mitigation methods to do more to protect people with epilepsy from the effects of climate change. (C) 2021 Elsevier Inc. All rights reserved.Item Pharmacokinetic characterization of favipiravir in patients with COVID-19(WILEY, 2022-01-01) Gulhan, Rezzan; Eryuksel, Emel; Oglu, Medine Gulcebi Idriz; Culpan, Yekta; Toplu, Aylin; Kocakaya, Derya; Tigen, Elif; Sengel, Buket Erturk; Sili, Uluhan; Yildizeli, Sehnaz Olgun; Balcan, Mehmet Baran; Elci, Abdullah; Bulut, Cenk; Karaalp, Atila; Yananli, Hasan Raci; Guner, Abdullah Emre; Hatipoglu, Mustafa; Karakurt, Sait; Korten, Volkan; Ratnaraj, Neville; Patsalos, Philip; Ay, Pinar; Onat, FilizThis prospective observational study describes the pharmacokinetic characteristics of favipiravir in adult patients hospitalized for mild to moderate COVID-19 with a positive RT-PCR test. Favipiravir was administered for 5 days, with a loading dose of 3200 mg and a maintenance dose of 1200 mg/day. Serial blood samples were collected on Day 2 and Day 4 of the therapy. Laboratory findings of the patients (n = 21) and in-hospital mortality were recorded. Favipiravir concentrations exhibited substantial variability and a significant decrease during the treatment of COVID-19. The median favipiravir trough concentration (C0-trough) on Day 2 was 21.26 (interquartile range {[}IQR], 8.37-30.78) mu g/mL, whereas it decreased significantly to 1.61 (IQR, 0.00-6.41) mu g/mL on Day 4, the area under the concentration-time curve decreased by 68.5\%. Day 2 C0-trough of female patients was higher than male patients. Our findings indicate that favipiravir concentrations show significant variability during the treatment of COVID-19 and therapeutic drug monitoring may be necessary to maintain targeted concentrations.Item The Acute and Delayed Effects of Vagal Nerve Stimulation on an Absence Epilepsy Model in WAG/Rij(TURKISH NEUROSURGICAL SOC, 2016-01-01) Uyar, Ramazan; Turk, Cezmi Cagri; Isik, Nejat; Kalelioglu, Mufit; Onat, Filiz; Ozek, MemetAIM: Vagal nerve stimulation (VNS) is an effective method of treatment for epilepsy patients either unresponsive to medical therapy or not suitable for resective surgeries. We designed an experimental study on Wistar Albino Glaxo rats from Rijswijk (WAG\textbackslash{}Rij) to investigate the effects of VNS on a non-convulsive epilepsy model. MATERIAL and METHODS: The experiment was performed on six WAG/Rij rats, a validated strain for genetic absence seizures. The animals were underwent VNS and the effects were investigated on electroencephalography (EEG) recordings at 22, 24, 26 hours of stimulation and 15 days after the cessation, for duration of spike and wave complexes (SWC), the numbers, mean duration of SWC and frequencies in an hour. RESULTS: EEG recordings demonstrated that the mean duration of SWC was 353.1 seconds and the number of activity per hour was 62 at the baseline. There were statistically significant decreases in the total duration of SWC and the number of activities (61.8\% and 78\% decrease, respectively). There were no significant decreases in the mean duration of SWC and the frequencies. CONCLUSION: The acute stimulation of the vagal nerve caused a statistically significant decrease both in overall duration of SWC and the number of complexes in an hour. Moreover, the positive effects seemed to last even 15 days after the cessation of the stimulation. Further studies focusing on different stimulation parameters and delayed effects of the VNS on human absence seizures are warranted.