Prognosis of epilepsy in a community-based study: 8 Years of follow-up in an Argentine community
ABSTRACT To assess the prognosis of epilepsy, the possibility of achieving remission of seizures, in patients who were identified in a population-based study carried out in Junín, a city of about 70,000 inhabitants in Buenos Aires Province, Argentina. On January 1, 1991 (prevalence day), 106 people had epilepsy, including 64 (60%) with the condition active.
Eight years later, we revisited the patients identified in the prevalence study. We analyzed risk factors in relation to remission of seizures. We also confirmed the specific cause of death.
Ninety-six patients were revisited (10 were completely lost to follow-up). We divided them into two groups: the group in terminal remission (defined as a seizure-free period that extended from prevalence day until the visit day in 1998) which included 64 people (66.7%), and the group of those who continued to have seizures which included 32 (33.3%) patients, of whom eight (25%) died. The overall standardized mortality ratio was 2.45; the rate was two and a half times that of the general national population.
The better prognosis was observed in the group with generalized idiopathic epilepsy syndrome. Patients with epilepsy secondary to underlying structural causes had the worst prognosis, with higher mortality.
- SourceAvailable from: Alessandro Bartoloni
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- "Some data, in fact, come from hospital-based studies (Ecuador and Martinique), and a possible selection bias leading to an overrepresentation of severe forms could in part explain the higher SMR. On the other hand, retrospective community-based studies are often carried out in small populations (Mali and Vasai), leading to a possible lack of precision of the reported estimates; furthermore, not all of the populations investigated were effectively ''untreated'' (Argentina, Ecuador, Martinique, and Tanzania) (Carpio et al., 2005; Diop et al., 2005; Kochen & Melcon, 2005). "
ABSTRACT: To evaluate the natural history and mortality of chronic epilepsy in an untreated prevalence cohort of people with epilepsy (PWE) in a rural area of Bolivia. During 1994-1996 we carried out an epidemiologic survey in a sample of 9,995 subjects in the Cordillera province. At the end of the survey we identified 130 PWE, of whom 118 were classified as having "active epilepsy." We revisited this cohort 10 years after the prevalence survey. We were able to trace 103 (87.3%) of the 118 PWE previously identified. Ten of the 103 subjects died during the follow-up period. Of the 93 PWE still alive, adequate information on the occurrence of seizures was available for 71 subjects, of whom 31 (43.7%) were seizure-free for more than 5 years; only 3 of these 31 subjects have taken an antiepileptic drug (AED) for more than 1 year. Generalized seizures were associated with a better prognosis. Mortality rate in our prevalent cohort was 10.0/1,000 person-year at risk [95% confidence interval (CI) 5.5-18.3], without a significant increased risk respect to the general population [standardized mortality rate (SMR) 1.34; 95% CI 0.68-2.39]; a significant increased risk of death was found for patients with remote symptomatic epilepsy (SMR 3.0; 95% CI 1.2-6.3) but not with idiopathic epilepsy. Three of the 10 subjects died of causes possibly related to epilepsy. Our data suggest that spontaneous remission of epilepsy occurs in a substantial proportion of untreated patients affected by chronic epilepsy; concerning mortality, we found a 3-fold increased mortality in patients with remote symptomatic epilepsy.Epilepsia 07/2009; 50(10):2199-206. DOI:10.1111/j.1528-1167.2009.02174.x · 4.58 Impact Factor
Conference Paper: An ISO-9000 design procedure for automotive electromagnetic devices[Show abstract] [Hide abstract]
ABSTRACT: This paper presents an overview of the ISO/QS-9000 objectives and how they apply to the design of electromagnetic products. ISO/QS-9000 is a methodical approach to product design and development. In addition, it provides the framework for effective management of the product development process. A wide range of disciplined efforts (based on the defined methodology of QS-9000) are described in this paper. These efforts start with a clear understanding of the customer wants and needs, develops a paper and hardware design and ends with a quality product delivered to a satisfied customerElectric Machines and Drives Conference Record, 1997. IEEE International; 06/1997
Conference Paper: A self calibrating quadrature generator with wide frequency range[Show abstract] [Hide abstract]
ABSTRACT: A quadrature local oscillator generator that produces 0° and 90° amplitude matched signals over a wide frequency range was fabricated using a high performance bipolar technology. This circuit employs a unique phase shifting circuit combined with an improved high frequency phase detector to produce quadrature outputs. RC based circuits, which have typically been used to generate high frequency quadrature signals, can operate only over a narrow frequency range. Other quadrature generation methods such as frequency dividers, use a reference LO frequency at least twice that of the desired quadrature signal and require a duty cycle adjustment circuit which has bandwidth limitations. The circuit described in this paper operates over a frequency range of 400 MHz through 700 MHz with low amplitude and phase imbalanceRadio Frequency Integrated Circuits (RFIC) Symposium, 1997., IEEE; 07/1997