RESUMO
BACKGROUND: Neurological disorders in kidney transplant patients may be related to several factors, including high toxicity to the use of immunosuppressive drugs. OBJECTIVE: To find out whether there was association between neurological complications and immunosuppression in a sample of patients who received renal transplantation. METHODS: Cross-sectional study in which 121 renal transplant patients participated, of which 22 (18%) had neurological disorders, chi-squared test was used to analyze the relation between neurological disorders and comorbidity such as diabetes mellitus and hypertension and time of immunosuppressant use. A significance level of p <0.05 was accepted for all determinations. RESULTS: Of the subjects studied, 13 were male (59%) and nine female (41%). The mean age of the patients included in the study was 33 ± 12 years. 59% of neurological disorders occurred between six months and five years after patients had received the transplant. Neurological alterations found were: tremor (7.4%), dizziness (4.1%), peripheral neuropathy (3.3%), headache (2.4%), and decreased strength (0.8%). CONCLUSION: No statistically significant association was found between neurological disorders and immunosuppressant use, or between them and the duration of immunosuppression.
Antecedentes: Las alteraciones neurológicas en pacientes trasplantados de riñón pueden relacionarse con diversos factores, entre ellos la toxicidad secundaria al uso de medicamentos inmunosupresores. Objetivo: Conocer si existió asociación entre complicaciones neurológicas e inmunosupresión en una muestra de pacientes que recibieron trasplante renal. Métodos: Estudio transversal en el que participaron 121 pacientes con trasplante renal, de los cuales 22 (18 %) presentaron alteraciones neurológicas, Se usó χ2 para analizar la relación entre alteraciones neurológicas y comorbilidad como diabetes mellitus e hipertensión arterial y tiempo del uso de inmunosupresor. Se aceptó un nivel de significación p<0.05 para todas las determinaciones Resultados: De los sujetos estudiados, 13 eran hombres (59%) y nueve mujeres (41%). La edad media de los pacientes incluidos en el estudio fue 33 ± 12 años. El 59 % de las alteraciones neurológicas ocurrieron entre seis meses y cinco años de que los pacientes habían recibido el trasplante. Las alteraciones neurológicas encontradas fueron: temblor (7.4%), vértigo (4.1%), neuropatía periférica (3.3%), cefalea (2.4%) y disminución de la fuerza (0.8 %). Conclusión: No se encontró relación estadísticamente significativa entre las alteraciones neurológicas y el inmunosupresor usado ni entre éstas y el tiempo que duró la inmunosupresión.
Assuntos
Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Doenças do Sistema Nervoso/etiologia , Transplantados , Adulto , Estudos Transversais , Ciclosporina , Diabetes Mellitus/etiologia , Feminino , Rejeição de Enxerto , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Tacrolimo , Adulto JovemRESUMO
PURPOSE: To investigate the efficacy of pregabalin in the treatment of refractory partial seizures. METHODS: This was a 21-week, open-label study of pregabalin (150-600 mg/day) as an adjunctive therapy in adults with refractory partial seizures. The study included an 8-week baseline period, a 9-week dose-optimization period, and a 12-week treatment-observation period. The primary assessment was mean percentage change in 28-day seizure rate between baseline and the last 12 weeks of treatment. RESULTS: In total, 136 Mexican patients were included in this study (55.9% women; mean age/epilepsy duration, 35.2/22.9 years). The median and mean (95% confidence interval [CI]) 28-day baseline seizure rates were 3.9 and 7.8 (5.4-10.2), respectively. The mean (95% CI) reduction in seizure frequency was 51.2% (43.0-59.3) over the last 12 weeks of treatment, while the median reduction was 57.9%. The percentage of patients with a ≥ 5 0% or ≥ 75% reduction in seizure frequency was 63.6% and 48.8%, respectively. The percentage of patients who were seizure-free during the last 4 and 12 weeks of treatment was 40.5% and 20.7%, respectively. The most common adverse events were somnolence (39.7%), dizziness (16.2%), and weight gain (14.0%). CONCLUSION: Pregabalin was well tolerated and associated with significant reductions in seizure frequency.