RESUMO
BACKGROUND: Tremor is a known side-effect of anticonvulsants, particularly of valproate. However, there is a dearth of information regarding detailed clinical features and functional impact of valproate-induced tremor. METHODS: We studied a cohort of patients treated with anticonvulsants for neurological disorders, through blinded evaluations using the Clinical Rating Scale for Tremor (CRST); we compared the frequency, severity and functional impact of drug-induced tremor between patients treated with valproate and those treated with other anticonvulsants. RESULTS: From a cohort of 218 consecutive patients, 171 were fully evaluated; 118 patients were taking valproate alone or combined with other anticonvulsants and 53 patients were taking other anticonvulsants. Mean age (±SD) at evaluation of the cohort was 32 ± 13 years, females represented 55.6% of cases. Tremor was more frequently observed in patients taking valproate particularly postural upper limb tremor: 49% vs. 15% (right-side) (P < 0.001) and 48.3% vs. 13.2% (left-side), (P < 0.001); had a higher total CRST score: 12.14 vs. 3.06 (P < 0.001), and required more frequently treatment for drug-induced tremor: 23.7% vs. 5.6% (P=0.005) compared with patients taking other anticonvulsants. Among 118 patients taking valproate, women had a higher total CRST score compared with men: 14.54 ± 14.9 vs. 9.56 ± 9.55 (P=0.034). A weak correlation between the total CRST score, dose per Kg of valproate and serum levels of valproate were observed. CONCLUSIONS: Tremor is frequently observed in patients taking valproate and is severe enough to require treatment in about 24% of cases.
Assuntos
Anticonvulsivantes/efeitos adversos , Tremor/induzido quimicamente , Ácido Valproico/efeitos adversos , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/tratamento farmacológico , Tremor/epidemiologia , Adulto JovemRESUMO
Se realizó un estudio propectivo a fin de determinar la prevalencia de ascariasis en niños del medio hospitalario público y privado. Tras un muestreo simple al azar, se tomaron 68 pacientes del medio público y 39 del privado, con edades compredidas entre 1 mes y 12 años. Se practicó examen coprológico simple y según la técnica de concentración de Kato. Se revisó la existencia de antecedentes de parasitosis intestinal y sintomatología. El análisis estadístico se realizó mediante x², F y Z. La prevalencia fue menor a la reportada en la literatura y no difirió (p>0,05) entre el medio público (11,76 por ciento) y privado (5,13 por ciento). La edad fue menor a la reportada en otros estudios. La sintomatología, fue vaga y demostró una especificidad diagnóstica de 61 por ciento. El antecedente como elemento diagnóstico presuntivo (especificidad 93,81 por ciento probabilidad pos-prueba 33 por ciento) demostró utilidad para pesquisa