Epilepsy for primary health care: a cost-effective Latin American E-learning initiative. A report from the Education Commission of the International League Against Epilepsy / Lady Diana Ladino Malagón  

Público ISBD Título : Epilepsy for primary health care: a cost-effective Latin American E-learning initiative. A report from the Education Commission of the International League Against Epilepsy Tipo de documento : documento electrónico Autores : Lady Diana Ladino Malagón, Fecha de publicación : 2018 Títulos uniformes : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Epilepsy  Latin America  online course  primary care  training  e-learning Resumen : Aims. A lack of neurologists in Latin America forces primary health care providers to manage epilepsy. With the main goal of improving diagnostic and therapeutic management of patients with epilepsy through training of physicians in the primary health care level, the International League Against Epilepsy Education Commission (2013-2017) created a lowcost, regional, virtual course. Methods. The course, set-up in Moodle platform, was structured in eigh modules, each lasting for a week. Teaching was based on written didactic material, videos, and interactive discussions, both in Spanish and Portuguese. Topics included epidemiology, diagnosis, classification, treatment, prognosis, social issues, and epilepsy policies. Each course was limited to 50 participants and priority was given to general practitioners. Certification was given to those approving the final examination. Results. Since 2015, five courses have been developed, involving 143 participants from 17 countries and 21 tutors. Of the participants, 61% worked in primary health care services. A total of 129 participants (90%) completed the course, and 110 submitted the final examination with an approval rate of 95%. From 85 participants completing the course evaluation, 98% would recommend the course to other colleagues, and 99% showed interest in taking other similar courses. High self-confidence for the management of patients with epilepsy increased from 21% at baseline to 73% after the course. Conclusions. The online course on epilepsy for primary care physicians in Latin America was shown to be a cost-effective course, with good retention and excellent approval rates. Our current challenges include periodic updating, complete self-sustainability, and exploring different strategies to reach our target audience more effectively. Mención de responsabilidad : Jaime Carrizosa, Patricia Braga, Marly Albuquerque, Alicia Bogacz, Jorge Burneo, Ana C Coan, Guilca Contreras, Laura Guilhoto, Álvaro Izquierdo, Lady Ladino, Katia Lin, Maria L Manreza, Lilia Morales, Loreto Ríos, Rodrigo Solarte, Kette Valente, Viviana Venegas, Angélica Uscátegui-Daccarett, Elza M Yacubian Referencia : Epileptic Disord. 2018 Oct 1;20(5):386-395. DOI (Digital Object Identifier) : 10.1684/epd.2018.0997 PMID : 30378539 En línea : https://www.jle.com/fr/revues/epd/e-docs/epilepsy_for_primary_health_care_a_cost [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4171 Epilepsy for primary health care: a cost-effective Latin American E-learning initiative. A report from the Education Commission of the International League Against Epilepsy [documento electrónico] / Lady Diana Ladino Malagón,  . - 2018. Obra : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Epilepsy  Latin America  online course  primary care  training  e-learning Resumen : Aims. A lack of neurologists in Latin America forces primary health care providers to manage epilepsy. With the main goal of improving diagnostic and therapeutic management of patients with epilepsy through training of physicians in the primary health care level, the International League Against Epilepsy Education Commission (2013-2017) created a lowcost, regional, virtual course. Methods. The course, set-up in Moodle platform, was structured in eigh modules, each lasting for a week. Teaching was based on written didactic material, videos, and interactive discussions, both in Spanish and Portuguese. Topics included epidemiology, diagnosis, classification, treatment, prognosis, social issues, and epilepsy policies. Each course was limited to 50 participants and priority was given to general practitioners. Certification was given to those approving the final examination. Results. Since 2015, five courses have been developed, involving 143 participants from 17 countries and 21 tutors. Of the participants, 61% worked in primary health care services. A total of 129 participants (90%) completed the course, and 110 submitted the final examination with an approval rate of 95%. From 85 participants completing the course evaluation, 98% would recommend the course to other colleagues, and 99% showed interest in taking other similar courses. High self-confidence for the management of patients with epilepsy increased from 21% at baseline to 73% after the course. Conclusions. The online course on epilepsy for primary care physicians in Latin America was shown to be a cost-effective course, with good retention and excellent approval rates. Our current challenges include periodic updating, complete self-sustainability, and exploring different strategies to reach our target audience more effectively. Mención de responsabilidad : Jaime Carrizosa, Patricia Braga, Marly Albuquerque, Alicia Bogacz, Jorge Burneo, Ana C Coan, Guilca Contreras, Laura Guilhoto, Álvaro Izquierdo, Lady Ladino, Katia Lin, Maria L Manreza, Lilia Morales, Loreto Ríos, Rodrigo Solarte, Kette Valente, Viviana Venegas, Angélica Uscátegui-Daccarett, Elza M Yacubian Referencia : Epileptic Disord. 2018 Oct 1;20(5):386-395. DOI (Digital Object Identifier) : 10.1684/epd.2018.0997 PMID : 30378539 En línea : https://www.jle.com/fr/revues/epd/e-docs/epilepsy_for_primary_health_care_a_cost [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4171

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Intracranial investigation of a patient with nodular heterotopia and hippocampal sclerosis: dealing with a dual pathology / Lady Diana Ladino Malagón  

Público ISBD Título : Intracranial investigation of a patient with nodular heterotopia and hippocampal sclerosis: dealing with a dual pathology Tipo de documento : documento electrónico Autores : Lady Diana Ladino Malagón, Fecha de publicación : 2017 Títulos uniformes : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Dual pathology  epilepsy surgery  periventricular nodular heterotopia  posterior-quadrant epilepsy  temporal lobectomy Resumen : The pre-operative assessment and surgical management of patients with dual pathology is challenging. We describe a patient with drug-resistant focal epilepsy with hippocampal sclerosis and extensive periventricular nodular heterotopia in the same hemisphere. The semiology, scalp EEG, and imaging were divergent, but the presence of focal interictal and ictal epileptic discharges of the putative ictal onset zone resulted in successful localization of the epileptogenic zone. A less aggressive resection was performed based on intracranial EEG recording. The patient has been seizure-free for three years since resection. Electroclinical hypotheses and challenges in defining the epileptogenic network are discussed. Mención de responsabilidad : Lady Diana Ladino, Chelsea Dash, Adam Wu, Jose Francisco Tellez-Zenteno Referencia : Epileptic Disord. 2017 Jun 1;19(2):195-201. DOI (Digital Object Identifier) : 10.1684/epd.2017.0912 PMID : 28625947 En línea : https://www.jle.com/fr/revues/epd/e-docs/intracranial_investigation_of_a_patient [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4027 Intracranial investigation of a patient with nodular heterotopia and hippocampal sclerosis: dealing with a dual pathology [documento electrónico] / Lady Diana Ladino Malagón,  . - 2017. Obra : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Dual pathology  epilepsy surgery  periventricular nodular heterotopia  posterior-quadrant epilepsy  temporal lobectomy Resumen : The pre-operative assessment and surgical management of patients with dual pathology is challenging. We describe a patient with drug-resistant focal epilepsy with hippocampal sclerosis and extensive periventricular nodular heterotopia in the same hemisphere. The semiology, scalp EEG, and imaging were divergent, but the presence of focal interictal and ictal epileptic discharges of the putative ictal onset zone resulted in successful localization of the epileptogenic zone. A less aggressive resection was performed based on intracranial EEG recording. The patient has been seizure-free for three years since resection. Electroclinical hypotheses and challenges in defining the epileptogenic network are discussed. Mención de responsabilidad : Lady Diana Ladino, Chelsea Dash, Adam Wu, Jose Francisco Tellez-Zenteno Referencia : Epileptic Disord. 2017 Jun 1;19(2):195-201. DOI (Digital Object Identifier) : 10.1684/epd.2017.0912 PMID : 28625947 En línea : https://www.jle.com/fr/revues/epd/e-docs/intracranial_investigation_of_a_patient [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4027

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How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery? / Lady Diana Ladino Malagón  

Público ISBD Título : How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery? Tipo de documento : documento electrónico Autores : Lady Diana Ladino Malagón, Fecha de publicación : 2016 Títulos uniformes : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Adult epilepsy  benign temporal epilepsy  mild course  prognosis  severe course  temporal lobe epilepsy Resumen : Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults and commonly requires surgical treatment. While an overwhelming preponderance of literature supports the notion that a large percentage of patients with TLE benefit from surgery, there is a paucity of outcome data on patients who demonstrate a sustained response to pharmacological treatment. In this study, we present an adult cohort of patients with TLE, with the purpose of identifying the proportion of patients with a mild course of the disease, as well as potential risk factors. A prospective cohort study of all patients with TLE assessed and followed by the Saskatchewan Epilepsy Program, from 1 March 2007 to Jan 29(th) 2014. Patients were dichotomized as having a mild (seizure freedom without surgical intervention) or severe (surgical intervention required and/or failure to achieve seizure remission) course. Descriptive statistics, odds ratios and confidence intervals were calculated to identify predictors of seizure freedom. The cohort consisted of 159 patients. Mean patient age at last follow-up visit was 46±14.4 (range: 19-88) years. Mean follow-up period was 43.4±22.6 (6 to 84) months. Forty-six patients (29%) demonstrated mild-course TLE while 113 (71%) had a severe course of TLE. Patients with a mild course of TLE were more likely to be older (p = 0.002), have late-onset epilepsy (p Mención de responsabilidad : Lizbeth Hernández-Ronquillo, Samantha Buckley, Lady Diana Ladino, Adam Wu, Farzad Moien-Afshari, Syed Aa Rizvi, Jose F Téllez-Zenteno Referencia : Epileptic Disord. 2016 Jun 1;18(2):137-47. DOI (Digital Object Identifier) : 10.1684/epd.2016.0822 PMID : 27100050 En línea : https://www.jle.com/fr/revues/epd/e-docs/how_many_adults_with_temporal_epilepsy_ [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3983 How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery? [documento electrónico] / Lady Diana Ladino Malagón,  . - 2016. Obra : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Adult epilepsy  benign temporal epilepsy  mild course  prognosis  severe course  temporal lobe epilepsy Resumen : Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults and commonly requires surgical treatment. While an overwhelming preponderance of literature supports the notion that a large percentage of patients with TLE benefit from surgery, there is a paucity of outcome data on patients who demonstrate a sustained response to pharmacological treatment. In this study, we present an adult cohort of patients with TLE, with the purpose of identifying the proportion of patients with a mild course of the disease, as well as potential risk factors. A prospective cohort study of all patients with TLE assessed and followed by the Saskatchewan Epilepsy Program, from 1 March 2007 to Jan 29(th) 2014. Patients were dichotomized as having a mild (seizure freedom without surgical intervention) or severe (surgical intervention required and/or failure to achieve seizure remission) course. Descriptive statistics, odds ratios and confidence intervals were calculated to identify predictors of seizure freedom. The cohort consisted of 159 patients. Mean patient age at last follow-up visit was 46±14.4 (range: 19-88) years. Mean follow-up period was 43.4±22.6 (6 to 84) months. Forty-six patients (29%) demonstrated mild-course TLE while 113 (71%) had a severe course of TLE. Patients with a mild course of TLE were more likely to be older (p = 0.002), have late-onset epilepsy (p Mención de responsabilidad : Lizbeth Hernández-Ronquillo, Samantha Buckley, Lady Diana Ladino, Adam Wu, Farzad Moien-Afshari, Syed Aa Rizvi, Jose F Téllez-Zenteno Referencia : Epileptic Disord. 2016 Jun 1;18(2):137-47. DOI (Digital Object Identifier) : 10.1684/epd.2016.0822 PMID : 27100050 En línea : https://www.jle.com/fr/revues/epd/e-docs/how_many_adults_with_temporal_epilepsy_ [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3983

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Obesity and its association with generalised epilepsy, idiopathic syndrome, and family history of epilepsy / Lady Diana Ladino Malagón  

Público ISBD Título : Obesity and its association with generalised epilepsy, idiopathic syndrome, and family history of epilepsy Tipo de documento : documento electrónico Autores : Lady Diana Ladino Malagón, Fecha de publicación : 2014 Títulos uniformes : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Body mass index  genetic syndrome  leisure activity  overweight  physical activity and waist circumference Resumen : Aim: Previous studies support the concept that obesity is a common comorbid condition in patients with epilepsy (PWE). In this study, we present the body mass index (BMI) and data from a survey to assess physical activity in a sample of PWE from an epilepsy clinic. Methods: Between June of 2011 and January of 2013, 100 PWE from an adult epilepsy clinic were included. We obtained BMI, waist circumference, and information regarding physical activity using a standardised questionnaire. Clinical, demographic, electrographic, and imaging parameters were collected from charts. Results: Mean age of patients was 40 ± 14 (18-77) years. The BMI distribution was as follows: 2 patients (2%) underweight, 26 (26%) normal weight, 34 (34%) overweight, 25 (25%) obese, and 13 (13%) with morbid obesity. In our study, obesity was defined as having a BMI ≥ 30. We found 38 (38%) patients in this range. There was no difference in the rate of drug-resistant epilepsy between obese and non-obese patients (55 vs. 55%; p=0.05). Leisure time habit was reported in 82% of obese patients and 79% of patients without obesity. Overall, the most frequent activity was walking (70%). Factors associated with obesity were generalised epilepsy (OR: 2.7, 1.1-6.6; p=0.012), idiopathic syndrome (OR: 2.7, 1.04-7; p=0.018), and family history of epilepsy (OR: 6.1, 1.5-24.2; p=0.002). Conclusion: Our study suggests an association between obesity, idiopathic generalised epilepsy, and family history of epilepsy. Our study shows that PWE are physically active and there is no clear relation between exercise and obesity. We could not identify any association between drug-resistant epilepsy and obesity. Absence of direct comparison with a control non-epileptic population; a cross-sectional design not allowing evaluation of a causal association among variables; and reliance on self-reported physical activity are to be considered as limitations of the present study. Mención de responsabilidad : Lady D Ladino, Lizbeth Hernández-Ronquillo, José F Téllez-Zenteno Referencia : Epileptic Disord. 2014 Sep;16(3):343-53. DOI (Digital Object Identifier) : 10.1684/epd.2014.0677 PMID : 25179745 En línea : https://www.jle.com/fr/revues/epd/e-docs/obesity_and_its_association_with_genera [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3767 Obesity and its association with generalised epilepsy, idiopathic syndrome, and family history of epilepsy [documento electrónico] / Lady Diana Ladino Malagón,  . - 2014. Obra : Epileptic Disorders Idioma : Inglés (eng) Palabras clave : Body mass index  genetic syndrome  leisure activity  overweight  physical activity and waist circumference Resumen : Aim: Previous studies support the concept that obesity is a common comorbid condition in patients with epilepsy (PWE). In this study, we present the body mass index (BMI) and data from a survey to assess physical activity in a sample of PWE from an epilepsy clinic. Methods: Between June of 2011 and January of 2013, 100 PWE from an adult epilepsy clinic were included. We obtained BMI, waist circumference, and information regarding physical activity using a standardised questionnaire. Clinical, demographic, electrographic, and imaging parameters were collected from charts. Results: Mean age of patients was 40 ± 14 (18-77) years. The BMI distribution was as follows: 2 patients (2%) underweight, 26 (26%) normal weight, 34 (34%) overweight, 25 (25%) obese, and 13 (13%) with morbid obesity. In our study, obesity was defined as having a BMI ≥ 30. We found 38 (38%) patients in this range. There was no difference in the rate of drug-resistant epilepsy between obese and non-obese patients (55 vs. 55%; p=0.05). Leisure time habit was reported in 82% of obese patients and 79% of patients without obesity. Overall, the most frequent activity was walking (70%). Factors associated with obesity were generalised epilepsy (OR: 2.7, 1.1-6.6; p=0.012), idiopathic syndrome (OR: 2.7, 1.04-7; p=0.018), and family history of epilepsy (OR: 6.1, 1.5-24.2; p=0.002). Conclusion: Our study suggests an association between obesity, idiopathic generalised epilepsy, and family history of epilepsy. Our study shows that PWE are physically active and there is no clear relation between exercise and obesity. We could not identify any association between drug-resistant epilepsy and obesity. Absence of direct comparison with a control non-epileptic population; a cross-sectional design not allowing evaluation of a causal association among variables; and reliance on self-reported physical activity are to be considered as limitations of the present study. Mención de responsabilidad : Lady D Ladino, Lizbeth Hernández-Ronquillo, José F Téllez-Zenteno Referencia : Epileptic Disord. 2014 Sep;16(3):343-53. DOI (Digital Object Identifier) : 10.1684/epd.2014.0677 PMID : 25179745 En línea : https://www.jle.com/fr/revues/epd/e-docs/obesity_and_its_association_with_genera [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3767

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