Guideline for Prevention of Surgical Site Infection, 1999 ☆ ☆☆ ★ ★★

Article de synthese sur le metabolisme de la methionine, acide amine essentiel, chez les mammiferes. Etude du schema metabolique, de la regulation du metabolisme (mise en evidence et importance relative de chaque facteur). Etude de la transamination de la methionine, du role de la S-adenosyl-methionine, de l'oxydation de l'homocysteine et de la cystathionine. Etude du disfonctionnement du metabolisme et des consequences chez les hommes

Methionine metabolism in mammals.

/pdf/practice-guideline-for-the-treatment-of-patients-with-major-ofberaz3o1.pdf

PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder

Opioids are the cornerstone therapy for the treatment of moderate to severe pain. Although common concerns regarding the use of opioids include the potential for detrimental side effects, physical dependence, and addiction, accumulating evidence suggests that opioids may yet cause another problem, often referred to as opioid-induced hyperalgesia. Somewhat paradoxically, opioid therapy aiming at alleviating pain may render patients more sensitive to pain and potentially may aggravate their preexisting pain. This review provides a comprehensive summary of basic and clinical research concerning opioid-induced hyperalgesia, suggests a framework for organizing pertinent information, delineates the status quo of our knowledge, identifies potential clinical implications, and discusses future research directions.

/pdf/opioid-induced-hyperalgesia-a-qualitative-systematic-review-2ry1pe62kk.pdf

Opioid-induced hyperalgesia: a qualitative systematic review.

Oxidative stress and mitochondrial dysfunction in Alzheimer's disease

Enhancement of recovery from psychiatric illness by methylfolate

Introduction .............................................................. Definition ................................................................. Predisposing Factors .......................................................... Classification .............................................................. TheNervousSystem ........................................................ Thecerebellum ......................................................... PeripheralNeuropathy .................................................... Subacute or Chronic Encephalopathy ........................................ Other Mental Symptoms .................................................... ....... ........................................... Folic Acid Deficiency ..................................................... MegaloblasticAnemia ..................................................... Folic Acid and Vitamin B1 Metabolism in Nonanemic Epileptic Patients ................................................ ClinicalImplicatio ns ...................................................... Neonatal Coagulation Defects .............................................. TheSkeletalSystem ........................................................ Metabolic Bone Disease and Vitamin D Deficiency ConnectiveTissue ........................................................... GumHypertrophy ....................................................... Facial Skin Changes .............. : .......................................

Chronic Antiepileptic Toxicity: A Review

Cerebrospinal fluid (CSF) S-adenosylmethionine (SAM) levels were significantly lower in severely depressed patients than in a neurological control group. The administration of SAM either intravenously or orally is associated with a significant rise of CSF SAM, indicating that it crosses the blood-brain barrier in humans. These observations provide a rational basis for the antidepressant effect of SAM, which has been confirmed in several countries. CSF SAM levels were low in a group of patients with Alzheimer's dementia suggesting a possible disturbance of methylation in such patients and the need for trials of SAM treatment.

https://jnnp.bmj.com/content/jnnp/53/12/1096.full.pdf

Cerebrospinal fluid S-adenosylmethionine in depression and dementia: effects of treatment with parenteral and oral S-adenosylmethionine.

Summary: Although anticonvulsant polytherapy has been widely and traditionally used in the treatment of epilepsy, there is little evidence of its advantages over monotherapy. It does, however, lead to problems of chronic toxicity, drug interactions, failure to evaluate individual drugs, and sometimes exacerbation of seizures. There are many causes of polytherapy which could be avoided by more careful monitoring and supervision of therapy. Studies in new, previously untreated referrals suggest there is considerable potential for monotherapy. In the event of failure of optimum monotherapy, the value of polytherapy is not yet clear. In chronic patients on polytherapy there may be scope for careful rationalization to two or sometimes one drug, with reduction in chronic toxicity and sometimes improved seizure control. Reduction of therapy, however, may be impossible or hazardous due to withdrawal seizures. Even after successful reduction, seizure control is much less satisfactory than in new referrals. It is easier to avoid polytherapy than to reduce it. There is a need to define more carefully the limits of effective anticonvulsant therapy.



ZUSAMMENFASSUNG

Obgleich die antikonvulsive Polytherapie in der Behandlung der Epilepsie eine lange Geschichte hat und weit verbreitet ist, gibt es wenig Hinweise, das sie der Monotherapie uberlegen ist. Im Gegenteil, sie fuhrt zu den Problemen der chronischen Toxicitat, den Interaktionen zwischen verschiedenen Medikamenten, den Schwierigkeiten, ein einziges Medikament beurteilen zu konnen und manchmal sogar zu einer Exacerbation der Anfalle. Es gibt viele Anlasse zur Polytherapie, die durch sorgfaltiges Beobachten und Uberwachen der Therapie vermieden werden konnen. Untersuchungen bei bisher unbehandelten neu uberwiesenen Patienten lassen vermuten, das sie ein wesentliches Potential fur die Monotherapie darstellen. Fur den Fall eines Versagens einer optimal gesteuerten Monotherapie ist der Wert der Polytherapie noch nicht klar zu ersehen. Bei chronisch kranken Patienten unter Polytherapie konnte es das Ziel sein, die Therapie sorgfaltig auf 2 oder manchmal 1 Medikament zu rationalisieren, dabei die chronische Toxizitat zu vermindern und manchmal die Anfallskontrolle zu verbessern. Eine Verminderung der Therapie kann jedoch wegen Entzugskrampfen unmoglich oder gefahrlich sein. Selbst nach erfolgreicher Reduktion ist die Anfallskontrolle bei diesen Patienten weniger befriedigend als bei neu eingestellten Patienten. Es ist leichter, eine Polytherapie zu vermeiden als zu ihr zuruckzufinden. Es besteht weiterhin die Notwendigkeit sorgfaitiger die Grenzen der effektiven antikonvulsiven Therapie zu bestimmen.

E. H. Reynolds

Papers

Enhancement of recovery from psychiatric illness by methylfolate

Chronic Antiepileptic Toxicity: A Review

Cerebrospinal fluid S-adenosylmethionine in depression and dementia: effects of treatment with parenteral and oral S-adenosylmethionine.

Monotherapy or Poly therapy for Epilepsy

Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy