RESUMO
Ahead of Print article withdrawn by publisher.
RESUMO
Epilepsy-related employment prevalence and retirement incidence were investigated in the German working population from 1994 to 2009. The overall mean prevalence of employment of people with epilepsy was 5.1±0.2 per 1000 workers. The employment rate among people with epilepsy increased from 63.5% in 1994 to 65.9% in 2000 (0.4% annually) and then more steeply from 66.8% in 2001 to 76.9% in 2009 (1.4% annually). A prominent increase in rate of employment of people with epilepsy since 2001 was temporarily associated with approval of leviteracetam in 2000 (P<0.001, OR=8.3, CI=6.45-10.12). The overall mean employment rate of people with epilepsy was lower than that of the general population (68.5% vs 90.1%, P<0.001). The overall mean incidence of epilepsy-related retirement (RI) during the study was 4.6±1.6/1000, similar to the RI for people with other illnesses (5.1±0.8/1000), and the risk of retiring because of epilepsy was not higher than that for other illnesses over the entire study period (P=0.52, OR=1.11, CI=0.86-1.43). The RI among workers with epilepsy, however, sharply declined from 8.3/1000 in 1994 to 2.9/1000 in 2000 (-65%, < 0.001), followed by a slight increase and stabilization at 3.9/1000 workers between 2001 and 2009. The decline in RI among people with epilepsy was temporarily associated with legislation of the Law on Support of Employment in 1996 (P=0.032, OR=2.15, CI=1.17-2.89) and approval of lamotrigine in 1993 (P=0.024, OR=2.64, CI=2.17-3.88). These patterns suggest that drug treatment and legislative laws may have led to increased employment and reduced retirement rates for people with epilepsy.
Assuntos
Efeitos Psicossociais da Doença , Emprego/estatística & dados numéricos , Epilepsia/epidemiologia , Aposentadoria/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Pessoas com Deficiência/estatística & dados numéricos , Epilepsia/psicologia , Feminino , Alemanha/epidemiologia , Glicopeptídeos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de ReferênciaRESUMO
Using a placebo-controlled, double-blind cross-over study the potential therapeutic effect of ubiquinone (coenzyme Q10) was investigated in 25 patients suffering from idiopathic dilated cardiomyopathy (New York Heart Association functional classification I, II and III). Over an initial period of 4 months, 15 patients were administered verum (3 x 33.3 mg coenzyme Q10 x day-1 p.o.) and subsequently given a placebo during the ensuing 4 months (V/P). The sequence of treatment was reversed within the remaining 10 patients (P/V). Therapeutic efficacy was assessed by means of echocardiogram, chest X-ray, radionuclide ventriculography in combination with exercise test and impedance cardiography. Control values for left ventricular function parameters were similar in both groups; left ventricular ejection fraction: 39.5 +/- 11.5% (P/V), 37.6 +/- 17.0% (V/P); left ventricular end-diastolic diameter: 65 +/- 9 mm (P/V), 67 +/- 8 mm (P/V); and cardiac output: 5.1 +/- 1.41 x min-1 (P/V), 5.1 +/- 1.11 x min-1 (V/P). Chronic treatment with ubiquinone had no influence on haemodynamic parameters, electrocardiogram, incidence of ventricular arrhythmias or on exercise tolerance. It was therefore impossible to demonstrate any therapeutic effect of ubiquinone in patients suffering from idiopathic dilated cardiomyopathy.
Assuntos
Cardiomiopatia Dilatada/tratamento farmacológico , Ubiquinona/uso terapêutico , Cardiomiopatia Dilatada/diagnóstico , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Função Ventricular Esquerda/fisiologiaRESUMO
In a chronic, placebo-controlled, double-blind cross-over study a potential therapeutic effect of coenzyme Q10 (ubiquinone) was investigated in 25 patients suffering from dilative cardiomyopathy (NYHA functional class I, II, III). During a period of four months patients were treated with 3x 33.3 mg of coenzyme Q10 per day, given orally, 15 patients received verum during the first four months and placebo during the following four months (V/P). In the second group of patients (n = 10) the sequence of treatment was reversed (P/V). Therapeutic effect was assessed by means of echocardiogram, chest x-ray, radionuclide ventriculography combined with exercise test and impedance cardiography. Control values for left ventricular function parameters were similar in both groups (left ventricular ejection fraction: 39.5 +/- 11.5% (P/V), 37.6 +/- 17.0% (V/P); left ventricular enddiastolic diameter: 65 +/- 9 mm (P/V), 67 +/- 8 mm (V/P); Cl: 5.1 +/- 1.4 l/min (P/V), 5.1 +/- 1.1 l/min (V/P]. Chronic treatment by coenzyme Q10 did not exhibit any influence on hemodynamic parameters, on the electrocardiogram, on incidence of ventricular arrhythmias, or on exercise tolerance. It was not possible to demonstrate any therapeutic effect of coenzyme Q10 in patients with dilative cardiomyopathy.