Aims and objectives. This study aims to describe behavioural aspects, cognition, and epilepsy course and identify predictors for Quality of Life (QoL) in adolescents and adults two to ten years...Show moreAims and objectives. This study aims to describe behavioural aspects, cognition, and epilepsy course and identify predictors for Quality of Life (QoL) in adolescents and adults two to ten years after achieving remission from epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS). Background. Children with EE-SWAS, a childhood epilepsy syndrome, often experience neurodevelopmental arrest or regression, which consists of a heterogeneous combination of behavioural and cognitive deficits. Three-quarters of the patients in EE-SWAS remission have permanent deficits. Long-term follow-up studies are scarce but suggest a relation between the aetiology, EE-SWAS duration, and use of corticosteroid treatment with neurodevelopmental outcome of patients in remission. Design. This study utilised a cross-sectional observational design with questionnaires and retrospective data collection. Methods. Parents or caregivers of patients digitally filled out the Epilepsy Questionnaire and the Quality of Life in Childhood Epilepsy Questionnaire-55 (QOLCE-55). Results. A total of 35 adolescents and adults with a mean age of 18.2 (SD±3.76) years were included in the statistical analysis. The participants consisted of 18 male and 17 female adolescents and adults who were in ≥ 2 years in EE-SWAS remission. An established aetiology occurred in 19 participants, the median EE-SWAS duration was 4.3 (IQR 2.0-7.0) years, and 13 participants received corticosteroid treatment. The mean QOLCE-55 score for the sample size was 50.0 (SD±16.97). A significant difference of 10.3 points between the means of the QOLCE-55 score of patients with an established (M=45.3, SD±16.20) and an unknown (M=55.6, SD±16.65) aetiology has been found (t=1.841, df=33, p=.038). No difference was found in the QOLCE-55 means between patients with and without corticosteroid treatment (t=0.831, df=33, p=.226). Moreover, no correlation was found between the EE-SWAS duration and QOLCE-55 scores (ρ= -.298, p=.052 (n=31). No statically significant predictors of the QOLCE-55 scores were found in the multivariate regression analysis with an established aetiology (B=-4.5, p=.430), duration (B=-0.1, p=.108), and corticosteroid treatment (B=3.2, p=.595). Conclusions. Although no statistically significant predictors of QoL in EE-SWAS remission in adolescents and adults were found, an established aetiology and longer duration of EE-SWAS showed a potential trend as predictors of a poorer QoL. The study’s findings confirm the presence of cognitive deficits experienced in EE-SWAS remission, aligning with previous literature.Show less
As far as bioarchaeological and historical sources can witness, respiratory diseases have affected humankind throughout history and still represent one of the most common causes of morbidity and...Show moreAs far as bioarchaeological and historical sources can witness, respiratory diseases have affected humankind throughout history and still represent one of the most common causes of morbidity and mortality nowadays. Nonetheless, palaeopathologists and bioarchaeologists in general seem to not have developed any interest in the topic, which at present remains unrepresented in the bioarchaeological literature. Clinical research on respiratory diseases has highlighted a link between poor air quality and the prevalence of chronic maxillary sinusitis, especially in developing countries where biomass fuels are employed in daily activities such as cooking and heating without a proper ventilation. Since historical sources suggest that respiratory diseases were equally affecting people in the past as they are in the present, if air quality is to be considered a significant triggering agent, it makes sense to expect the highest rates of chronic maxillary sinusitis in populations exposed to consistent concentrations of air pollutants, rather than on populations living in open spaces such as the countryside. This study considers two populations from Post-Medieval the Netherlands, each one representative of a low-class rural and urban environments respectively. A total of 105 individuals were examined in this study. 50 (47.6%) of the examined individuals showed signs of sinusitis in one or both maxillary sinuses. Even if a significant prevalence was found in the urban context (56.9% versus the 38.9% recorded in the rural population), the initial hypothesis was nevertheless questioned by the consideration of several factors which may have increased the chances of developing sinusitis in the past but that are no longer observable on the skeleton. Some of those are allergic reactions and localised inflammations of the respiratory tract. As these are no longer observable on skeletal remains and therefore are barely mentioned in bioarchaeological literature, the conclusions of this thesis encouraged future research to focus on respiratory diseases as their aetiologies are more complex than it was assumed in previous studies.Show less
