Cristina Papayannis - Academia.edu (original) (raw)
Papers by Cristina Papayannis
Neurología Argentina, Sep 30, 2023
Revista Científica ANMAT, Aug 23, 2023
Revista Científica ANMAT, Nov 24, 2021
(ANMAT) realiza las actividades de evaluación y fiscalización de los estudios de farmacología clí... more (ANMAT) realiza las actividades de evaluación y fiscalización de los estudios de farmacología clínica comprendidos dentro del ámbito de aplicación y alcance de la Disposición ANMAT 6677/10. La pandemia declarada por la Organización Mundial de la Salud, a consecuencia del virus SARS-COV-2, exigió a las agencias regulatorias del mundo una rápida adaptación para ser capaces de plantear medidas y ofrecer respuestas con la celeridad que la emergencia sanitaria requería. Por un lado, la comprensión de la epidemiología y el espectro clínico de la enfermedad por coronavirus fueron evolucionando, y el conocimiento de la carga de la enfermedad resaltó la necesidad médica urgente de desarrollar vacunas y medicamentos como estrategias de prevención y tratamiento para esta patología. Esta situación generó que la investigación clínica farmacológica adquiriera un rol protagonista en la búsqueda de respuestas a esta enfermedad, científicamente sólidas y en el menor tiempo posible. Por otro lado, se debían preservar las actividades de investigación clínica de calidad que se estaban llevando a cabo, protegiendo la seguridad y el bienestar de los participantes de los estudios, y evitando la diseminación viral y saturación del sistema de salud. A consecuencia de ello, con este trabajo, se propone realizar una descripción de las medidas adoptadas en pandemia por el Departamento de Ensayos Clínicos de ANMAT, y analizar los estudios de farmacología clínica para COVID-19 recibidos y autorizados en ANMAT durante el período comprendido entre el 1 de mayo de 2020 y el 03 de agosto de 2021.
American Journal of Neuroradiology, Aug 1, 2003
Seizure-european Journal of Epilepsy, Jun 1, 2012
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright
Sociedad Neurológica Argentina, Sep 1, 2009
Resumen Introducción: Las malformaciones del desarrollo cortical (MDC) son responsables de un amp... more Resumen Introducción: Las malformaciones del desarrollo cortical (MDC) son responsables de un amplio espectro de procesos que tienen clínicamente en común la presencia de retardo mental y epilepsia. Dentro de las MDC la incidencia de epilepsia es alta, su aparición es precoz y la frecuencia de crisis aumenta con la edad. Cuanto más grande es la banda heterotópica peor es el pronóstico y mayor es la frecuencia de crisis. Observación Clínica: Reportamos dos casos de epilepsia refractaria sintomática a una heterotopía en banda, donde los estudios de IRM muestran una lesión típica, que aparece como una banda homogénea de sustancia gris situada entre los ventrículos laterales y la corteza cerebral. Discusión: Estas malformaciones pueden ser diagnosticadas "in vivo" a través de las IRM. Aunque la constelación de datos clínicos y el EEG son sugestivos para el diagnóstico, los hallazgos en las imágenes son el único elemento que permite su caracterización. En los pacientes que presentan epilepsia refractaria se debe considerar como probable diagnostico sintomático a las MDC. Palabras claves: diagnóstico etiológico, epilepsia refractaria, heterotopia en banda, malformaciones del desarrollo, resonancia magnética Summary Introduction: Cortical developmental malformations (CDM) are responsible for a number of clinical conditions that have mental retardation and seizure as a common clinical feature. The incidence of seizure among patients with CDM is high. Seizures are typically early in onset and its frequency increases with age. The frequency of seizures and prognosis are directly related with the size of the heterotopic band (large heterotopic bands are associated with high frequency of seizure and poor prognosis). Clinical Observation: Here, we report two cases of refractory symptomatic epilepsy due to band heterotopia. The MRI exam of the brain showed a typical lesion of homogeneous bands of grey matter situated between the lateral ventricle and the cerebral cortex. Discussion: The clinical and EEG findings are suggestive of CMD. IRM is the only test that can confirm the diagnosis in "in vivo". CDM should be considered as a possible diagnosis in patients with refractory epilepsy.
Neurología Argentina, 2016
Actas españolas de psiquiatría
The association between psychotic disorders and epilepsy has been controversial. Different subtyp... more The association between psychotic disorders and epilepsy has been controversial. Different subtypes of psychotic disorders in epilepsy patients have been described according to temporal relationship with seizures-postictal (PIP), interictal (IIP) and bimodal (BP) psychoses are described in literature. Determine clinical characteristics of patients with refractory partial epilepsy and psychoses and compare the results with a control group of patients with refractory partial epilepsy without psychoses. A total of 57 patients with refractory partial epilepsy and psychotic disorders (psychotic group [PG]) and 56 patients with refractory partial epilepsy and without psychoses (control group, CG) were evaluated according to DSM-IV criteria and SCID-I. All patients underwent complete neurological, neuroimaging, neuropsychological, and psychiatric assessment. Clinical, demographic and neuroimaging data were compared between patients in CG and PG. In PG 15 patients (26 %) had criteria for PI...
Epilepsy Research and Treatment, 2012
Purpose. The main purpose is to define more accurately the epileptogenic zone (EZ) with noninvasi... more Purpose. The main purpose is to define more accurately the epileptogenic zone (EZ) with noninvasive methods in those patients with MRI diagnosis of focal cortical dysplasia (FCD) and epilepsy who are candidates of epilepsy surgery.Methods. Twenty patients were evaluated prospectively between 2007 and 2010 with comprehensive clinical evaluation, video-electroencephalography, diffusion tensor imaging (DTI), and high-resolution EEG to localize the equivalent current dipole (ECD).Key Findings. In 11 cases with white matter asymmetries in DTI the ECDs were located next to lesion on MRI with mean distance of 14.63 millimeters with topographical correlation with the EZ.Significance. We could establish a hypothesis of EZ based on Video-EEG, high-resolution EEG, ECD method, MRI, and DTI. These results are consistent with the hypothesis that the EZ in the FCD is complex and is often larger than visible lesion in MRI.
Neurología Argentina, 2013
ABSTRACT In the last few years the number of antiepileptic drugs available has increased consider... more ABSTRACT In the last few years the number of antiepileptic drugs available has increased considerably, in particular for those patients who do not respond to the existing drugs. The aim of this study was to perform an update of treatment guidelines published in 2005, that will be helpful to physicians who take care of adult epileptic patients. Material and methods A bibliographical search was done for those relevant articles referred to the pharmacological treatment of the epilepsy, analyzing the efficacy, tolerability and safety of the antiepileptic drugs. Results According to the evolutive stage of the disease, epilepsy patients were grouped into those with recent diagnosis and drug-resistant patients. We analyzed antiepileptic drugs approved for marketing and the evidence for the treatment according to the seizure type: focal or generalized at onset. Conclusion As a result of analyzing the available evidence was possible to perform an update of the previous treatment guidelines establishing a therapeutic approach based on the type of epilepsy. Although, there is no evidence in the literature, that support the treatment of patients according to a particular epileptic syndrome.
Rev Neurol …, 2006
Resumen: Introducción: Aunque el síndrome de la Epilepsia Mesial Temporal con Esclerosis del Hipo... more Resumen: Introducción: Aunque el síndrome de la Epilepsia Mesial Temporal con Esclerosis del Hipocampo (EMTEH) fue considerado como un trastorno adquirido, actualmente es aceptado que factores genéticos serían importantes en su génesis. El ...
Epilepsy & Behavior, 2009
The issue of psychotic disorders in epilepsy has given rise to great controversy among profession... more The issue of psychotic disorders in epilepsy has given rise to great controversy among professionals; however, there are not many studies in this area and the physiopathological mechanisms remain unknown. The aim of this study was to describe the spectrum of psychotic disorders in an Argentine population with refractory temporal lobe epilepsy (RTLE) and to determine the risk factors associated with psychotic disorders. Clinical variables of the epileptic syndrome were compared among a selected population with RTLE with and without psychotic disorders (DSM-IV/Ictal Classification of psychoses). Logistic regression was performed. Sixty-three patients with psychotic disorders (Psychotic Group, PG) and 60 controls (Control Group, CG) were included. The most frequent psychotic disorders were brief psychotic episodes (35%) (DSM-IV) and interictal psychosis (50%) (Ictal Classification). Risk factors for psychotic disorders were bilateral hippocampal sclerosis, history of status epilepticus, and duration of epilepsy greater than 20 years.
Brain and Development, 2001
Although once thought to be rare, malformations of cortical development are being increasingly re... more Although once thought to be rare, malformations of cortical development are being increasingly recognized as the underlying cause of developmental delay in children and of epilepsy in children and young adults. Advances in neuroimaging and developmental neurobiology have created the tools by which these important malformations have been investigated. Through a symbiotic type of relationship, these investigations, and the search for a better understanding of these malformations, have led to advances in neuroimaging techniques and better understanding of both normal and abnormal brain development. In this review, the most common malformations or cortical development associated with epilepsy are discussed in regard to their clinical manifestations, classi®cation, imaging appearance and basic neurobiology. q
Acta Neurologica Scandinavica, 2008
AJNR. American journal of neuroradiology, 2003
We describe a patient who showed cystic lesions in the midbrain and obstructive hydrocephalus. MR... more We describe a patient who showed cystic lesions in the midbrain and obstructive hydrocephalus. MR imaging features corresponded to abnormal dilatation of perivascular spaces. Similar clinical and MR imaging findings were described in previous reports of patients presenting with mesencephalo-thalamic expanding lacunae; the diagnosis of some of those cases was confirmed at postmortem examination This condition is extremely rare but should be part of a differential diagnosis when evaluating cystic abnormalities in this area of the brain.
Neurología Argentina, Sep 30, 2023
Revista Científica ANMAT, Aug 23, 2023
Revista Científica ANMAT, Nov 24, 2021
(ANMAT) realiza las actividades de evaluación y fiscalización de los estudios de farmacología clí... more (ANMAT) realiza las actividades de evaluación y fiscalización de los estudios de farmacología clínica comprendidos dentro del ámbito de aplicación y alcance de la Disposición ANMAT 6677/10. La pandemia declarada por la Organización Mundial de la Salud, a consecuencia del virus SARS-COV-2, exigió a las agencias regulatorias del mundo una rápida adaptación para ser capaces de plantear medidas y ofrecer respuestas con la celeridad que la emergencia sanitaria requería. Por un lado, la comprensión de la epidemiología y el espectro clínico de la enfermedad por coronavirus fueron evolucionando, y el conocimiento de la carga de la enfermedad resaltó la necesidad médica urgente de desarrollar vacunas y medicamentos como estrategias de prevención y tratamiento para esta patología. Esta situación generó que la investigación clínica farmacológica adquiriera un rol protagonista en la búsqueda de respuestas a esta enfermedad, científicamente sólidas y en el menor tiempo posible. Por otro lado, se debían preservar las actividades de investigación clínica de calidad que se estaban llevando a cabo, protegiendo la seguridad y el bienestar de los participantes de los estudios, y evitando la diseminación viral y saturación del sistema de salud. A consecuencia de ello, con este trabajo, se propone realizar una descripción de las medidas adoptadas en pandemia por el Departamento de Ensayos Clínicos de ANMAT, y analizar los estudios de farmacología clínica para COVID-19 recibidos y autorizados en ANMAT durante el período comprendido entre el 1 de mayo de 2020 y el 03 de agosto de 2021.
American Journal of Neuroradiology, Aug 1, 2003
Seizure-european Journal of Epilepsy, Jun 1, 2012
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright
Sociedad Neurológica Argentina, Sep 1, 2009
Resumen Introducción: Las malformaciones del desarrollo cortical (MDC) son responsables de un amp... more Resumen Introducción: Las malformaciones del desarrollo cortical (MDC) son responsables de un amplio espectro de procesos que tienen clínicamente en común la presencia de retardo mental y epilepsia. Dentro de las MDC la incidencia de epilepsia es alta, su aparición es precoz y la frecuencia de crisis aumenta con la edad. Cuanto más grande es la banda heterotópica peor es el pronóstico y mayor es la frecuencia de crisis. Observación Clínica: Reportamos dos casos de epilepsia refractaria sintomática a una heterotopía en banda, donde los estudios de IRM muestran una lesión típica, que aparece como una banda homogénea de sustancia gris situada entre los ventrículos laterales y la corteza cerebral. Discusión: Estas malformaciones pueden ser diagnosticadas "in vivo" a través de las IRM. Aunque la constelación de datos clínicos y el EEG son sugestivos para el diagnóstico, los hallazgos en las imágenes son el único elemento que permite su caracterización. En los pacientes que presentan epilepsia refractaria se debe considerar como probable diagnostico sintomático a las MDC. Palabras claves: diagnóstico etiológico, epilepsia refractaria, heterotopia en banda, malformaciones del desarrollo, resonancia magnética Summary Introduction: Cortical developmental malformations (CDM) are responsible for a number of clinical conditions that have mental retardation and seizure as a common clinical feature. The incidence of seizure among patients with CDM is high. Seizures are typically early in onset and its frequency increases with age. The frequency of seizures and prognosis are directly related with the size of the heterotopic band (large heterotopic bands are associated with high frequency of seizure and poor prognosis). Clinical Observation: Here, we report two cases of refractory symptomatic epilepsy due to band heterotopia. The MRI exam of the brain showed a typical lesion of homogeneous bands of grey matter situated between the lateral ventricle and the cerebral cortex. Discussion: The clinical and EEG findings are suggestive of CMD. IRM is the only test that can confirm the diagnosis in "in vivo". CDM should be considered as a possible diagnosis in patients with refractory epilepsy.
Neurología Argentina, 2016
Actas españolas de psiquiatría
The association between psychotic disorders and epilepsy has been controversial. Different subtyp... more The association between psychotic disorders and epilepsy has been controversial. Different subtypes of psychotic disorders in epilepsy patients have been described according to temporal relationship with seizures-postictal (PIP), interictal (IIP) and bimodal (BP) psychoses are described in literature. Determine clinical characteristics of patients with refractory partial epilepsy and psychoses and compare the results with a control group of patients with refractory partial epilepsy without psychoses. A total of 57 patients with refractory partial epilepsy and psychotic disorders (psychotic group [PG]) and 56 patients with refractory partial epilepsy and without psychoses (control group, CG) were evaluated according to DSM-IV criteria and SCID-I. All patients underwent complete neurological, neuroimaging, neuropsychological, and psychiatric assessment. Clinical, demographic and neuroimaging data were compared between patients in CG and PG. In PG 15 patients (26 %) had criteria for PI...
Epilepsy Research and Treatment, 2012
Purpose. The main purpose is to define more accurately the epileptogenic zone (EZ) with noninvasi... more Purpose. The main purpose is to define more accurately the epileptogenic zone (EZ) with noninvasive methods in those patients with MRI diagnosis of focal cortical dysplasia (FCD) and epilepsy who are candidates of epilepsy surgery.Methods. Twenty patients were evaluated prospectively between 2007 and 2010 with comprehensive clinical evaluation, video-electroencephalography, diffusion tensor imaging (DTI), and high-resolution EEG to localize the equivalent current dipole (ECD).Key Findings. In 11 cases with white matter asymmetries in DTI the ECDs were located next to lesion on MRI with mean distance of 14.63 millimeters with topographical correlation with the EZ.Significance. We could establish a hypothesis of EZ based on Video-EEG, high-resolution EEG, ECD method, MRI, and DTI. These results are consistent with the hypothesis that the EZ in the FCD is complex and is often larger than visible lesion in MRI.
Neurología Argentina, 2013
ABSTRACT In the last few years the number of antiepileptic drugs available has increased consider... more ABSTRACT In the last few years the number of antiepileptic drugs available has increased considerably, in particular for those patients who do not respond to the existing drugs. The aim of this study was to perform an update of treatment guidelines published in 2005, that will be helpful to physicians who take care of adult epileptic patients. Material and methods A bibliographical search was done for those relevant articles referred to the pharmacological treatment of the epilepsy, analyzing the efficacy, tolerability and safety of the antiepileptic drugs. Results According to the evolutive stage of the disease, epilepsy patients were grouped into those with recent diagnosis and drug-resistant patients. We analyzed antiepileptic drugs approved for marketing and the evidence for the treatment according to the seizure type: focal or generalized at onset. Conclusion As a result of analyzing the available evidence was possible to perform an update of the previous treatment guidelines establishing a therapeutic approach based on the type of epilepsy. Although, there is no evidence in the literature, that support the treatment of patients according to a particular epileptic syndrome.
Rev Neurol …, 2006
Resumen: Introducción: Aunque el síndrome de la Epilepsia Mesial Temporal con Esclerosis del Hipo... more Resumen: Introducción: Aunque el síndrome de la Epilepsia Mesial Temporal con Esclerosis del Hipocampo (EMTEH) fue considerado como un trastorno adquirido, actualmente es aceptado que factores genéticos serían importantes en su génesis. El ...
Epilepsy & Behavior, 2009
The issue of psychotic disorders in epilepsy has given rise to great controversy among profession... more The issue of psychotic disorders in epilepsy has given rise to great controversy among professionals; however, there are not many studies in this area and the physiopathological mechanisms remain unknown. The aim of this study was to describe the spectrum of psychotic disorders in an Argentine population with refractory temporal lobe epilepsy (RTLE) and to determine the risk factors associated with psychotic disorders. Clinical variables of the epileptic syndrome were compared among a selected population with RTLE with and without psychotic disorders (DSM-IV/Ictal Classification of psychoses). Logistic regression was performed. Sixty-three patients with psychotic disorders (Psychotic Group, PG) and 60 controls (Control Group, CG) were included. The most frequent psychotic disorders were brief psychotic episodes (35%) (DSM-IV) and interictal psychosis (50%) (Ictal Classification). Risk factors for psychotic disorders were bilateral hippocampal sclerosis, history of status epilepticus, and duration of epilepsy greater than 20 years.
Brain and Development, 2001
Although once thought to be rare, malformations of cortical development are being increasingly re... more Although once thought to be rare, malformations of cortical development are being increasingly recognized as the underlying cause of developmental delay in children and of epilepsy in children and young adults. Advances in neuroimaging and developmental neurobiology have created the tools by which these important malformations have been investigated. Through a symbiotic type of relationship, these investigations, and the search for a better understanding of these malformations, have led to advances in neuroimaging techniques and better understanding of both normal and abnormal brain development. In this review, the most common malformations or cortical development associated with epilepsy are discussed in regard to their clinical manifestations, classi®cation, imaging appearance and basic neurobiology. q
Acta Neurologica Scandinavica, 2008
AJNR. American journal of neuroradiology, 2003
We describe a patient who showed cystic lesions in the midbrain and obstructive hydrocephalus. MR... more We describe a patient who showed cystic lesions in the midbrain and obstructive hydrocephalus. MR imaging features corresponded to abnormal dilatation of perivascular spaces. Similar clinical and MR imaging findings were described in previous reports of patients presenting with mesencephalo-thalamic expanding lacunae; the diagnosis of some of those cases was confirmed at postmortem examination This condition is extremely rare but should be part of a differential diagnosis when evaluating cystic abnormalities in this area of the brain.