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Topiramate was assessed in an open-label trial as broad-spectrum antiepileptic monotherapy, independently from the epilepsy type or syndrome. Adults and children aged 2 years and older, who were diagnosed with epilepsy within the last 5 years, treatment-naive or failing prior treatment with one antiepileptic drug (AED), received individually adjusted doses of topiramate, after escalation to 100mg/day over 4 weeks (maximum 400mg/day) or 3mg/kg/day over 6 weeks (maximum 9 mg/kg/day), respectively. Patients were followed foror=7 months and optionally up to a maximum of 13 months. Data were analysed for all patients (n=692), as well as for focal (n=421) and generalized epilepsies (n=148). The median topiramate dose used was 125 mg/day in adults and 3.3mg/kg/day in children (or=12 years). Overall, 80% of patients completed the 7-month study. During this period, 44.3% were seizure-free, while 76.3% achievedor=50% reduction in mean monthly seizure frequency. Patients with focal and generalized epilepsies alike responded to treatment (73.9 and 83.8% with at least 50% seizure reduction): 39.4% of patients with focal epilepsy and 61.5% of those with generalized epilepsy were seizure-free. The mean monthly seizure frequency was significantly reduced versus baseline at all visits (p0.001). Similar response rates were obtained from the 237 patients completing the 1-year observation period. During the mandatory 7-month period of study, 8.8% of patients reported insufficient tolerability as a reason for dropout. The most frequent adverse event was paraesthesia. Our results support findings that emerge from controlled studies that topiramate is effective and well tolerated when used as initial or second monotherapy. They also suggest that in a naturalistic setting, overall good retention on treatment and seizure freedom are observed at low doses in a broad spectrum of epilepsies.

Environmental pollution by plastic particles is of major global concern, as a potential threat to aquatic organisms and ecosystems. The accumulation of microplastics in freshwater and marine environments has strong ecological implications due to their long persistence, potential toxicity, and ability to adsorb other pollutants, acting as vectors of pathogens. Nevertheless, while the number of studies on the presence of microplastics in the wild fish increased, less attention has been paid to the farmed fish species. Here, we investigated the occurrence of microparticles in the digestive tracts of Sparus aurata and Cyprinus carpio at different life stages and reared by an intensive and semi-intensive production system, respectively. Our results showed the presence of natural microfibers and microplastics, with microfibers (~ 90%) being the dominant type. In both fish species, the presence of microparticles was not revealed at larval stage. Fry and adult S. aurata specimens showed microfiber abundances of 0.21 and 1.3 items/individual, respectively. A lower load of microparticles (p < 0.05) occurred in fry (0.06 items/individual) and adult C. carpio specimens (0.25 items/individual). As to the chemical composition of the micro-items, natural (20%), semi-synthetic (28%), and single or blended synthetic fibers (52%) were identified in S. aurata. Linen, rayon, lyocell, cotton: polyester and polyester (12.5% concentration for each polymer) fibers were identified in C. carpio, while PTFE (37.5%) was present as fragments. Rayon was the most frequent chemical type (21.2%). The polymer composition of the extracted microparticles showed significant differences between the fish species analysed (p < 0.05). Notably, a considerably lower contamination level of synthetic polymers (average 0.11 items/individual) was detected in the farmed fishes compared with the data obtained in other studies on feral ones. To the best of our knowledge, this is the first study reporting the plastic and the non-plastic microfiber contamination in the farmed S. aurata and C. carpio at different life stages.