Parenteral treatment with defibrotide for patients with chronic peripheral occlusive arteriopathy

AbstractThe Trial of Parkinson’s And Zoledronic acid (TOPAZ, https://clinicaltrials.gov/ct2/show/NCT03924414) is a unique collaboration between experts in movement disorders and osteoporosis to test the efficacy of zoledronic acid, an FDA-approved parenteral treatment for osteoporosis, for fracture prevention in people with neurodegenerative parkinsonism. Aiming to enroll 3,500 participants age 65 years or older, TOPAZ is one of the largest randomized, placebo-controlled clinical trials ever attempted in parkinsonism. The feasibility of TOPAZ is enhanced by its design as a U.S.- wide home-based trial without geographical limits. Participants receive information from multiple sources, including specialty practices, support groups and websites. Conducting TOPAZ in participants’ homes takes advantage of online consent technology, the capacity to confirm diagnosis using telemedicine and the availability of research nursing to provide screening and parenteral therapy in homes. Home-based clinical research may provide an efficient, convenient, less expensive method that opens participation in clinical trials to almost anyone with parkinsonism.

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Parenteral Treatment of Episodic Tension-Type Headache: A Systematic Review

Headache The Journal of Head and Face Pain ◽

10.1111/head.12287 ◽

2014 ◽

Vol 54 (2) ◽

pp. 260-268 ◽

Cited By ~ 13

Author(s):

Danielle Weinman ◽

Olivia Nicastro ◽

Olabiyi Akala ◽

Benjamin W. Friedman

Keyword(s):

Systematic Review ◽

Tension Type Headache ◽

Parenteral Treatment ◽

Type Headache

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Occlusive arteriopathy and brain tumor

Journal of Neurosurgery ◽

10.3171/jns.1978.49.1.0022 ◽

1978 ◽

Vol 49 (1) ◽

pp. 22-35 ◽

Cited By ~ 53

Author(s):

Koreaki Mori ◽

Fuji Takeuchi ◽

Masatsune Ishikawa ◽

Hajime Handa ◽

Mitsuo Toyama ◽

...

Keyword(s):

Brain Tumor ◽

Cerebral Angiography ◽

Mass Effect ◽

Clinical Analysis ◽

Sudden Onset ◽

Circle Of Willis ◽

Ischemic Lesion ◽

Neurocutaneous Syndrome ◽

The Brain ◽

Occlusive Arteriopathy

✓ Four cases with the association of occlusive arteriopathy and brain tumor are presented. A clinical analysis of these cases and cases reported in the literature revealed that occlusive arteriopathy at the base of the brain was often associated with a slowly growing basal tumor in children. Possible causes of occlusive arteriopathy in these cases were compression of the circle of Willis by a slowly growing basal tumor, secondary arterial occlusive changes by radiation therapy for a basal tumor, or vasculopathy associated with neurocutaneous syndrome. Symptoms of sudden onset or episodic nature suggest the presence of occlusive arteriopathy rather than the mass effect of a tumor. Cerebral angiography is mandatory whenever computerized tomography (CT), performed to rule out recurrence of a basal tumor, shows an ischemic lesion with low-density areas without any evidence of mass effect of the tumor. Cerebral angiography is also necessary when a basal tumor is suspected in children, particularly in cases associated with neurocutaneous syndrome and a basal tumor. Care should be taken not to scarify the abnormal vascular network at the base of the brain at the time of operation, because it is considered to be functioning as collateral circulation. The potential hazards of radiotherapy to radiation-induced occlusive changes of the circle of Willis must be considered in treating a benign basal brain tumor in children. Even in adults, repeated large doses of irradiation could cause occlusive arteriopathy.

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