Subcutaneous Apomorphine Infusion – An Update

2012 ◽  
Vol 7 ((Suppl.1)) ◽  
pp. 8 ◽  
Author(s):  
Regina Katzenschlager ◽  
Keyword(s):  
Dopaminergic Drugs ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Oral Medications ◽  
Best Medical Treatment ◽  
Subcutaneous Apomorphine ◽  
Randomised Controlled ◽  
Non Motor Symptoms ◽  
Term Data

Continuous delivery of dopaminergic drugs is an important treatment strategy to delay or reverse motor complications in Parkinson’s disease (PD). Subcutaneous apomorphine (APO) infusion has been shown (in uncontrolled studies) to significantly reduce ‘off’ time and dyskinesia duration and severity, and long-term data show the beneficial effects persist for several years. There is some evidence that the maximum antidyskinetic effect of APO infusion may be attained when oral medications are reduced or discontinued, making monotherapy an important clinical goal. Recent studies demonstrate possible positive effects of APO infusion on the non-motor symptoms of PD. However, more trials are needed to assess the neuropsychiatric effects of this treatment. Moreover, randomised controlled trials are needed to compare APO infusion with best medical treatment and with other invasive treatments such as levodopa/carbidopa intestinal gel infusion and deep brain stimulation.

scholarly journals Noninvasive ventilation in stable hypercapnic COPD: what is the evidence?

2018 ◽  
Vol 4 (2) ◽  
pp. 00012-2018 ◽  
Author(s):  
Marieke L. Duiverman
Keyword(s):  
Noninvasive Ventilation ◽  
High Intensity ◽  
Randomised Controlled Trials ◽  
Therapy Monitoring ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Positive Effects ◽  
Copd Patients ◽  
Randomised Controlled

Long-term noninvasive ventilation (NIV) to treat chronic hypercapnic respiratory failure is still controversial in severe chronic obstructive pulmonary disease (COPD) patients. However, with the introduction of high-intensity NIV, important benefits from this therapy have also been shown in COPD. In this review, the focus will be on the arguments for long-term NIV at home in patients with COPD. The rise of (high-intensity) NIV in COPD and the randomised controlled trials showing positive effects with this mode of ventilation will be discussed. Finally, the challenges that might be encountered (both in clinical practice and in research) in further optimising this therapy, monitoring and following patients, and selecting the patients who might benefit most will be reviewed.

Reporting of long-term extension studies: lack of consistency calls for consensus

2011 ◽  
Vol 70 (6) ◽  
pp. 886-890 ◽  
Author(s):  
Maya H Buch ◽  
Daniel Aletaha ◽  
Paul Emery ◽  
Josef S Smolen
Keyword(s):  
Conflicts Of Interest ◽  
Therapeutic Interventions ◽  
Ethical Considerations ◽  
Double Blind ◽  
Safety Reporting ◽  
Potential Safety ◽  
Reliable Interpretation ◽  
Randomised Controlled ◽  
Term Data

Double-blind, randomised controlled studies represent the gold-standard approach to determine the safety and efficacy of therapeutic interventions. In chronic conditions such as rheumatoid arthritis (RA), long-term data are vital to confirm maintenance of effect and identify potential safety signals. The recent introduction of numerous biological therapies for RA has been followed by various long-term extension (LTE) studies. Although useful, the design and method of analysis in such studies vary significantly, partly due to their complexity. This viewpoint highlights general considerations needed when undertaking a LTE study and illustrates the lack of consistency in studies of RA to date. It addresses issues of selection bias, patient discontinuation and missing data. Although used for safety reporting, the lack of adequate powering makes LTE studies of limited benefit. Ethical considerations and challenges are highlighted, including potential conflicts of interest. Finally, the authors suggest the need for consensus to ensure more reliable interpretation and application of data for clinical practice. Following the development of guidelines on reporting of clinical trials in RA and more recently, registry data, a similar approach for LTE studies would be a useful endeavour.

Beneficial effects of a probiotic blend on gastrointestinal side effects induced by leflunomide and amlodipine in a rat model

2017 ◽  
Vol 8 (5) ◽  
pp. 801-808 ◽  
Author(s):  
S.-C. Song ◽  
Y.-M. An ◽  
J.-H. Shin ◽  
M.-J. Chung ◽  
J.-G. Seo ◽  
...  
Keyword(s):  
Side Effects ◽  
Gut Microbiota ◽  
Large Intestine ◽  
Rat Model ◽  
Beneficial Effects ◽  
Oral Medications ◽  
Tnf Α ◽  
Gastrointestinal Side Effects ◽  
Total Composition

Patients with metabolic disorders frequently suffer from side effects induced by long-term oral medications. The present study using a rat model system indicated that leflunomide (LF) and amlodipine (AMD), the active ingredients contained in the medications for rheumatoid arthritis and hypertension, respectively, appeared to induce various bowel problems including constipation and inflammation. In the small and large intestine, LF increased the expression of tumour necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 compared to the null control and AMD increased the expression of both TNF-α and IL-1β, although its effect on IL-6 was only increased in the large intestine. It is noteworthy that the probiotic blend tested was found to alleviate intestinal complications caused by LF and AMD. Analysis of the gut microbiota revealed that AMD induced compositional changes in the gut microbiota. Namely, members of the phylum Bacteroidetes, which constituted only about 0.3% of the microbiota in the null control, made up more than 10% of the total composition in the AMD-administered rats. Interestingly, the probiotic blend was also found to normaliSe the gut microbiota.

scholarly journals Tricuspid Annuloplasty: Transcatheter Approaches

2021 ◽  
Vol 23 (10) ◽  
Author(s):  
Martin Arnold ◽  
Julia Haug ◽  
Melanie Landendinger
Keyword(s):  
Clinical Experience ◽  
Tricuspid Regurgitation ◽  
Clinical Evidence ◽  
Clinical Symptoms ◽  
Published Data ◽  
Clinical Routine ◽  
Positive Effects ◽  
Tricuspid Annuloplasty ◽  
Term Data

Abstract Purpose of Review New transcatheter techniques to perform tricuspid annuloplasty are evolving and are introduced into the clinical routine. Yet, clinical experience is limited. Recent Findings Currently, 3 different techniques for tricuspid annuloplasty have been used in larger clinical cohorts. They can be divided into direct annuloplasty techniques and suture plication techniques. The largest clinical evidence is related to direct annuloplasty techniques. It has been shown that annular dimensions can be effectively reduced. This translates into an improvement of the degree of tricuspid regurgitation and improvement of clinical symptoms. Due to the newness of this type of therapy, long-term data is limited, but for one of the described techniques, published data show that the positive effects persist over a 2-year period. Summary Transcatheter approaches are safe and are able to treat tricuspid regurgitation effectively. There are still differences in the efficacy of the different techniques. Clinical experience varies among the different approaches.

scholarly journals Vitamins and cardiovascular disease

2008 ◽  
Vol 101 (8) ◽  
pp. 1113-1131 ◽  
Author(s):  
S. Honarbakhsh ◽  
M. Schachter
Keyword(s):  
Population Group ◽  
Western World ◽  
Negative Effects ◽  
Mortality And Morbidity ◽  
Beneficial Effects ◽  
Clinical Endpoints ◽  
Randomised Controlled ◽  
The Right ◽  
Β Carotene

CVD is a major cause of mortality and morbidity in the Western world. In recent years its importance has expanded internationally and it is believed that by 2020 it will be the biggest cause of mortality in the world, emphasising the importance to prevent or minimise this increase. A beneficial role for vitamins in CVD has long been explored but the data are still inconsistent. While being supported by observational studies, randomised controlled trials have not yet supported a role for vitamins in primary or secondary prevention of CVD and have in some cases even indicated increased mortality in those with pre-existing late-stage atherosclerosis. The superiority of combination therapy over single supplementation has been suggested but this has not been confirmed in trials. Studies have indicated that β-carotene mediates pro-oxidant effects and it has been suggested that its negative effects may diminish the beneficial effects mediated by the other vitamins in the supplementation cocktail. The trials that used a combination of vitamins that include β-carotene have been disappointing. However, vitamin E and vitamin C have in combination shown long-term anti-atherogenic effects but their combined effect on clinical endpoints has been inconsistent. Studies also suggest that vitamins would be beneficial to individuals who are antioxidant-deficient or exposed to increased levels of oxidative stress, for example, smokers, diabetics and elderly patients, emphasising the importance of subgroup targeting. Through defining the right population group and the optimal vitamin combination we could potentially find a future role for vitamins in CVD.

scholarly journals Early Social Enrichment Improves Social Motivation and Skills in a Monogenic Mouse Model of Autism, theOprm1−/−Mouse

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Luciana Garbugino ◽  
Eleonora Centofante ◽  
Francesca R. D’Amato
Keyword(s):  
Environmental Enrichment ◽  
Maternal Separation ◽  
Receptor Gene ◽  
Social Motivation ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Abnormal Response ◽  
Environmental Stimulation ◽  
Social Environmental

Environmental enrichment has been proven to have positive effects on both behavioral and physiological phenotypes in rodent models of mental and neurodevelopmental disorders. In this study, we used mice lacking theµ-opioid receptor gene (Oprm1−/−), which has been shown to have deficits in social competence and communication, to assess the hypothesis that early enrichment can ameliorate sociability during development and adulthood. Due to the immaturity of sensory-motor capabilities of young pups, we chose as environmental stimulation a second lactating female, who provided extra maternal care and stimulation from birth. The results show that double mothering normalized the abnormal response to maternal separation inOprm1−/−pups and increased social motivation in juveniles and adult knockout mice. Additionally, we observed thatOprm1−/−mice act as less attractive social partners than wild types, which suggests that social motivation can be modulated by the stimulus employed. This experiment supports previous findings suggesting that early social environmental stimulation has profound and long-term beneficial effects, encouraging the use of nonpharmacological interventions for the treatment of social defects in neurodevelopmental diseases.

scholarly journals Beneficial Effects of Pet Ownership on Some Aspects of Human Health and Behaviour

1991 ◽  
Vol 84 (12) ◽  
pp. 717-720 ◽  
Author(s):  
James Serpell
Keyword(s):  
Human Health ◽  
General Health Questionnaire ◽  
The Other ◽  
Health Questionnaire ◽  
Pet Ownership ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Recreational Walking ◽  
Dog Owners

A 10-month prospective study was carried out which examined changes in behaviour and health status in 71 adult subjects following the acquisition of a new pet (either dogs or cats). A group of 26 subjects without pets served as a comparison over the same period. Both pet-owning groups reported a highly significant reduction in minor health problems during the first month following pet acquisition, and this effect was sustained in dog owners through to 10 months. The pet-acquiring groups also showed improvements in their scores on the 30-item General Health Questionnaire over the first 6 months and, in dog owners, this improvement was maintained until 10 months. In addition, dog owners took considerably more physical exercise while walking their dogs than the other two groups, and this effect continued throughout the period of study. The group without pets exhibited no statistically significant changes in health or behaviour, apart from a small increase in recreational walking. The results provide evidence that pet acquisition may have positive effects on human health and behaviour, and that in some cases these effects are relatively long term.

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