scholarly journals Investigation of apomorphine during sleep in Parkinson’s: Improvement in UPDRS Scores

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Miguel A. Pieroni
Keyword(s):  
Placebo Group ◽  
Confidence Interval ◽  
Rem Sleep ◽  
Therapeutic Approach ◽  
Dopamine Agonists ◽  
D2 Receptors ◽  
Significant Benefit ◽  
The Mean ◽  
Updrs Part ◽  
Stimulation Of

Sleep is responsible for several functions required for homeostasis. REM sleep could be a rearrangement period where limits of certain functions can be moved to a new state of balance. This study proposes that dopaminergic deficit may be responsible for the circadian dysregulation that occur with neurodegeneration and therefore a restitution of REM sleep and an improvement in Parkinson disease’s symptoms can be achieved with the controlled use of dopamine agonists during the night. Twenty parkinsonian patients underwent to a onemonth study of subcutaneous nocturnal apomorphine treatment at the beginning of each REM stage. This therapeutic approach led to a significant benefit for patients in all of the 3 UPDRS scores. The mean change from baseline in the MDS-UPDRS Part I, II and III was significantly greater in the apomorphine vs. placebo group. In the UPDRS Part I total score was 0.8 (95% confidence interval [CI]: 1.612, -0.012) and 3.3 (95% CI: 4.732, 1.867) for the placebo and apomorphine groups, respectively (difference between groups: 2.5, 95% CI: 3.454, 1.545; P = 0.002). For UPDRS Part II total score, the mean change was 1.3 (95% CI: 2.692, - 0.09) and 4.6 (6.916, 2.28). Difference between groups: 3.3, 95% CI: 4.752, 1.847; P = 0.013. In UPDRS Part III was 1.1 (95% CI: 2.425, -0.225) and 5.5 (95% CI: 8.808, 2.191). Difference between groups: 4.4, (95% CI: 6.321, 2.478; P = 0.012). We can conclude that sleep alteration in PD can be improved by stimulation of D2 receptors. The symptomatic benefits obtained due to restoration of REM functions were significant.

scholarly journals Efficacy and safety of oral tolvaptan in patients undergoing hemodialysis: a Phase 2, double-blind, randomized, placebo-controlled trial

2020 ◽  
Author(s):  
Hiroaki Ogata ◽  
Naoko Shimofurutani ◽  
Tadashi Okada ◽  
Hisashi Nagamoto ◽  
Tadao Akizawa
Keyword(s):  
Placebo Group ◽  
Confidence Interval ◽  
Urine Volume ◽  
Phase 2 ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Fluid Removal ◽  
Interdialytic Weight Gain ◽  
The Mean ◽  
Total Fluid

Abstract Background Loop diuretics are used to manage fluid retention in patients with end-stage kidney disease undergoing hemodialysis (HD). This randomized, double-blind, placebo-controlled, Phase 2 trial evaluated the efficacy and safety of tolvaptan, a vasopressin V2 receptor antagonist, in Japanese HD patients. Methods A total of 124 patients (24-h urine volume ≥500 mL) on thrice-weekly HD were randomized to receive oral tolvaptan 15 mg/day (n = 40), tolvaptan 30 mg/day (n = 40) or placebo (n = 44) for 24 weeks. Efficacy endpoints were change from baseline in 24-h urine volume, total fluid removal by HD per week and interdialytic weight gain (IDWG). Safety was assessed via the incidence of treatment-emergent adverse events (TEAEs). Results At treatment end, the difference (95% confidence interval) from the placebo group in the mean change from baseline in 24-h urine volume was significant in the tolvaptan 15 mg {429.1 mL [95% confidence interval (CI) 231.0, 627.2]; P < 0.0001} and 30 mg [371.6 mL (95% CI 144.1, 599.2); P = 0.0017] groups. The mean changes from baseline in total fluid removal by HD and IDWG were not significantly different in the tolvaptan groups versus the placebo group. Although the proportion of patients with TEAEs was lower in the placebo group (77.3%) than in the tolvaptan groups (92.3%), tolvaptan was safe and well-tolerated during the study period. Conclusions Tolvaptan significantly sustained diuretic action for 24 weeks in HD patients but did not reduce total fluid removal by HD per week and IDWG to the same extent.

Analgesic Efficacy of Preoperative Parecoxib Sodium in an Orthopedic Pain Model

2004 ◽  
Vol 94 (3) ◽  
pp. 305-314 ◽  
Author(s):  
Paul J. Desjardins ◽  
Louise Traylor ◽  
Richard C. Hubbard
Keyword(s):  
Placebo Group ◽  
Postoperative Pain ◽  
Confidence Interval ◽  
Rescue Medication ◽  
Analgesic Efficacy ◽  
Selective Inhibitor ◽  
Efficacy And Safety ◽  
Pain Model ◽  
Preoperative Administration ◽  
The Mean

The efficacy and safety of preoperative intravenous administration of parecoxib sodium, a novel parenteral prodrug of a cyclooxygenase-2 selective inhibitor, in treating postoperative pain resulting from bunionectomy were evaluated in 50 patients who were part of a larger cohort of orthopedic and podiatric patients. Following bunionectomy, the median time to rescue medication (survival analysis) was 4 hours 18 min (95% confidence interval, 3 hours 4 min to 4 hours 37 min) in the placebo group, 7 hours 5 min (95% confidence interval, 3 hours 20 min to >24 hours) in the 20-mg parecoxib sodium group, and 10 hours 43 min (95% confidence interval, 4 hours 42 min to 14 hours 7 min) in the 40-mg parecoxib sodium group (significant for 40-mg parecoxib sodium versus placebo). Four or more hours after surgery, the mean pain-intensity (categorical) score was significantly lower in both parecoxib sodium groups than in the placebo group. Preoperative administration of parecoxib sodium was well tolerated and significantly reduced postoperative pain in patients who had undergone bunionectomy. (J Am Podiatr Med Assoc 94(3): 305–314, 2004)

CHROMATOGRAPHY OF THE 17-KETOGENIC STEROIDS IN THE DIAGNOSIS AND CONTROL OF CONGENITAL ADRENAL HYPERPLASIA

1960 ◽  
Vol XXXIII (II) ◽  
pp. 230-250 ◽  
Author(s):  
Eileen E. Hill
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
List Type ◽  
Adrenal Hyperplasia ◽  
Normal Children ◽  
Paediatric Practice ◽  
The Mean ◽  
Cortisone Therapy ◽  
And Control ◽  
Clinical Problems ◽  
Stimulation Of

ABSTRACT A method for the fractionation of the urinary 17-ketogenic steroids with no oxygen grouping at C11 and those oxygenated at C11, is applied to the clinical problems of congenital adrenal hyperplasia. In normal children the mean ratio of the non-oxygenated to oxygenated steroids is 0.24. In childrern with congenital adrenal hyperplasia the ratio is 2.3. The reason for this difference in ratio is discussed. The changes in ratio found under stimulation of the adrenal gland with exogenous or endogenous corticotrophin and the suppression with cortisone therapy are studied. This test can be applied to isolated samples of urine, a major advantage in paediatric practice, and can be carried out in routine laboratories. It is found to be reliable in the diagnosis and sensitive in the control of congenital adrenal hyperplasia.

Therapeutic Effects of Hab Shabyar on Open-Angle Glaucoma: A Double-Blinded, Randomized, Placebo-Controlled Trial

2019 ◽  
Vol 8 ◽  
pp. 1218
Author(s):  
Ebrahim Khalil BaniHabib ◽  
Ali Mostafai ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ghadir Mohammdi
Keyword(s):  
Placebo Group ◽  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Controlled Trial ◽  
Intervention Group ◽  
Therapeutic Effects ◽  
Open Angle ◽  
The Mean ◽  
The Right ◽  
Double Blinded

Background: Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma. Materials and Methods: In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group was received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group was received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared at before the intervention (t1), one month (t2), and two months (t3) after the intervention. Results: The mean decrease in intraocular pressure for the right eye at three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The patients in the intervention group expressed more satisfaction than the patients in the placebo group (P≤0.001). Conclusion: Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming of timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.[GMJ.2019;In press:e1218]

Deep brain stimulation of the posterior limb of the internal capsule in the treatment of central poststroke neuropathic pain of the lower limb: case series with long-term follow-up and literature review

2020 ◽  
Vol 133 (3) ◽  
pp. 830-838 ◽  
Author(s):  
Andrea Franzini ◽  
Giuseppe Messina ◽  
Vincenzo Levi ◽  
Antonio D’Ammando ◽  
Roberto Cordella ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Lower Limb ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Vas Score ◽  
The Mean ◽  
Deep Brain ◽  
Stimulation Of

OBJECTIVECentral poststroke neuropathic pain is a debilitating syndrome that is often resistant to medical therapies. Surgical measures include motor cortex stimulation and deep brain stimulation (DBS), which have been used to relieve pain. The aim of this study was to retrospectively assess the safety and long-term efficacy of DBS of the posterior limb of the internal capsule for relieving central poststroke neuropathic pain and associated spasticity affecting the lower limb.METHODSClinical and surgical data were retrospectively collected and analyzed in all patients who had undergone DBS of the posterior limb of the internal capsule to address central poststroke neuropathic pain refractory to conservative measures. In addition, long-term pain intensity and level of satisfaction gained from stimulation were assessed. Pain was evaluated using the visual analog scale (VAS). Information on gait improvement was obtained from medical records, neurological examination, and interview.RESULTSFour patients have undergone the procedure since 2001. No mortality or morbidity related to the surgery was recorded. In three patients, stimulation of the posterior limb of the internal capsule resulted in long-term pain relief; in a fourth patient, the procedure failed to produce any long-lasting positive effect. Two patients obtained a reduction in spasticity and improved motor capability. Before surgery, the mean VAS score was 9 (range 8–10). In the immediate postoperative period and within 1 week after the DBS system had been turned on, the mean VAS score was significantly lower at a mean of 3 (range 0–6). After a mean follow-up of 5.88 years, the mean VAS score was still reduced at 5.5 (range 3–8). The mean percentage of long-term pain reduction was 38.13%.CONCLUSIONSThis series suggests that stimulation of the posterior limb of the internal capsule is safe and effective in treating patients with chronic neuropathic pain affecting the lower limb. The procedure may be a more targeted treatment method than motor cortex stimulation or other neuromodulation techniques in the subset of patients whose pain and spasticity are referred to the lower limbs.

The Expression of Dopamine Receptors Gene and their Potential Role in Targeting Breast Cancer Cells with Selective Agonist and Antagonist Drugs. Could it be the Novel Insight to Therapy?

2019 ◽  
Vol 16 (2) ◽  
pp. 184-197 ◽  
Author(s):  
Hossein Bakhtou ◽  
Asiie Olfatbakhsh ◽  
Abdolkhaegh Deezagi ◽  
Ghasem Ahangari
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Cancer Cells ◽  
Dopamine Receptors ◽  
Breast Cancer Cells ◽  
D2 Receptors ◽  
Healthy Individuals ◽  
Agonist And Antagonist ◽  
The Mean ◽  
Mcf 7

Background:Breast cancer is one of the common causes of mortality for women in Iran and other parts of the world. The substantial increasing rate of breast cancer in both developed and developing countries warns the scientists to provide more preventive steps and therapeutic measures. This study is conducted to investigate the impact of neurotransmitters (e.g., Dopamine) through their receptors and the importance of cancers via damaging immune system. It also evaluates dopamine receptors gene expression in the women with breast cancer at stages II or III and dopamine receptor D2 (DRD2) related agonist and antagonist drug effects on human breast cancer cells, including MCF-7 and SKBR-3.Methods:The patients were categorized into two groups: 30 native patients who were diagnosed with breast cancer at stages II and III, with the mean age of 44.6 years and they were reported to have the experience of a chronic stress or unpleasant life event. The second group included 30 individuals with the mean age of 39 years as the control group. In order to determine the RNA concentration in all samples, the RNA samples were extracted and cDNA was synthesized. The MCF-7 cells and SKBR-3 cells were treated with dopamine receptors agonists and antagonists. The MTT test was conducted to identify oxidative and reductive enzymes and to specify appropriate dosage at four concentrations of dopamine and Cabergoline on MCF-7 and SKBR-3 cells. Immunofluorescence staining was done by the use of a mixed dye containing acridine orange and ethidiume bromide on account of differentiating between apoptotic and necrotic cells. Flow cytometry assay was an applied method to differentiate necrotic from apoptotic cells.Results:Sixty seven and thirty three percent of the patients were related to stages II and III, respectively. About sixty three percent of the patients expressed ER, while fifty seven percent expressed PR. Thirty seven percent of the patients were identified as HER-2 positive. All types of D2-receptors were expressed in PBMC of patients with breast cancer and healthy individuals. The expression of the whole dopamine receptor subtypes (DRD2-DRD4) was carried out on MCF-7 cell line. The results of RT-PCR confirmed the expression of DRD2 on SKBR-3 cells, whereas the other types of D2- receptors did not have an expression. The remarkable differences in gene expression rates between patients and healthy individuals were revealed in the result of the Real-time PCR analysis. The over expression in DRD2 and DRD4 genes of PBMCs was observed in the patients with breast cancer at stages II and III. The great amount of apoptosis and necrosis occurred after the treatment of MCF-7 cells by Cabergoline from 25 to 100 µmolL-1 concentrations.Conclusion:This study revealed the features of dopamine receptors associated with apoptosis induction in breast cancer cells. Moreover, the use of D2-agonist based on dopamine receptors expression in various breast tumoral cells could be promising as a new insight of complementary therapy in breast cancer.

scholarly journals Onchocerciasis control in Ghana (1974–2016)

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Nana-Kwadwo Biritwum ◽  
Dziedzom K. de Souza ◽  
Odame Asiedu ◽  
Benjamin Marfo ◽  
Uche Veronica Amazigo ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Vector Control ◽  
Control Strategy ◽  
Financial Support ◽  
Control Programme ◽  
Ivermectin Treatment ◽  
Mobile Community ◽  
The Mean ◽  
The Impact ◽  
Onchocerciasis Control

Abstract Background The control of onchocerciasis in Ghana started in 1974 under the auspices of the Onchocerciasis Control Programme (OCP). Between 1974 and 2002, a combination of approaches including vector control, mobile community ivermectin treatment, and community-directed treatment with ivermectin (CDTI) were employed. From 1997, CDTI became the main control strategy employed by the Ghana OCP (GOCP). This review was undertaken to assess the impact of the control interventions on onchocerciasis in Ghana between 1974 and 2016, since which time the focus has changed from control to elimination. Methods In this paper, we review programme data from 1974 to 2016 to assess the impact of control activities on prevalence indicators of onchocerciasis. This review includes an evaluation of CDTI implementation, microfilaria (Mf) prevalence assessments and rapid epidemiological mapping of onchocerciasis results. Results This review indicates that the control of onchocerciasis in Ghana has been very successful, with a significant decrease in the prevalence of infection from 69.13% [95% confidence interval) CI 60.24–78.01] in 1975 to 0.72% (95% CI 0.19–1.26) in 2015. Similarly, the mean community Mf load decreased from 14.48 MF/skin snip in 1975 to 0.07 MF/skin snip (95% CI 0.00–0.19) in 2015. Between 1997 and 2016, the therapeutic coverage increased from 58.50 to 83.80%, with nearly 100 million ivermectin tablets distributed. Conclusions Despite the significant reduction in the prevalence of onchocerciasis in Ghana, there are still communities with MF prevalence above 1%. As the focus of the GOCP has changed from the control of onchocerciasis to its elimination, both guidance and financial support are required to ensure that the latter goal is met.

scholarly journals Can Health-Promoting Schools Contribute to Better Health Behaviors? Physical Activity, Sedentary Behavior, and Dietary Habits among Israeli Adolescents

2021 ◽  
Vol 18 (3) ◽  
pp. 1183
Author(s):  
Hila Beck ◽  
Riki Tesler ◽  
Sharon Barak ◽  
Daniel Sender Moran ◽  
Adilson Marques ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Confidence Interval ◽  
Health Behaviors ◽  
Sedentary Behavior ◽  
Dietary Habits ◽  
Group Differences ◽  
Time Behavior ◽  
Health Promoting ◽  
The Mean

Schools with health-promoting school (HPS) frameworks are actively committed to enhancing healthy lifestyles. This study explored the contribution of school participation in HPS on students’ health behaviors, namely, physical activity (PA), sedentary behavior, and dieting. Data from the 2018/2019 Health Behavior in School-aged Children study on Israeli adolescents aged 11–17 years were used. Schools were selected from a sample of HPSs and non-HPSs. Between-group differences and predictions of health behavior were analyzed. No between-group differences were observed in mean number of days/week with at least 60 min of PA (HPS: 3.84 ± 2.19 days/week, 95% confidence interval of the mean = 3.02–3.34; non-HPS: 3.93 ± 2.17 days/week, 95% confidence interval of the mean = 3.13–3.38). Most children engaged in screen time behavior for >2 h/day (HPS: 60.83%; non-HPS: 63.91%). The odds of being on a diet were higher among more active children (odds ratio [OR] = 1.20), higher socio-economic status (OR = 1.23), and female (OR = 2.29). HPS did not predict any health behavior. These findings suggest that HPSs did not contribute to health behaviors more than non-HPSs. Therefore, health-promoting activities in HPSs need to be improved in order to justify their recognition as members of the HPS network and to fulfill their mission.

scholarly journals Evaluating Endoscopic Ipsilateral Endonasal Corridor Approaches to the Anterolateral Wall of the Maxillary Sinus: A Computerized Tomography Study

2021 ◽  
Author(s):  
Navarat Vatcharayothin ◽  
Pornthep Kasemsiri ◽  
Sanguansak Thanaviratananich ◽  
Cattleya Thongrong
Keyword(s):  
Confidence Interval ◽  
Maxillary Sinus ◽  
Inferior Turbinate ◽  
Radial Access ◽  
Sinus Wall ◽  
Nasal Floor ◽  
Significant Difference ◽  
Anterolateral Wall ◽  
The Mean ◽  
Maxillary Sinuses

Abstract Introduction The endoscopic access to lesions in the anterolateral wall of the maxillary sinus is a challenging issue; therefore, the evaluation of access should be performed. Objective To assess the accessibility of three endoscopic ipsilateral endonasal corridors. Methods Three corridors were created in each of the 30 maxillary sinuses from 19 head cadavers. Accessing the anterolateral wall of the maxillary sinus was documented with a straight stereotactic navigator probe at the level of the nasal floor and of the axilla of the inferior turbinate. Results At level of the nasal floor, the prelacrimal approach, the modified endoscopic Denker approach, and the endoscopic Denker approach allowed mean radial access to the anterolateral maxillary sinus wall of 42.6 ± 7.3 (95% confidence interval [CI]: 39.9–45.3), 56.0 ± 6.1 (95%CI: 53.7–58.3), and 60.1 ± 6.2 (95%CI: 57.8–62.4), respectively. Furthermore, these approaches provided more lateral access to the maxillary sinus at the level of the axilla of the inferior turbinate, with mean radial access of 45.8 ± 6.9 (95%CI: 43.3–48.4) for the prelacrimal approach, 59.8 ± 4.7 (95% CI:58.1–61.6) for the modified endoscopic Denker approach, and 63.6 ± 5.5 (95%CI: 61.6–65.7) for the endoscopic Denker approach. The mean radial access in each corridor, either at the level of the nasal floor or the axilla of the inferior turbinate, showed a statistically significant difference in all comparison approaches (p < 0.05). Conclusions The prelacrimal approach provided a narrow radial access, which allows access to anteromedial lesions of the maxillary sinus, whereas the modified endoscopic Denker and the endoscopic Denker approaches provided more lateral radial access and improved operational feasibility on far anterolateral maxillary sinus lesions.

scholarly journals Intravenous lidocaine reduces perioperative opioids without negatively affecting the electrical stapedial reflex threshold in pediatric cochlear implants

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
W. Z. Bakhet ◽  
L. M. El Fiky ◽  
H. A. Debis
Keyword(s):  
Placebo Group ◽  
Cochlear Implants ◽  
Opioid Consumption ◽  
Intravenous Lidocaine ◽  
Lidocaine Group ◽  
Registration Number ◽  
Stapedial Reflex ◽  
The Mean ◽  
Reflex Threshold ◽  
High Doses

Abstract Background Total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used for pediatric cochlear implants (CIs) surgery as it does not suppress the electrical stapedial reflex threshold (ESRT). However, high doses of remifentanil exacerbate postoperative pain and increase opioid consumption. Intravenous lidocaine reduces pain and opioid requirement. This study investigated the effect of intravenous lidocaine on perioperative opioid consumption and ESRT in pediatric CIs. Results The mean (95% CI) remifentanil consumption was significantly lower in lidocaine group than in placebo group [0.57 (0.497–0.643) vs 0.69 (0.63–0.75)] μg/kg/min, P = 0.016. The mean (95% CI) propofol consumption was significantly lower in lidocaine group than in placebo group [155.5 (146–165) vs 171 (161–181) μg/kg/min, P = 0.02. MBP and HR were significantly lower after surgical incision, laryngeal mask airway (LMA) removal, and at PACU admission in the lidocaine group compared with the placebo group. The PACU pain score was significantly lower in the lidocaine group compared to the placebo group. The mean (95% CI) pethidine consumption in PACU was significantly lower in the lidocaine group than in the placebo group 7.0 (6.17–7.83) vs. 8.9 (7.84–9.96) mg, P = 0.012. There were no differences between groups regarding ESRT response. Conclusions Intravenous lidocaine infusion reduced perioperative opioid requirements without altering the ESRT in pediatric CIs. Trial registration Clinical registration number: NCT04194294.

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