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https://www.readbyqxmd.com/read/27900070/potentially-inappropriate-medications-by-beers-criteria-in-older-outpatients-prevalence-and-risk-factors
#1
Yeon-Jung Lim, Ha-Yeon Kim, Jaekyung Choi, Ji Sun Lee, Ah-Leum Ahn, Eun-Jung Oh, Dong-Yung Cho, Hyuk-Jung Kweon
BACKGROUND: Prescription of inappropriate medicine to elderly patients is a major public health care concern. The Beers criteria have been commonly employed as a screening tool to identify the use of potentially inappropriate medications (PIMs). The present study investigated the prevalence of PIM use according to the Beers criteria as well as factors related to PIM use. METHODS: Data obtained from a retrospective survey included 25,810 outpatients aged ≥65 years from a university medical center in Seoul, Korea...
November 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27890484/25-years-of-advances-in-definition-classification-and-treatment-of-status-epilepticus
#2
Eugen Trinka, Reetta Kälviäinen
PURPOSE: Status epilepticus (SE) requires not only urgent symptomatic treatment with antiepileptic drugs but also rapid identification and treatment of its cause. This narrative review summarizes the most important advances in classification and treatment of SE. METHOD: Data sources included MEDLINE, EMBASE, ClinicalTrials.gov, and back tracking of references in pertinent studies, reviews, and books. RESULTS: SE is now defined as "a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1)...
November 14, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27886007/sleep-wake-profile-in-dementia-with-lewy-bodies-alzheimer-s-disease-and-normal-aging
#3
Annachiara Cagnin, Federica Fragiacomo, Giulia Camporese, Matteo Turco, Cinzia Bussè, Mario Ermani, Sara Montagnese
BACKGROUND: Alterations of the sleep-wake cycle are common features of neurodegenerative dementia. OBJECTIVES: To study differences in sleep-wake profiles in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and healthy controls. METHODS: 30 DLB and 32 AD patients, and 33 healthy elderly participants were studied. Patients were evaluated for global cognitive impairment, extrapyramidal signs, fluctuations of attention, and behavioral disorders...
November 19, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27881622/stability-of-21-cocaine-opioid-and-benzodiazepine-drug-analytes-in-spiked-meconium-at-three-temperatures
#4
Fang Wu, Stephanie J Marin, Gwendolyn A McMillin
In this study, the stability of 21 cocaine, opioid and benzodiazepine analytes in spiked meconium was investigated at three storage temperatures: 4°C, room temperature (RT), and 37°C (body temperature). The drugs/metabolites included were hydrocodone, hydromorphone, codeine, morphine, 6-acetylmorphine (6-AM), oxycodone, oxymorphone, cocaine, cocaethylene, benzoylecgonine, m-hydroxybenzoylecgonine, diazepam, oxazepam, temazepam, nordiazepam, chlordiazepoxide, lorazepam, alprazolam, alpha-hydroxyalprazolam, clonazepam, 7-aminoclonazepam, midazolam, alpha-hydroxymidazolam and zolpidem...
November 22, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27866243/monitoring-of-adherence-to-headache-treatments-by-means-of-hair-analysis
#5
Anna Ferrari, Manuela Licata, Cecilia Rustichelli, Carlo Baraldi, Daniele Vandelli, Filippo Marchesi, Federica Palazzoli, Patrizia Verri, Enrico Silingardi
PURPOSE: The aim of this study was to evaluate the potential of hair analysis to monitor medication adherence in headache patients undergoing chronic therapy. For this purpose, the following parameters were analyzed: the detection rate of 23 therapeutic drugs in headache patients' hair, the degree of agreement between the self-reported drug and the drug found in hair, and whether the levels found in hair reflected the drug intake reported by the patients. METHODS: The study included 93 patients suffering from primary headaches declaring their daily intake of at least one of the following drugs during the 3 months before the hair sampling: alprazolam, amitriptyline, citalopram, clomipramine, clonazepam, delorazepam, diazepam, duloxetine, fluoxetine, flurazepam, levomepromazine, levosulpiride, lorazepam, lormetazepam, mirtazapine, paroxetine, quetiapine, sertraline, topiramate, trazodone, triazolam, venlafaxine, and zolpidem...
November 20, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27843704/association-between-antiepileptic-drugs-and-hepatocellular-carcinoma-in-patients-with-epilepsy-a-population-based-case-control-study
#6
Dong-Zong Hung, Cheng-Li Lin, Yi-Wen Li, Yen-Ning Lin, Ying-Ray Lee, Charles-C N Wang, Jih-Jung Chen, Yun-Ping Lim
BACKGROUND: This study explored whether antiepileptic drugs (AEDs) use increases the risk of hepatocellular carcinoma (HCC). METHODS: We conducted a case-control study using data from the National Health Insurance system of Taiwan. The case group comprised 1,454 epilepsy patients with newly diagnosed HCC, and the control group comprised 1,448 epilepsy patients without HCC. Both groups had similar distributions of sex and age, and follow-up duration. Possible associations with the AEDs in Taiwan were examined...
November 2016: Brain and Behavior
https://www.readbyqxmd.com/read/27843043/hyperekplexia-report-on-phenotype-and-genotype-of-16-jordanian-patients
#7
Amira Masri, Seo-Kyung Chung, Mark I Rees
BACKGROUND: Hyperekplexia, is a rare disorder characterized by excessive startle response to acoustic, visual, or other stimuli. It is inherited in autosomal recessive and dominant pattern. OBJECTIVE: To describe the clinical and genetic features of hyperekplexia in Jordanian patients. METHODS: This retrospective study includes all patients with proved genetic diagnosis of hyperekplexia who presented to our clinic at the Jordan University Hospital from January 2001 through July 2015...
November 11, 2016: Brain & Development
https://www.readbyqxmd.com/read/27778062/cytisine-inhibits-the-protective-activity-of-various-classical-and-novel-antiepileptic-drugs-against-6%C3%A2-hz-induced-psychomotor-seizures-in-mice
#8
Piotr Tutka, Maria W Kondrat-Wróbel, Katarzyna Zaluska, Dorota Żółkowska, Magdalena Florek-Łuszczki, Jarogniew J Łuszczki
BACKGROUND: Cytisine (CYT) is a partial agonist of brain α4β2 nicotinic acetylcholine receptors widely used in Central/Eastern Europe for smoking cessation. OBJECTIVES: This study evaluated the effect of CYT on the ability of classical and novel antiepileptic drugs to prevent seizures evoked by the 6-Hz test, a model of psychomotor seizures in mice thought as a model of drug-resistant seizures. RESULTS: CYT administered intraperitoneally (i...
October 25, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27752878/treatment-of-rem-sleep-behavior-disorder
#9
REVIEW
Youngsin Jung, Erik K St Louis
REM sleep behavior disorder (RBD) is a common parasomnia disorder affecting between 1 and 7 % of community-dwelling adults, most frequently older adults. RBD is characterized by nocturnal complex motor behavior and polysomnographic REM sleep without atonia. RBD is strongly associated with synucleinopathy neurodegeneration. The approach to RBD management is currently twofold: symptomatic treatment to prevent injury and prognostic counseling and longitudinal follow-up surveillance for phenoconversion toward overt neurodegenerative disorders...
November 2016: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/27740861/prevalence-and-concentrations-of-drugs-in-elderly-suspected-drugged-drivers
#10
Gudrun Høiseth, Linn Engeset Austdal, Elisabeth Wiik, Stig Tore Bogstrand, Jørg Mørland
Objective Elderly drivers are somewhat more likely to be involved in car crashes than middle aged drivers, but less likely to be involved than the younger drivers. This study aimed to assess the extent of drug use in elderly suspected drunk and drugged drivers, with respect to which drugs were detected and at which concentrations. Methods Blood samples from elderly suspected drunk and drugged drivers from February 1(st) 2012 to May 22(th) 2013 were identified from the database at the Norwegian Institute of Public Health and were retrospectively analyzed for a broad repertoire of drugs relevant for impairment...
October 14, 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27712640/importance-of-rapid-eye-movement-sleep-behavior-disorder-to-the-primary-care-physician
#11
Stuart J McCarter, Michael J Howell
Sleep disorders and neurodegenerative diseases are commonly encountered in primary care. A common, but underdiagnosed sleep disorder, rapid eye movement sleep behavior disorder (RBD), is highly associated with Parkinson disease and related disorders. Rapid eye movement sleep behavior disorder is common. It is estimated to affect 0.5% of the general population and more than 7% of individuals older than 60 years; however, most cases go unrecognized. Rapid eye movement sleep behavior disorder presents as dream enactment, often with patients thrashing, punching, and kicking while they are sleeping...
October 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27699054/opsoclonus-myoclonus-ataxia-syndrome-in-an-hiv-infected-child
#12
Noella Maria Delia Pereira, Ira Shah, Shilpa Kulkarni
Opsoclonus-myoclonus-ataxia (OMA) syndrome typically presents with chaotic eye movements and myoclonus with some patients exhibiting ataxia and behavioural disturbances. The pathogenesis may be inflammatory with an infectious or paraneoplastic trigger. We present a 13-year-old HIV-infected girl who was initially started on highly active antiretroviral therapy (HAART) in March 2013 with a CD4 count of 79 cells/cumm. Initially, the patient did not comply with treatment, resulting in a CD4+ count of 77 cells/mm(3) in November 2015 and prompting a new HAART scheme comprising lamivudine, tenofovir and ritonavir-boosted atazanavir...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27693801/the-%C3%AE-2%C3%AE-3%C3%AE-2-gabaa-receptor-preferring-agonist-ns11394-aggravates-dystonia-in-the-phenotypic-dt-sz-model
#13
Christine Spröte, Franziska Richter, Anne Bauer, Julia Gerstenberger, Angelika Richter
Dystonia is a movement disorder, characterized by involuntary muscle contractions resulting in abnormal movements and/or postures. Antidystonic effects of benzodiazepines in patients with different types of dystonia could be replicated in the dt(sz) mutant hamster, a phenotypic model of paroxysmal dystonia. Compounds with preferred binding at specific subunits of the gamma aminobutyric acid type A (GABAA) receptor may provide a more beneficial spectrum of effects in comparison with benzodiazepines. We therefore examined the effects of the α1β3γ2 GABAA receptor preferring compound zolpidem (2...
September 30, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27685474/nitrobenzodiazepines-postmortem-brain-and-blood-reference-concentrations
#14
Louise Skov, Karen Marie Dollerup Holm, Kristian Linnet
Reference concentrations are needed to evaluate postmortem toxicology results and usually femoral blood is the specimen of choice. However, brain tissue has been suggested as a viable alternative specimen, since postmortem blood concentrations can be difficult to interpret due to postmortem redistribution, among other factors. Here we present reference concentrations of postmortem brain and femoral blood of the nitrobenzodiazepines clonazepam, flunitrazepam, and nitrazepam that are of particular interest since they commonly are converted to their corresponding 7-aminometabolites in the postmortem situation...
September 12, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27661035/delayed-regaining-of-gait-ability-in-a-patient-with-brain-injury-a-case-report
#15
Sung Ho Jang, Hyeok Gyu Kwon
BACKGROUND: Little is known about delay in regaining gait ability at a chronic stage after brain injury. In this study, we report on a single patient who regained the gait ability during 2 months of intensive rehabilitation starting 2 years after a brain injury. METHODS AND RESULTS: A 40-year-old male patient diagnosed with viral encephalitis underwent comprehensive rehabilitation until 2 years after onset. However, he could not even sit independently and presented with severe physical deconditioning and severe ataxia...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27648847/intranasal-brain-targeted-clonazepam-polymeric-micelles-for-immediate-control-of-status-epilepticus-in-vitro-optimization-ex-vivo-determination-of-cytotoxicity-in-vivo-biodistribution-and-pharmacodynamics-studies
#16
Samia A Nour, Nevine S Abdelmalak, Marianne J Naguib, Hassan M Rashed, Ahmed B Ibrahim
Clonazepam (CZ) is an anti-epileptic drug used mainly in status epilepticus (SE). The drug belongs to Class II according to BCS classification with very limited solubility and high permeability and it suffers from extensive first-pass metabolism. The aim of the present study was to develop CZ-loaded polymeric micelles (PM) for direct brain delivery allowing immediate control of SE. PM were prepared via thin film hydration (TFH) technique adopting a central composite face-centered design (CCFD). The seventeen developed formulae were evaluated in terms of entrapment efficiency (EE), particle size (PS), polydispersity index (PDI), zeta potential (ZP), and in vitro release...
November 2016: Drug Delivery
https://www.readbyqxmd.com/read/27642316/simultaneous-determination-of-six-benzodiazepines-in-spiked-soft-drinks-by-high-performance-liquid-chromatography-with-ultra-violet-detection-hplc-uv
#17
Kambiz Soltaninejad, Mohammad Karimi, Alireza Nateghi, Bahram Daraei
A high performance liquid chromatographic method with ultra violet detection for simultaneous analysis of six benzodiazepines (BZDs) (chlordiazepoxide, diazepam, clonazepam, midazolam , flurazpam, and lorazepam) has been developed for forensic screening of adulterated non-alcoholic drinks. Samples were analyzed after a simple procedure for preparation using pH adjustment and filtering. Isocratic elution on a C18 column (250mm × 4.6 mm, 5μm) in the temperature 45ºC with a mobile phase consisting of 15mM phosphate buffer: methanol (50:50 v/v) at a flow rate 1...
2016: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/27639091/optimization-of-clonazepam-therapy-adjusted-to-patient-s-cyp3a-status-and-nat2-genotype
#18
Katalin Tóth, Gábor Csukly, Dávid Sirok, Ales Belic, Ádám Kiss, Edit Háfra, Máté Déri, Ádám Menus, István Bitter, Katalin Monostory
BACKGROUND: The shortcomings of clonazepam therapy include tolerance, withdrawal symptoms, and adverse effects such as drowsiness, dizziness, and confusion leading to increased risk of falls. Inter-individual variability in the incidence of adverse events in patients partly originates from the differences in clonazepam metabolism due to genetic and nongenetic factors. METHODS: Since the prominent role in clonazepam nitro-reduction and acetylation of 7-amino-clonazepam is assigned to CYP3A and N-acetyl transferase 2 enzymes, respectively, the association between the patients' CYP3A status (CYP3A5 genotype, CYP3A4 expression) or N-acetyl transferase 2 acetylator phenotype and clonazepam metabolism (plasma concentrations of clonazepam and 7-amino-clonazepam) was evaluated in 98 psychiatric patients suffering from schizophrenia or bipolar disorders...
October 3, 2016: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27629998/myoclonus-and-seizures-in-progressive-myoclonus-epilepsies-pharmacology-and-therapeutic-trials
#19
Roberto Michelucci, Elena Pasini, Patrizia Riguzzi, Eva Andermann, Reetta Kälviäinen, Pierre Genton
Generalized motor seizures, usually tonic-clonic, tonic-vibratory, myoclonic or clonic, and stimulus-sensitive/action myoclonus are typical features of progressive myoclonus epilepsies (PMEs). Despite the introduction of many anticonvulsants, the treatment of these symptoms, particularly myoclonus, remains challenging, due to the incomplete and often transitory effects of most drugs. Moreover, treatment is only symptomatic, since therapy targeting the underlying aetiology for these genetic conditions is in its infancy...
September 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27596103/current-treatment-options-for-early-onset-pediatric-epileptic-encephalopathies
#20
REVIEW
Rolla Shbarou
The management of early-onset, genetically determined epilepsies is often challenging. First-line anti-epileptic drugs (AEDs) often include phenobarbital, phenytoin, oxcarbazepine, carbamazepine, clonazepam, levetiracetam, and valproic acid. Combinations of medications are used in these patients with often intractable seizures, and they include topiramate, clobazam, felbamate, lacosamide, lamotrigine, rufinamide, vigabatrin, ACTH, oral steroids, and the ketogenic diet. Vagus nerve stimulator therapy offers some relief in selected patients...
October 2016: Current Treatment Options in Neurology
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