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Intrathecal therapy

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https://www.readbyqxmd.com/read/29349778/intrathecal-baclofen-therapy-in-children-an-analysis-of-individualized-goals
#1
Peck Yee Liew, Kirsty Stewart, Debra Khan, Sarah Jane Arnup, Adam Scheinberg
AIM: To determine whether intrathecal baclofen (ITB) therapy improves performance and performance satisfaction in goal areas identified by patients' parents. METHOD: This study formed part of an ongoing multicentre national audit involving six paediatric ITB pump implant centres across Australia. The Canadian Occupational Performance Measure was the primary outcome measure utilized at baseline, 6 months, and 12 months after pump implants in paediatric patients receiving ITB therapy for the first time between 31st December 2009 and 31st December 2014...
January 19, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29346227/refractory-pain-management-in-amyloid-associated-peripheral-neuropathy
#2
Nafisseh S Warner, James C Watson, Markus A Bendel, Susan M Moeschler
OBJECTIVE: Systemic amyloidosis is a disease that often involves multiple organ systems, including the peripheral nervous system. Patients may present with severe, refractory neuropathic pain; however, the optimal treatment approach for pain for these patients remains unclear. CASE REPORT: A man with severe, refractory neuropathic pain in his bilateral upper and lower extremities and the trunk secondary to amyloid neuropathy is presented. Multiple medication trials, including neuropathic and opioid agents, produced considerable adverse effects and minimal relief...
January 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29336363/utility-and-safety-of-intrathecal-methotrexate-treatment-in-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-a-pilot-study
#3
Xun-Zhe Yang, Hua-Dong Zhu, Hai-Tao Ren, Yi-Cheng Zhu, Bin Peng, Li-Ying Cui, Hong-Zhi Guan
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune neurologic syndrome that occurs with or without tumor association. However, some severe cases are refractory to systemic immunotherapy. This pilot study aimed to evaluate the utility and safety of intrathecal methotrexate injection for severe patients with anti-NMDAR encephalitis who did not respond to first-line immunotherapy. METHODS: Intrathecal injections with methotrexate and dexamethasone were performed weekly in four legible patients within consecutive 4 weeks...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29326296/intrathecal-baclofen-therapy-versus-conventional-medical-management-for-severe-poststroke-spasticity-results-from-a-multicentre-randomised-controlled-open-label-trial-sisters
#4
Michael Creamer, Geoffrey Cloud, Peter Kossmehl, Michael Yochelson, Gerard E Francisco, Anthony B Ward, Jörg Wissel, Mauro Zampolini, Abdallah Abouihia, Nathalie Berthuy, Alessandra Calabrese, Meghann Loven, Leopold Saltuari
BACKGROUND: Intrathecal baclofen (ITB) is a treatment option for patients with severe poststroke spasticity (PSS) who have not reached their therapy goal with other interventions. METHODS: 'Spasticity In Stroke-Randomised Study' (SISTERS) was a randomised, controlled, open-label, multicentre phase IV study to evaluate the efficacy and safety of ITB therapy versus conventional medical management (CMM) with oral antispastic medications for treatment of PSS. Patients with chronic stroke with spasticity in ≥2 extremities and an Ashworth Scale (AS) score ≥3 in at least two affected muscle groups in the lower extremities (LE) were randomised (1:1) to ITB or CMM...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29319155/economic-evaluation-and-cost-of-interventions-for-cerebral-palsy-a-systematic-review
#5
REVIEW
Sophy T F Shih, Utsana Tonmukayakul, Christine Imms, Dinah Reddihough, H Kerr Graham, Liz Cox, Rob Carter
AIM: Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. METHOD: Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 10, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29315225/fm19g11-and-ependymal-progenitor-stem-cell-combinatory-treatment-enhances-neuronal-preservation-and-oligodendrogenesis-after-severe-spinal-cord-injury
#6
Ana Alastrue-Agudo, Francisco Javier Rodriguez-Jimenez, Eric López Mocholi, Francesca De Giorgio, Slaven Erceg, Victoria Moreno-Manzano
Spinal cord injury (SCI) suffers from a lack of effective therapeutic strategies. We have previously shown that individual therapeutic strategies, transplantation of ependymal stem/progenitor cells of the spinal cord after injury (epSPCi) or FM19G11 pharmacological treatment, induce moderate functional recovery after SCI. Here, the combination of treatments has been assayed for functional and histological analysis. Immediately after severe SCI, one million epSPCi were intramedullary injected, and the FM19G11 compound or dimethyl sulfoxide (DMSO) (as the vehicle control) was administrated via intrathecal catheterization...
January 9, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29311456/-a-survey-of-the-adverse-effects-and-influence-of-concomitant-drugs-for-methotrexate-intrathecal-administration
#7
Masanobu Uchiyama, Miho Ueno, Yasushi Takamatsu, Koichi Matsuo, Osamu Imakyure, Hidetoshi Kamimura
 In general, the intraventricular administration of cytotoxic antitumor drugs provides a high drug concentration in the cerebrospinal fluid with a reduced risk of systemic adverse reactions. Methotrexate (MTX) high-dose therapy requires close monitoring when performed in combination with trimethoprim-sulfamethoxazole (ST) therapy and proton pump inhibitor (PPI) and nonsteroidal anti-inflammatory drug administration for excretion delay and toxicity enhancement. While the frequency of systemic side effects is thought to be low with intrathecal administration, such effects do rarely but occasionally occur...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29286562/isolated-late-testicular-relapse-of-b-cell-acute-lymphoblastic-leukemia-treated-with-intensive-systemic-chemotherapy-and-response-based-testicular-radiation-a-children-s-oncology-group-study
#8
Julio C Barredo, Caroline Hastings, Xiamin Lu, F Meenakshi Devidas, Yichen Chen, Daniel Armstrong, Naomi Winick, Brent Lee Wood, Rochelle Yanofsky, Mignon Loh, Julie M Gastier-Foster, Dean Thomas Jorstad, Robert Marcus, Kim Ritchey, William L Carrol, Stephen P Hunger
BACKGROUND: The incidence of isolated testicular relapse (ITR) of acute lymphoblastic leukemia (ALL) has decreased with contemporary treatment strategies, but outcomes are suboptimal with a 58% 5-year overall survival (OS). This study aimed to improve outcome in patients with ITR of B-cell ALL (B-ALL) occurring after 18 months of first clinical remission using intensive systemic chemotherapy and to decrease long-term sequelae by limiting use of testicular radiation. PROCEDURE: Forty patients in first ITR of B-ALL were enrolled...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29285750/the-use-of-stem-cell-therapy-to-reverse-opioid-tolerance
#9
Fei Li, LiPing Liu, Kathleen Cheng, Zhongbo Chen, Jianguo Cheng
Opioid tolerance (OT) and opioid-induced hyperalgesia (OIH) are major challenges in medicine. Here we report that transplantation of mesenchymal stem cells (MSCs) prevented and reversed OT and OIH in rats and mice. The preventive and therapeutic effects were long-lasting and consistent across different assessment schemes. Both intrathecal and intravenous transplantations were effective and safe. This emerging therapeutic strategy has thus shown promise to impact clinical practice and improve the efficacy and safety of opioid therapy...
December 29, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29277248/communication-pathways-to-and-from-the-inner-ear-and-their-contributions-to-drug-delivery
#10
REVIEW
Alec N Salt, Keiko Hirose
The environment of the inner ear is highly regulated in a manner that some solutes are permitted to enter while others are excluded or transported out. Drug therapies targeting the sensory and supporting cells of the auditory and vestibular systems require the agent to gain entry to the fluid spaces of the inner ear, perilymph or endolymph, which surround the sensory organs. Access to the inner ear fluids from the vasculature is limited by the blood-labyrinth barriers, which include the blood-perilymph and blood-strial barriers...
December 19, 2017: Hearing Research
https://www.readbyqxmd.com/read/29276474/experimental-gene-therapy-with-serine-histogranin-and-endomorphin-1-for-the-treatment-of-chronic-neuropathic-pain
#11
Stanislava Jergova, Catherine E Gordon, Shyam Gajavelli, Jacqueline Sagen
The insufficient pain relief provided by current pharmacotherapy for chronic neuropathic pain is a serious medical problem. The enhanced glutamate signaling via NMDA receptors appears to be one of the key events in the development of chronic pain. Although effective, clinical use of systemic NMDA antagonists is limited by adverse effects such as hallucinations and motor dysfunction. Opioids are also potent analgesics but their chronic use is accompanied by tolerance and risk of addiction. However, combination of NMDA antagonists and opioids seems to provide a stable pain relieve at subthreshold doses of both substances, eliminating development of side effects...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/29273846/intrathecal-oligoclonal-bands-synthesis-in-multiple-sclerosis-is-it-always-a-prognostic-factor
#12
Jessica Frau, Luisa Maria Villar, Claudia Sardu, Maria Antonietta Secci, Lucia Schirru, Diana Ferraro, Giancarlo Coghe, Lorena Lorefice, Giuseppe Fenu, Roberta Bedin, Patrizia Sola, Maria Giovanna Marrosu, Eleonora Cocco
BACKGROUND: Oligoclonal IgM (OCMB) and IgG (OCGB) bands were found to be associated with poor multiple sclerosis (MS) prognosis. OBJECTIVE: We aimed to evaluate the prognostic value of OCMB/OCGB in a cohort of Sardinian MS patients. MATERIALS AND METHODS: We recruited patients from the University of Cagliari. They underwent lumbar puncture for diagnostic purposes. Demographic and the following clinical data were recorded: clinical course; time to reach EDSS 3 and 6; EDSS at last follow-up; and MS treatments...
December 22, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29249183/aav-gene-delivery-to-the-spinal-cord-serotypes-methods-candidate-diseases-and-clinical-trials
#13
Nathan Hardcastle, Nicholas M Boulis, Thais Federici
Adeno-associated viral (AAV) vector-mediated gene delivery to the spinal cord has finally entered the pathway towards regulatory approval. Phase 1 clinical trials using AAV gene therapy for pediatric disorders - spinal muscular atrophy (SMA) and giant axonal neuropathy (GAN) - are now underway. Areas covered: This review addresses the latest progress in the field of AAV gene delivery to the spinal cord, particularly focusing on the most prominent AAV serotypes and delivery methodologies to the spinal cord. Candidate diseases and scaling up experiments in large animals are also discussed...
December 18, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29248528/feasibility-safety-and-efficacy-of-subcutaneous-peripheral-nerve-field-stimulation-for-the-treatment-of-refractory-low-back-pain-a-two-year-single-center-study
#14
Basem Ishak, Benito Campos, Heike Brunn, Andreas W Unterberg, Rezvan Ahmadi
Chronic low back pain is challenging to treat. Minimal invasive neurostimulation therapies, such as subcutaneous peripheral nerve field stimulation (SPNS), improve pain relief and quality of life,. The goal of the present study was to assess the usefulness, safety, and efficacy of SPNS in patients with chronic low back pain (CLBP). Twenty-six consecutive patients with CLBP were prospectively included in the study. For trial neurostimulation, two electrodes were implanted vertically at a depth of 1 cm into the subcutaneous tissue, ≤ 10 cm from the region of maximum pain...
December 14, 2017: Neuroscience
https://www.readbyqxmd.com/read/29241820/outcomes-of-adjunctive-therapy-with-intrathecal-or-intraventricular-administration-of-colistin-for-post-neurosurgical-meningitis-and-ventriculitis-due-to-carbapenem-resistant-acinetobacter-baumannii
#15
Sarunyou Chusri, Ittichai Sakarunchai, Narongdet Kositpantawong, Siripen Panthuwong, Wichai Santimaleeworagun, Sutthiporn Pattharachayakul, Kamonnut Singkhamanan, Yohei Doi
The efficacy and safety of intrathecal or intraventricular (ITH/IVT) colistin in addition to intravenous (IV) colistin for meningitis and ventriculitis due to carbapenem-resistant Acinetobacter baumannii (CRAB) is unclear. In this retrospective observational study of 40 patients with post-neurosurgical meningitis and ventriculitis due to CRAB, 33 patients without concomitant infection received appropriate dosage regimens of IV colistin. Seventeen of the 33 patients received additional ITH/IVT colistin and 16 patients received only IV colistin...
December 11, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29241656/adipose-derived-stem-cells-decrease-pain-in-a-rat-model-of-oxaliplatin-induced-neuropathy-role-of-vegf-a-modulation
#16
Lorenzo Di Cesare Mannelli, Barbara Tenci, Laura Micheli, Alessia Vona, Francesca Corti, Matteo Zanardelli, Andrea Lapucci, Ann Maria Clemente, Paola Failli, Carla Ghelardini
Oxaliplatin therapy of colorectal cancer induces a dose-dependent neuropathic syndrome in 50% of patients. Pharmacological treatments may offer limited relief; scientific efforts are needed for new therapeutic approaches. Therefore we evaluated in a preclinical setting the pain relieving properties of mesenchymal stem cells and its secretome. Rat adipose stem cells (rASCs) were administered in a rat model of oxaliplatin-induced neuropathy. A single intravenous injection of rASCs reduced oxaliplatin-dependent mechanical hypersensitivity to noxious and non-noxious stimuli taking effect 1 h after administration, peaking 6 h thereafter and lasting 5 days...
December 11, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29230121/leptomeningeal-disease-and-the-evolving-role-of-molecular-targeted-therapy-and-immunotherapy
#17
REVIEW
Katharine Hall Thomas, Robert A Ramirez
Background: Leptomeningeal disease (LMD) is a complication that results from solid tumor metastasis. Prognosis is extremely poor. As therapeutic options for solid tumors improve, the rate of LMD continues to increase. Until recently, treatment has been limited to radiation therapy, intrathecal chemotherapy, and systemic chemotherapy, with an overall survival of 2-3 months. Targeted molecular therapy and immunotherapies are promising new options for increasing overall survival and clinical improvement; however, optimal clinical management remains unknown...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29226091/successful-treatment-of-multicompartmental-cerebral-ventriculitis-caused-by-acinetobacter-baumanii
#18
Mahableshwar Albur
We present a case report of a 58-year- old woman with subarachnoid haemorrhage complicated by non-communicating hydrocephalus. During the course of her neurosurgical management, she developed external-ventricular drain associated ventriculitis which in turn was complicated by lack of communication between third and fourth ventricles. The causative organism was a fully-sensitive Acinetobacter baumanii, a nosocomial pathogen often associated with complicated treatment regimens and poor outcomes. This patient was successfully managed by a multi-disciplinary team involving neurosurgeons, neuroradiologists and infection specialists...
2018: IDCases
https://www.readbyqxmd.com/read/29225468/therapy-of-an-incomplete-spinal-cord-injury-by-intrathecal-injection-of-epo-and-subcutaneous-injection-of-epo-vitamin-c-and-g-csf
#19
Augustinus Bader, Martin Reinhardt, Achim Beuthe, Klaus Röhl, Shibashish Giri
Spinal cord injury is a rare disease with an incidence about 40 cases per million population in the USA. The most common reasons are traffic accidents, falls, violence and sports. A 53-year-old male patient presented with an incomplete tetraparesis as a result of a spinal cord injury after the accident. It was not possible to treat him with steroids because he was out of the therapeutic time period of 8 hours when he presented to the hospital. The main problem of spinal cord injuries is the secondary injury caused by inflammation and swelling of the spinal cord...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29224250/multiple-autologous-bone-marrow-derived-cd271-mesenchymal-stem-cell-transplantation-overcomes-drug-resistant-epilepsy-in-children
#20
Olga Milczarek, Danuta Jarocha, Anna Starowicz-Filip, Stanislaw Kwiatkowski, Bogna Badyra, Marcin Majka
There is a need among patients suffering from drug-resistant epilepsy (DRE) for more efficient and less toxic treatments. The objective of the present study was to assess the safety, feasibility, and potential efficacy of autologous bone marrow cell transplantation in pediatric patients with DRE. Two females and two males (11 months to 6 years) were enrolled and underwent a combined therapy consisting of autologous bone marrow nucleated cells (BMNCs) transplantation (intrathecal: 0.5 × 109 ; intravenous: 0...
December 10, 2017: Stem Cells Translational Medicine
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