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Intrathecal therapy

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https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#1
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28321095/primary-adrenal-diffuse-large-b-cell-lymphoma-positive-for-cd5-and-cd10
#2
Yoshikazu Yamamoto, Yuichi Sumii, Yutaro Shiraishi, Kazuhiro Ikeuchi, Haruto Yamada, Daigo Niiya, Yasuhiro Shiote, Kazuhiko Yamamoto, Kenji Imajo
A 69-year-old man presented with back pain over the prior few months and was hospitalized because of bilateral adrenal masses and fracture of the left sixth rib. The mass on the right measured 6.5×3.6×7.0 cm, that on the left 8.1×4.8×6.9 cm, on CT. The final diagnosis was CD5- and CD10-positive primary adrenal diffuse large B-cell lymphoma (PA-DLBCL) with rib involvement. After EPOCH therapy accompanied with rituximab and intrathecal treatment, the tumors decreased dramatically. However, he died due to disease progression 8 months after the diagnosis...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28315230/clinical-outcome-and-molecular-characterization-of-brain-metastases-from-esophageal-and-gastric-cancer-a-systematic-review
#3
REVIEW
Michele Ghidini, Fausto Petrelli, Jens Claus Hahne, Annamaria De Giorgi, Laura Toppo, Claudio Pizzo, Margherita Ratti, Sandro Barni, Rodolfo Passalacqua, Gianluca Tomasello
The aim of the study was to collect the available data on central nervous system (CNS) metastases from esophageal and gastric cancer. A PubMed, EMBASE, SCOPUS, Web of Science, LILACS, Ovid and Cochrane Library search was performed. Thirty-seven studies including 779 patients were considered. Among the data extracted, treatment of tumor and brain metastases (BMs), time to BMs development, number and subsite, extracerebral metastases rate, median overall survival (OS) and prognostic factors were included. For esophageal cancer, the median OS from diagnosis of BMs was 4...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28298911/autoantibodies-against-the-n-methyl-d-aspartate-receptor-subunit-nr1-untangling-apparent-inconsistencies-for-clinical-practice
#4
REVIEW
Hannelore Ehrenreich
This viewpoint review provides an integrative picture of seemingly contradictory work published on N-methyl-d-aspartate receptor 1 (NMDAR1) autoantibodies (AB). Based on the present state of knowledge, it gives recommendations for the clinical decision process regarding immunosuppressive treatment. Brain antigen-directed AB in general and NMDAR1-AB in particular belong to a preexisting autoimmune repertoire of mammals including humans. Specific autoimmune reactive B cells may get repeatedly (perhaps transiently) boosted by various potential stimulants (e...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28298035/effect-of-intrathecal-milrinone-injection-via-lumbar-catheter-on-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#5
Masaomi Koyanagi, Hitoshi Fukuda, Benjamin Lo, Minami Uezato, Yoshitaka Kurosaki, Nobutake Sadamasa, Akira Handa, Masaki Chin, Sen Yamagata
OBJECTIVE Delayed cerebral ischemia (DCI) is an important complication after aneurysmal subarachnoid hemorrhage (aSAH). Although intrathecal milrinone injection via lumbar catheter to prevent DCI has been previously reported to be safe and feasible, its effectiveness remains unknown. The goal of this study was to evaluate whether intrathecal milrinone injection treatment after aSAH significantly reduced the incidence of DCI. METHODS The prospectively maintained aSAH database was used to identify patients treated between January 2010 and December 2015...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28296770/evaluation-of-intrathecal-drug-delivery-system-for-intractable-pain-in-advanced-malignancies-a-prospective-cohort-study
#6
Shuyue Zheng, Liangliang He, Xiaohui Yang, Xiuhua Li, Zhanmin Yang
Pain is prevalent in advanced malignancies; however, some patients cannot get adequate pain relief by conservative routes of analgesic administration or experience serious side effects related to high dose of opioids. For those who have exhausted multimodal conservative analgesic, intrathecal drug delivery is an alternative intervention for truly effective pain management. The objective of this study was to evaluate the clinical efficacy and safety of intrathecal drug delivery system (IDDS) for the treatment of intractable pain in advanced cancer patients...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28291470/comparative-efficacy-of-multiple-variables-of-mesenchymal-stem-cell-transplantation-for-the-treatment-of-neuropathic-pain-in-rats
#7
LiPing Liu, Zhen Hua, Jun Shen, Yan Yin, Jing Yang, Kathleen Cheng, Aijun Liu, Lina Wang, Jianguo Cheng
OBJECTIVES: The current treatment options for neuropathic pain due to nerve injuries are limited and largely unsatisfactory. Mesenchymal stem cell transplantation (MSC) has shown promise as an emerging therapy for neuropathic pain. However, a number of critical parameters, including the sources of cells, the number of cells, and routes of transplantation, need to be elucidated before it can be tested clinically. METHODS: MSCs were isolated from rat bone marrow (rBM-MSCs) and adipose tissue (rAD-MSCs) and characterized by flow cytometry and functional differentiation...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291215/-complications-of-intrathecal-baclofen-therapy
#8
D L Paskhin, A V Dekopov, A A Tomsky, E D Isagulyan, E M Salova
AIM: To analyze complications of intrathecal baclofen therapy and identify high-risk groups. MATERIAL AND METHODS: We implanted 52 pumps to spastic patients for chronic intrathecal baclofen infusion. Two groups of patients were distinguished: 23 patients with spinal spasticity (group 1) and 29 patients with cerebral spasticity (group 2). The mean patient age was 37.2±14.6 years in group 1 and 17.3±10.3 years in group 2. Surgery was performed according to a standard procedure...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28286633/successful-intrathecal-chemotherapy-combined-with-radiotherapy-followed-by-pomalidomide-and-low-dose-dexamethasone-maintenance-therapy-for-a-primary-plasma-cell-leukemia-patient
#9
Yusuke Yamashita, Shinobu Tamura, Takehiro Oiwa, Hiroshi Kobata, Kodai Kuriyama, Toshiki Mushino, Shogo Murata, Hiroki Hosoi, Akinori Nishikawa, Nobuyoshi Hanaoka, Takashi Sonoki
Primary plasma cell leukemia (PPCL) is a rare aggressive variant of plasma cell disorder and frequently presents with extramedullary disease. Central nervous system (CNS) involvement with PPCL has an extremely poor prognosis. We describe a 46-year-old man with PPCL treated with a combination of lenalidomide, bortezomib, and dexamethasone as induction therapy following upfront allogeneic stem cell transplantation (allo-SCT). Despite achieving a very good partial response, the patient suffered from an isolated CNS relapse 12 months after allo-SCT...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28275350/blockade-of-p2x4-receptors-inhibits-neuropathic-pain-related-behavior-by-preventing-mmp-9-activation-and-consequently-pronociceptive-interleukin-release-in-a-rat-model
#10
Agnieszka M Jurga, Anna Piotrowska, Wioletta Makuch, Barbara Przewlocka, Joanna Mika
Neuropathic pain is still an extremely important problem in today's medicine because opioids, which are commonly used to reduce pain, have limited efficacy in this type of pathology. Therefore, complementary therapy is needed. Our experiments were performed in rats to evaluate the contribution of the purinergic system, especially P2X4 receptor (P2X4R), in the modulation of glia activation and, consequently, the levels of nociceptive interleukins after chronic constriction injury (CCI) of the right sciatic nerve, a rat model of neuropathic pain...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28271991/new-therapy-for-spinal-muscular-atrophy-offers-modest-bang-for-pharamaceutical-buck
#11
Thomas Morrow
Spinraza is a breakthrough, no doubt. It is a survival SMN-2-directed antisense oligonucleotide indicated for the treatment of SMA in pediatric and adult patients and is administered by injections into the spinal fluid (intrathecally). But it is another ultraexpensive drug, and the evidence so far points to a modest improvement in motor milestones.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28269795/smn-blood-levels-in-a-porcine-model-of-spinal-muscular-atrophy
#12
Xueqian Wang, Samantha R Renusch, Sandra I Duque, Allison M Wehr, Xiaokui-Molly Mo, Vicki L McGovern, W David Arnold, Arthur H M Burghes, Stephen J Kolb
BACKGROUND: Spinal Muscular Atrophy (SMA) is an autosomal recessive motor neuron disease that results in loss of spinal motor neurons, muscular weakness and, in severe cases, respiratory failure and death. SMA is caused by a deletion or mutation of the SMN1 gene and retention of the SMN2 gene that leads to low SMN expression levels.The measurement of SMN mRNA levels in peripheral blood samples has been used in SMA clinical studies as a pharmacodynamic biomarker for response to therapies designed to increase SMN levels...
2017: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/28257279/intrathecal-baclofen-therapy-for-the-treatment-of-spasticity-in-sj%C3%A3-gren-larsson-syndrome
#13
Eveline Teresa Hidalgo, Cordelia Orillac, Andrew Hersh, David H Harter, William B Rizzo, Howard L Weiner
Intrathecal baclofen therapy is widely accepted as a treatment option for patients with severe spasticity. The current treatment of spasticity in patients with Sjögren-Larsson syndrome is largely symptomatic, given that no effective causal therapy treatments are available. We report the outcome of 2 patients with Sjögren-Larsson syndrome who had pump implantation for intrathecal baclofen. We observed a positive response, with a decrease of spasticity, reflecting in the Modified Ashworth Scale, and parents and caregivers observed a functional improvement in both patients...
January 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#14
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension (SIH) syndrome results from spontaneous spinal CSF leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas. Two lumbar epidural blood patches were unsuccessful...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28247269/dynamic-of-csf-and-serum-biomarkers-in-hiv-1-subtype-c-encephalitis-with-cns-genetic-compartmentalization-case-study
#15
Sergio M de Almeida, Indianara Rotta, Clea E Ribeiro, Michelli F Oliveira, Antoine Chaillon, Ana Paula de Pereira, Ana Paula Cunha, Marise Zonta, Joao França Bents, Sonia M Raboni, Davey Smith, Scott Letendre, Ronald J Ellis
Despite the effective suppression of viremia with antiretroviral therapy, HIV can still replicate in the central nervous system (CNS). This was a longitudinal study of the cerebrospinal fluid (CSF) and serum dynamics of several biomarkers related to inflammation, the blood-brain barrier, neuronal injury, and IgG intrathecal synthesis in serial samples of CSF and serum from a patient infected with HIV-1 subtype C with CNS compartmentalization.The phylogenetic analyses of plasma and CSF samples in an acute phase using next-generation sequencing and F-statistics analysis of C2-V3 haplotypes revealed distinct compartmentalized CSF viruses in paired CSF and peripheral blood mononuclear cell samples...
February 28, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28237420/long-term-therapy-with-intrathecal-baclofen-improves-quality-of-life-in-children-with-severe-spastic-cerebral-palsy
#16
Tanja Kraus, Kathrin Gegenleitner, Martin Svehlik, Michael Novak, Gerhardt Steinwender, Georg Singer
INTRODUCTION: Children with severe spastic cerebral palsy (CP) are highly limited in daily life activities causing a reduced quality of life (QoL). This is partly due to an increased muscle tone causing pain and contractures. Continuous intrathecal infusion of baclofen (ITB) reduces the spasticity of affected patients. The hypothesis of the present study was that ITB leads to a significant improvement of QoL in non-ambulant children with CP. PATIENTS AND METHODS: 13 patients (10 male, 3 female, mean age 14 years) were included...
February 11, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28235424/comparative-analysis-of-curative-effect-of-bone-marrow-mesenchymal-stem-cell-and-bone-marrow-mononuclear-cell-transplantation-for-spastic-cerebral-palsy
#17
Xuebin Liu, Xiaojun Fu, Guanghui Dai, Xiaodong Wang, Zan Zhang, Hongbin Cheng, Pei Zheng, Yihua An
BACKGROUND: Bone marrow mesenchymal stem cells (BMMSCs) and bone marrow mononuclear cells (BMMNCs) are both used to treat spastic cerebral palsy. However, the differences in therapeutic effect remain unknown. METHODS: A total of 105 patients with spastic cerebral palsy were enrolled and randomly assigned to three groups: the BMMSC group, the BMMNC group and the control group. Patients in both transplantation groups received four intrathecal cell injections. Patients in the control group received Bobath therapy...
February 24, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28230014/nimotuzumab-treatment-and-outcome-analysis-in-patients-with-leptomeningeal-metastasis-from-nonsmall-cell-lung-cancer
#18
Yanfang Ju, Jinliang Wang, Shengjie Sun, Shunchang Jiao
OBJECTIVE: Leptomeningeal metastasis (LM) leades a devastating consequence in patients with nonsmall cell lung cancer(NSCLC). Treatment is very limited for patients with LM. We introduced to use nimotuzumab (also known as h-R3) combined with methotrexate for treating LM in NSCLC patients. PATIENTS AND METHODS: In the present report, twenty patients with LM of NSCLC were included, and the clinicopathology information and outcomes after treatment were analyzed. RESULTS: All the twenty patients with LM were lung adenocarcinoma...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28229399/neurological-complications-of-the-leukemias-across-the-ages
#19
REVIEW
Stephanie Berg, Sucha Nand
PURPOSE OF REVIEW: Acute and chronic leukemias are heterogeneous diseases and can affect any part of the body upon initial discovery. Understanding the sequela of systemic involvement is key for proper diagnosis and treatment. RECENT FINDINGS: Over the decades, new research has emerged regarding neurological complications of the myeloid or lymphoid leukemias. Central nervous system involvement usually confers a poor prognosis and requires emergent treatment. Standard of care still involves systemic therapy, intrathecal administration of chemotherapeutic agents, and cranial radiation...
February 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28213069/a-pilot-study-of-cell-mediated-gene-therapy-for-spinal-cord-injury-in-mini-pigs
#20
Islamov Rustem Robertovich, Sokolov Mikhail Evgenyevich, Bashirov Farid Vagizovich, Fadeev Filip Olegovich, Shmarov Maxim Michaylovich, Naroditskiy Boris Savelyevich, Povysheva Tatyana Vyacheslavovna, Shaymardanova Gulnara Ferdinantovna, Yakupov Radik Albertovich, Chelyshev Yuri Aleksandrovich, Lavrov Igor Aleksandrovich
Currently, in clinical practice there is no efficient way to overcome the sequences of neurodegeneration after spinal cord traumatic injury. Using a new experimental model of spinal cord contusion injury on miniature pigs, we proposed to deliver therapeutic genes encoding vascular endothelial growth factor (VEGF), glial cell line-derived neurotrophic factor (GDNF) and neural cell adhesion molecule (NCAM) to the damaged area, using umbilical cord blood mononuclear cells (UCBC). In this study, genetically engineered UCBC (2×10(6) cells in 200 ml of saline) were injected intrathecally to mini-pigs 10days after SCI...
February 14, 2017: Neuroscience Letters
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