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Marta Magaz Martínez, José Luis Martínez Porras, Borja Oliva, Luis Abreu
Treatment with continuous infusion of intraduodenal (Duodopa®) levodopa / carbidopa is indicated in patients with advanced Parkinson's disease who have not responded to conventional treatment. We present here the case of a patient with this type of probe that debuted jejunitis. A distal phytobezoar was the main causal agent. This rare complication may be favored in cases of intestinal hypomotility. Treatment involves its withdrawal as soon as possible and replacement by a new probe, which results in healing...
December 2016: Revista Española de Enfermedades Digestivas
A A Timofeeva, I I Belozertseva
Parkinson's disease (PD) is a chronic progressive neurodegenerative disease that restricts activities of daily living. The prevalence of PD and inevitable disability show the importance of medical/social expertise (MSE) in the system of care for PD patients. Currently, the MSE is based on the Hoehn and Yahr scale that indicates the prevalence of disease but does not evaluate the severity of symptoms. To assess restrictions of activities of daily living, one should consider non-motor symptoms of PD, movement fluctuations and dyskinesia, the efficacy and tolerability of pharmacological treatment, the use of invasive treatment methods (deep brain stimulation, intrajejunal introduction of duodopa)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
C Zulli, M Sica, R De Micco, A Del Prete, M R Amato, A Tessitore, F Ferraro, P Esposito
OBJECTIVE: Levodopa is the gold standard in the pharmacological treatment of Parkinson's disease (PD) and its oral administration is associated with the development of disabling motor and non-motor complications in advanced disease. Levodopa is rapidly metabolized and has a short plasma half-life thus requiring frequent, repeated dosing. Impaired gastric emptying is common in PD, and likely contributes to the unpredictable motor responses observed with orally-dosed levodopa. A new therapeutic protocol for patients with advanced PD include a carbidopa/levodopa combination using continuous, modulated enteral administration achieved inserting a Jejunal Extension Tube Placement through Percutaneous Endoscopic Gastrostomy (PEG-J)...
June 2016: European Review for Medical and Pharmacological Sciences
Marta Magaz Martínez, José Luis Martínez Porras, Marta López Gómez, José Santiago, Cristina Bernardo, Luis Abreu
No abstract text is available yet for this article.
May 27, 2016: Gastroenterología y Hepatología
Karin Wirdefeldt, Per Odin, Dag Nyholm
BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is available in several countries for the treatment of advanced levodopa-responsive Parkinson's disease (PD) with severe motor fluctuations and dyskinesia when other treatments have not given satisfactory results. OBJECTIVE: Our objective was to summarize the present evidence base for LCIG therapy through a systematic review of the literature. METHODS: Studies were identified from the PubMed and EMBASE databases up to 12 March 2016 using the following search terms: Parkinson disease, duodopa, levodopa/carbidopa intestinal gel, levodopa-carbidopa intestinal gel, LCIG, l-dopa infusion, levodopa infusion, duodenal l-dopa infusion, and duodenal levodopa infusion...
May 2016: CNS Drugs
Amanda H Lim, Mark N Schoeman, Nam Q Nguyen
STUDY AIM: To assess the clinical outcomes of patients who received direct percutaneous endoscopic jejunostomy (DPEJ) for enteral feeding. MATERIALS AND METHODS: This is a 10-year cohort study in a single tertiary center. Main outcome measurements were technical success, and short- and long-term outcomes. DPEJ was attempted in 83 patients (51 men; 55 ± 2 years) for dysphagia (n = 35), gastroparesis with recurrent aspiration (n = 30), and levodopa drug infusion for severe Parkinson's disease (n = 18)...
December 2015: Endoscopy International Open
O Băjenaru, A Ene, B O Popescu, J A Szász, M Sabău, D F Mureşan, L Perju-Dumbrava, C D Popescu, A Constantinescu, I Buraga, M Simu
Chronic treatment with oral levodopa is associated with an increased frequency of motor complications in the late stages of Parkinson's disease (PD). Continuous administration of levodopa-carbidopa intestinal gel (LCIG-Duodopa(®), Abbott Laboratories), which has been available in Romania since 2009, represents an option for treating patients with advanced PD. Our primary objective was to report changes in motor complications after initiation of LCIG therapy. The secondary objectives were as follows: to determine the impact of LCIG therapy on the daily levodopa dose variation before/and after LCIG, to collect patient self-assessments of quality of life (QoL), and to study the overall tolerability and safety of LCIG administration...
April 2016: Journal of Neural Transmission
Javier del-Hoyo-Francisco, Marco Bustamante-Balén, Irene Martínez-Torres, Alejandra Barrios-Barrios, Carla Satorres-Paniagua, Vicente Pons-Beltrán
No abstract text is available yet for this article.
May 2015: Revista Española de Enfermedades Digestivas
M C Altavista, E Cassetta, L Brusa, F Viselli, A Denaro, M Ventriglia, P Pasqualetti, A Peppe
OBJECTIVE: Verifying the validity and feasibility of the WOQ-19 as a useful tool in routine clinical practice and in management of patients. METHODS: 532 consecutive Parkinson's disease (PD) patients were recruited from 6 different neurological outpatient units, specialized in movement disorders, of central Italy. Inclusion criteria were diagnosis of PD and any current pharmacological treatment of PD while exclusion criteria were evident cognitive or depressive impairment, infusion with dopamine agonists or Duodopa, or Deep Brain Stimulation therapy...
February 2015: Parkinsonism & related Disorders
Sophie M Lehnerer, Urban M Fietzek, Michael Messner, Andres O Ceballos-Baumann
Continuous jejunal levodopa infusion is an increasingly used therapy option in patients with Parkinson's disease who experience severe fluctuations from oral levodopa. In a number of recent reports polyneuropathy in patients receiving jejunal levodopa infusion was referenced to cobalamin (vitamin B12) deficiency. We describe one of three cases from our hospital with severe subacute polyneuropathy that developed during jejunal levodopa infusion, and occurred despite vitamin substitution therapy and normal vitamin B12 and holotranscobalamin serum levels...
October 2014: Journal of Neural Transmission
Barbara Anne Pickut, Chris van der Linden, Sophie Dethy, Hilde Van De Maele, Diederik Zegers de Beyl
Data concerning efficacy, safety, and patient satisfaction of levodopa/carbidopa intestinal gel (LCIG, Duodopa, AbbVie, Wavre, Belgium) infusion in routine clinical practice were needed to maintain reimbursement of the drug in Belgium. Patients with advanced Parkinson's disease in 27 neurology centers across Belgium were included. Of 100 patients who underwent naso-intestinal (NI) evaluation with LCIG, 67 received permanent treatment with LCIG via percutaneous endoscopic gastrostomy and jejunal tube (PEG/J)...
June 2014: Neurological Sciences
M Zibetti, A Merola, C A Artusi, L Rizzi, S Angrisano, D Reggio, C De Angelis, M Rizzone, L Lopiano
BACKGROUND AND PURPOSE: Levodopa/carbidopa intestinal gel (LCIG) infusion is nowadays becoming an established therapeutic option for advanced Parkinson's disease (PD) patients with fluctuating symptoms unresponsive to conventional oral treatment. As the implementation of LCIG therapy is increasing, there is a need for safety and efficacy data from current clinical practice. METHODS: All PD patients treated with LCIG at our centre over a 7-year period were analysed to determine the duration of treatment, retention rate, reasons for discontinuation, LCIG efficacy in motor complications, modifications of concomitant therapy and adverse events...
February 2014: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Karolina Pytka, Małgorzata Zygmunt, Barbara Filipek
Parkinson's disease (PD) is a chronic, progressive disease of the central nervous system (CNS), characterized by a slow loss of dopaminergic neurons in the substantia nigra, leading to significant decrease in dopamine (DA) levels in the striatum. Currently used drugs, such as levodopa (L-DOPA), amantadine, dopamine agonists (D) or anticholinergic drugs, are not effective enough, and do not eliminate the causes of disease. Many research centers are conducting research on new forms of currently used drugs (e...
2013: Postȩpy Higieny i Medycyny Doświadczalnej
A Merola, M Zibetti, M G Rizzone, M Troiano, C A Artusi, S Angrisano, D Cocito, L Lopiano
BACKGROUND: Although peripheral neuropathies (PN) have been described in patients with Parkinson's disease (PD) treated with oral dopaminergic therapies, anecdotal reports of subacute severe PN have been reported during treatment with enteral levodopa/carbidopa infusion (Duodopa). AIM OF THE STUDY: We prospectively assessed clinical and electrophysiological data of 15 consecutive patients with PD treated with Duodopa for a mean follow-up of 9 months. METHODS: Nerve conduction studies and a clinical evaluation with a standardized battery of peripheral neuropathy scales were performed at baseline and after a mean follow-up of 9 months...
January 2014: Acta Neurologica Scandinavica
T Foltynie, C Magee, C James, G J M Webster, A J Lees, P Limousin
Treatment options in advanced Parkinson's disease (PD) include subcutaneous apomorphine, pallidal or subthalamic nucleus Deep Brain Stimulation (DBS), or levodopa/carbidopa intestinal gel (LCIG/Duodopa). In this study, we describe the outcome of 12 PD patients with PD related complications started on LCIG, with respect to their quality of life measured by a disease specific validated scale-the PDQ39, together with diaries recording time spent "On," "Off," "Dyskinetic," or "Asleep." At the time of latest follow up, improvements were observed in both the PDQ39 Summary index as well as diary reports of PD symptom control following introduction of LCIG, supporting its use in well selected patients...
2013: Parkinson's Disease
C Ossig, H Reichmann
Levodopa/Carbidopa, respectively, Levodopa/Benserazide is the most effective treatment for Parkinson's disease and during the progress of the disease, patients will inevitably need to be treated with it. Nonetheless, after a certain time period most of the patients experience side effects. Mainly disturbing are motor and non-motor fluctuations and dyskinesia. Numerous options from changing the medication regimen, to continuos dopaminergic drug delivery via apomorphine or Duodopa pumps and stereotactical interventions are available...
April 2013: Journal of Neural Transmission
L Timmermann, C Eggers, H Salimi Dafsari, K A M Pauls, M T Barbe
Idiopathic Parkinson's disease is still a clinical diagnosis. However, modern imaging and nuclear techniques allow very early diagnosis and lead to higher security in the differential diagnosis between idiopathic Parkinson's disease and atypical Parkinson syndromes. At early stages of the disease, modification of disease progression and symptom control are key factors of the therapy. Continuous dopaminergic stimulation is even more important at later stages with first fluctuations. In stages where conservative medical options have been exhausted continuous pump therapies with Duodopa and apomorphine are attractive options...
October 2012: Fortschritte der Neurologie-Psychiatrie
Stephen Wørlich Pedersen, Jesper Clausen, Mie Manon Gregerslund
Continuous dopaminergic delivery is recognized for the capacity to ameliorate symptoms in Parkinson's disease (PD). In advanced PD the short comings of orally administered Levodopa/Carbidopa include fluctuations resulting in unstable effect and dyskinesia. Levodopa/Carbidopa intestinal gel, LCIG, (Duodopa®, Abbott Laboratories) is delivered continuously through a percutaneous endoscopic gastrostomy with the inner tube placed in the duodenum by means of a device (CADD legacy Duodopa pump (CE 0473)). The therapy implies continuous dopaminergic delivery directly to the duodenum and is therefore unaffected by gastric emptying and represents a major adjuvant in the treatment of advanced PD with significant improvement in motor and non-motor symptoms...
2012: Open Neurology Journal
Maurizio Zibetti, Aristide Merola, Valeria Ricchi, Alice Marchisio, Carlo Alberto Artusi, Laura Rizzi, Elisa Montanaro, Dario Reggio, Claudio De Angelis, Mario Rizzone, Leonardo Lopiano
Duodenal infusion of levodopa/carbidopa gel (Duodopa) is an effective treatment option for advanced Parkinson's disease (PD). Long-term clinical experience up to 16 years suggests that the safety of this procedure is acceptable, while several observational studies showed that Duodopa reduces motor fluctuations and dyskinesias improving patients' quality of life (QoL). The aim of this study is to investigate the long-term motor and cognitive outcome of Duodopa treatment in advanced PD patients and its' impact on the QoL...
January 2013: Journal of Neurology
S E Pålhagen, N Dizdar, T Hauge, B Holmberg, R Jansson, J Linder, D Nyholm, O Sydow, M Wainwright, H Widner, A Johansson
BACKGROUND: This interim 12-month analysis is a part of an open-label, observational, prospective study on health outcomes and cost impact of levodopa/carbidopa intestinal gel (LCIG, Duodopa) in Parkinson disease (PD). The specific aim was to investigate clinical and health-related quality of life (HRQoL) effects in routine care. METHODS: Unified PD rating scale (UPDRS) was the primary efficacy measurement. PD QoL questionnaire 39 (PDQ-39) assessed HRQoL. Subjects were assessed at baseline, ≥3 months after surgery, and then every 3 months...
December 2012: Acta Neurologica Scandinavica
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