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Intrathecal drug therapy

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https://www.readbyqxmd.com/read/29719742/toxic-myelitis-and-arachnoiditis-after-intrathecal-delivery-of-bupivacaine-via-an-implanted-drug-delivery-system-case-report-and-review-of-the-literature
#1
Meng Huang, Brian Dalm, Richard K Simpson
The off-label usage of amino-amide anesthetics in intrathecal drug delivery systems (IDDS) for the treatment of chronic non-malignant and malignant pain is supported in the polyanalgesic consensus guidelines as a second-line adjunctive therapy. Although strong evidence for its clinical efficacy is lacking, its clinical safety profile has been well established within established dosing parameters. Despite the rarity of neurological adverse reactions to intrathecal bupivacaine, whether given as regional anesthesia or intrathecal therapy, neurologic morbidity associated with its administration is well documented...
February 27, 2018: Curēus
https://www.readbyqxmd.com/read/29626288/evidence-for-intrathecal-sodium-butyrate-as-a-novel-option-for-leptomeningeal-metastasis
#2
Hidemitsu Nakagawa, Yoshihiro Yui, Satoru Sasagawa, Kazuyuki Itoh
INTRODUCTION: The prognosis for leptomeningeal metastasis (LM) remains extremely poor regardless of intrathecal chemotherapy with various drugs, and thus, new treatments are necessary. Butyrate is an endogenous 4-carbon saturated fatty acid, has been investigated as an anti-tumor agent because of its multiple suppressive effects on several tumors. In this study, we investigated the cellular basis of sodium butyrate (SB), a sodium salt compound of butyrate, in vitro and evaluated the clinical potential of intrathecal SB administration for LM in vivo...
April 6, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29617640/rna-targeted-therapeutics
#3
REVIEW
Stanley T Crooke, Joseph L Witztum, C Frank Bennett, Brenda F Baker
RNA-targeted therapies represent a platform for drug discovery involving chemically modified oligonucleotides, a wide range of cellular RNAs, and a novel target-binding motif, Watson-Crick base pairing. Numerous hurdles considered by many to be impassable have been overcome. Today, four RNA-targeted therapies are approved for commercial use for indications as diverse as Spinal Muscular Atrophy (SMA) and reduction of low-density lipoprotein cholesterol (LDL-C) and by routes of administration including subcutaneous, intravitreal, and intrathecal delivery...
April 3, 2018: Cell Metabolism
https://www.readbyqxmd.com/read/29596541/association-of-cerebrospinal-fluid-biomarkers-of-central-nervous-system-injury-with-neurocognitive-and-brain-imaging-outcomes-in-children-receiving-chemotherapy-for-acute-lymphoblastic-leukemia
#4
Yin Ting Cheung, Raja B Khan, Wei Liu, Tara M Brinkman, Michelle N Edelmann, Wilburn E Reddick, Deqing Pei, Angela Panoskaltsis-Mortari, Deokumar Srivastava, Cheng Cheng, Leslie L Robison, Melissa M Hudson, Ching-Hon Pui, Kevin R Krull
Importance: Little is known about treatment-related neurotoxic mechanisms in children with acute lymphoblastic leukemia (ALL) treated with chemotherapy only. Objective: To examine concentration of cerebrospinal fluid (CSF) biomarkers of brain injury at ALL diagnosis and during cancer therapy and to evaluate associations with long-term neurocognitive and neuroimaging outcomes and relevant genetic polymorphisms. Design, Setting, and Participants: This prospective cohort study included 235 patients with ALL who received a chemotherapy-only protocol...
March 29, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29556256/spinal-muscular-atrophy-type-i-and-the-dual-role-of-viruses-an-interview-with-professor-basil-t-darras-professor-of-neurology-pediatrics-at-harvard-medical-school
#5
Ioannis N Mammas, Demetrios A Spandidos
According to Professor Basil T. Darras, Professor of Neurology (Pediatrics) at Harvard Medical School and Director of the Spinal Muscular Atrophy (SMA) Program at Boston Children's Hospital in Boston (MA, USA), the diagnosis of SMA type I is clinical and is based on detailed general physical and neurological examinations. SMA type I remains the most common genetic disease resulting in death in infancy and is really devastating for the child, the parents, as well as the medical professionals with the privilege of caring for patients with SMA and their parents...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29543644/intrathecal-drug-delivery-systems-for-refractory-pancreatic-cancer-pain-observational-follow-up-study-over-an-11-year-period-in-a-comprehensive-cancer-center
#6
Gabriel Carvajal, Denis Dupoiron, Valerie Seegers, Nathalie Lebrec, François Boré, Pierre-Yves Dubois, Damien Leblanc, Thierry Delorme, Sabrina Jubier-Hamon
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death in Europe and the United States. Studies have demonstrated that patients with pancreatic cancer have a high prevalence of pain, with rates varying from 47% to 82%. Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. METHODS: The IDDS for pancreatic cancer pain was a follow-up observational study designed to evaluate 11-year results of IDDS for refractory pancreatic cancer pain at the Institut de Cancérologie de L'Ouest, Paul Papin in France...
March 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29542370/role-of-primary-care-physicians-in-intrathecal-pain-management-a-narrative-review-of-the-literature
#7
Gladstone C McDowell, Joseph Winchell
OBJECTIVES: The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misuse and overdose. It is important for PCPs to be aware of pain management strategies other than systemic opioid dose escalation when patients with chronic pain fail to respond to conservative therapies and to initiate a multimodal treatment plan...
March 28, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29536184/coccidioidal-meningitis-a-review-on-diagnosis-treatment-and-management-of-complications
#8
REVIEW
Royce Johnson, Jackie Ho, Pete Fowler, Arash Heidari
PURPOSE OF REVIEW: This article summarizes the diagnosis and treatment of coccidioidal meningitis (CM) and its complications. An overview of current and prospective pharmacologic treatment options and monitoring parameters is provided. A consensus has not been reached regarding universally accepted therapeutic serum levels for azoles because of insufficient evidence. We describe the preferred therapeutic drug level ranges that our institution uses to monitor azole therapy. RECENT FINDINGS: Ho et al...
March 13, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29433947/antiglutamic-acid-decarboxylase-65-gad65-antibody-associated-epilepsy
#9
REVIEW
Ahmad Daif, Rimas V Lukas, Naoum P Issa, Adil Javed, Stephen VanHaerents, Anthony T Reder, James X Tao, Peter Warnke, Sandra Rose, Vernon L Towle, Shasha Wu
Glutamic acid decarboxylase (GAD) antibody-associated encephalitis causes both acute seizures and chronic epilepsy with predominantly temporal lobe onset. This condition is challenging in diagnosis and management, and the incidence of GAD antibody (Ab)-related epilepsy could be much higher than commonly believed. Imaging and CSF evidence of inflammation along with typical clinical presentations, such as adult onset temporal lobe epilepsy (TLE) with unexplained etiology, should prompt testing for the diagnostic antibodies...
March 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29404792/intrathecal-drug-delivery-and-spinal-cord-stimulation-for-the-treatment-of-cancer-pain
#10
REVIEW
Fangfang Xing, R Jason Yong, Alan David Kaye, Richard D Urman
PURPOSE OF REVIEW: The purpose of the present investigation is to summarize the body and quality of evidence including the most recent studies in support of intrathecal drug delivery systems and spinal cord stimulation for the treatment of cancer-related pain. RECENT FINDINGS: In the past 3 years, a number of prospective studies have been published supporting intrathecal drug delivery systems for cancer pain. Additional investigation with adjuvants to morphine-based analgesia including dexmedetomidine and ziconotide support drug-induced benefits of patient-controlled intrathecal analgesia...
February 5, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29387478/retrospective-review-of-metastatic-melanoma-patients-with-leptomeningeal-disease-treated-with-intrathecal-interleukin-2
#11
Isabella C Glitza, Michelle Rohlfs, Nandita Guha-Thakurta, Roland L Bassett, Chantale Bernatchez, Adi Diab, Scott E Woodman, Cassian Yee, Rodabe N Amaria, Sapna P Patel, Hussein Tawbi, Michael Wong, Wen-Jen Hwu, Patrick Hwu, Amy Heimberger, Ian E McCutcheon, Nicholas Papadopoulos, Michael A Davies
Objectives: Metastatic melanoma patients with leptomeningeal disease (LMD) have an extremely poor prognosis, with a median survival measured in weeks, and few treatment options. Outcomes of a retrospective cohort of patients with LMD that were treated with intrathecal interleukin-2 (IT IL-2) were reviewed to assess the long-term efficacy of this therapy. Methods: The records of metastatic melanoma patients with LMD who were treated with IT IL-2 from 2006 to 2014 in a Compassionate Investigational New Drug study were reviewed...
2018: ESMO Open
https://www.readbyqxmd.com/read/29364542/drug-induced-aseptic-meningitis-a-mini-review
#12
REVIEW
Melissa Yelehe-Okouma, Julie Czmil-Garon, Elise Pape, Nadine Petitpain, Pierre Gillet
Aseptic meningitis associates a typical clinical picture of meningitis with the absence of bacterial or fungal material in the cerebrospinal fluid. Drug-induced aseptic meningitis (DIAM) may be due to two mechanisms: (i) a direct meningeal irritation caused by the intrathecal administration of drugs and (ii) an immunologic hypersensitivity reaction to a systemic administration. If the direct meningeal irritation allows a rather easy recognition, the immunologic hypersensitivity reaction is a source of challenging diagnostics...
January 24, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29346227/refractory-pain-management-in-amyloid-associated-peripheral-neuropathy
#13
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/29311456/-a-survey-of-the-adverse-effects-and-influence-of-concomitant-drugs-for-methotrexate-intrathecal-administration
#14
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/29277248/communication-pathways-to-and-from-the-inner-ear-and-their-contributions-to-drug-delivery
#15
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/29273846/intrathecal-oligoclonal-bands-synthesis-in-multiple-sclerosis-is-it-always-a-prognostic-factor
#16
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...
February 2018: Journal of Neurology
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/29225468/therapy-of-an-incomplete-spinal-cord-injury-by-intrathecal-injection-of-epo-and-subcutaneous-injection-of-epo-vitamin-c-and-g-csf
#18
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
#19
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...
January 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29163174/sustained-complete-response-to-metronomic-chemotherapy-in-a-child-with-refractory-atypical-teratoid-rhabdoid-tumor-a-case-report
#20
Mahe Berland, Laetitia Padovani, Angélique Rome, Grégoire Pech-Gourg, Dominique Figarella-Branger, Nicolas André
Atypical teratoid rhabdoid tumor (ATRT) is a rare and highly aggressive embryonal tumor of the central nervous system with a dismal prognosis and no definitive guidelines for treatment, especially at relapse or in case of refractory disease. Metronomic chemotherapy (MC) has emerged as a new treatment option in solid malignancies, with lower toxicity and is frequently combined with drug repositioning. We report a case of ATRT in an 8-year-old boy who progressed during multimodal therapy including surgical resection, chemotherapy and radiotherapy...
2017: Frontiers in Pharmacology
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