Dextromethorphan/Quinidine for Pseudobulbar Affect Following Stroke: Safety and Effectiveness in the PRISM II Trial
Publication date: Available online 30 June 2018Source: PM&RAuthor(s): Richard D. Zorowitz, David N. Alexander, Andrea E. Formella, Fred Ledon, Charles Davis, Joao SiffertAbstractBackgroundDextromethorphan (DM)/quinidine (Q) was approved for pseudobulbar affect (PBA) treatment based upon efficacy and safety trials in patients with PBA secondary to amyotrophic lateral sclerosis or multiple sclerosis. The PRISM II trial evaluated DM/Q as PBA treatment in patients with stroke, dementia or traumatic brain injury.ObjectiveTo report results from the stroke cohort of PRISM II, including the Stroke Impact Scale (SIS).DesignOpen-label trial evaluating twice daily DM/Q over 90 daysStudy participantsAdults (n=113) with a clinical diagnosis of PBA secondary to stroke; stable psychiatric medications were allowed.MethodsPRISM II was an open-label, 12-week trial enrolling adults with PBA secondary to dementia, stroke (reported here), or TBI. All study participants received DM/Q 20/10 mg twice daily. Study visits occurred at baseline and at day 30 and day 90.Setting150 US centers.Main Outcome MeasurementsPrimary efficacy measure was change from baseline to day 90 in Center for Neurologic Study-Lability Scale (CNS-LS) scores. Secondary outcomes included PBA episodes (estimated over 7 days), Clinical and Patient/Caregiver Global Impression of Change (CGI-C and PGI-C), Quality of Life-Visual Analog Scale (QOL-VAS), SIS, Patient Health Questionnaire (PHQ-9), and Mini-Mental State Examination (MMS...
Authors: Jhandi SK, Goyal M, Tiwari A PMID: 30899962 [PubMed - as supplied by publisher]
CONCLUSION: This study presents opinions from stroke survivors, partners of stroke survivors, clinicians and researchers. The information about content, timing and mode of delivery will be used to develop and evaluate a comprehensive sexuality rehabilitation programme. PMID: 30895327 [PubMed - as supplied by publisher]
Authors: Bhui K PMID: 30896382 [PubMed - in process]
DISCUSSION: Computerized cognitive training significantly improved global cognitive function, which was supported by the improved brain plasticity. Incorporation of biomarkers should be implemented in cognitive training trials. PMID: 30894299 [PubMed - as supplied by publisher]
CONCLUSION: Even experienced participants benefit from silicone models. Silicone models are a good preparation for animal models but cannot replace them. Categorizing participants depending on their experience and their individual needs before practical training may allow for more efficient endovascular training. PMID: 30895839 [PubMed - as supplied by publisher]
ConclusionRecurrence of medulloblastoma may occur despite more than 15 years of complete remission.Because of this fact it is mandatory to continue the follow-up of these patients.Aggressive management of recurrence is recommended in absence of disease dissemination.
CONCLUSIONS: This study adds an attempt for treatment ranking of both efficacy and safety outcomes. Future trials comparing directly NOACs are needed in order to provide conclusive proofs for these results and not only circumstantial evidence offered by a network meta-analysis. PMID: 30896311 [PubMed - as supplied by publisher]
Hundreds of neighborhood residents of a petrochemical plant that burned for three days and briefly emitted cancer-causing benzene into the air brought their coughs, headaches and other symptoms to a mobile clinic on Friday set up by local health officials.
AbstractPurpose of reviewThis review seeks to establish the role of beta-blockers (B-adrenergic receptor antagonists) in the pathophysiology of migraine prophylaxis, compare the efficacy of this group of medications with other common prophylactic agents, and also explore the relative benefits of using individual beta-blockers compared with others.Recent findingsNew evidence supports beta-blockers having several mechanisms of action in migraine prophylaxis. Numerous trials reveal significant clinical differences between various beta-blockers in migraine prophylaxis and that commonly used doses of beta-blockers are not optim...