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...
Publication date: 21 February 2019Source: Cell, Volume 176, Issue 5Author(s): Mary T. Joy, Einor Ben Assayag, Dalia Shabashov-Stone, Sigal Liraz-Zaltsman, Jose Mazzitelli, Marcela Arenas, Nora Abduljawad, Efrat Kliper, Amos D. Korczyn, Nikita S. Thareja, Efrat L. Kesner, Miou Zhou, Shan Huang, Tawnie K. Silva, Noomi Katz, Natan M. Bornstein, Alcino J. Silva, Esther Shohami, S. Thomas CarmichaelSummaryWe tested a newly described molecular memory system, CCR5 signaling, for its role in recovery after stroke and traumatic brain injury (TBI). CCR5 is uniquely expressed in cortical neurons after stroke. Post-stroke neuronal kno...
By collecting data on MS patients’ activities and abilities, parent company Roche Group hopes to create new drugs and diagnostics to combat this deadly disease Biotechnology company Genentech, a subsidiary of multinational pharmaceutical/diagnostics company Roche Holdings AG, has developed a smartphone application (app) that enables patients with Multiple Sclerosis (MS) to monitor and track their […]
HIGH blood pressure symptoms can include chest pain, headaches, and feeling very tired. But you could also reveal your risk of deadly hypertension symptoms by checking your urine after using the toilet. This is the colour of wee you should never ignore.
Women with pelvic floor disorders commonly experience defecatory symptoms and are at an increased risk of constipation. Fiber can improve symptoms of constipation, while high saturated fat intake can potentially worsen constipation. Our primary aim was to describe dietary patterns in women undergoing surgery for pelvic organ prolapse (POP). Our secondary aim was to determine the association of bowel symptoms with diet.
A 72-year-old man presents with a severe headache that began suddenly a few hours prior. Can you make the correct diagnosis?Osmosis
Katja Vohl, Alexander Duscha, Barbara Gisevius, Johannes Kaisler, Ralf Gold, Aiden Haghikia
Tobias D. Faizy, Gabriel Broocks, Christian Thaler, Geraldine Rauch, Pimrapat Gebert, Klarissa H. St ürner, Fabian Flottmann, Hannes Leischner, Helge C. Kniep, Jan-Patrick Stellmann, Christoph Heesen, Jens Fiehler, Susanne Gellißen, Uta Hanning
AbstractThe current literature indicates carotid endarterectomy (CEA) as the preferred treatment for symptomatic, moderate to severe carotid artery stenosis. However, recommendations for the management of acute tandem stenosis and complete occlusion, as well as postintervention restenosis of the carotid artery, remain controversial. Here, we review the literature evaluating these conditions and provide suggestions for clinical decision-making. Acute tandem stenosis or occlusion of the common and internal carotid arteries may be treated with angioplasty alone, reserving carotid artery stenting (CAS) or CEA for severe and co...