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Baclofen Withdrawal

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121. Simultaneous explantation and implantation of intrathecal pumps: a case series. (Abstract)

that the pump be explanted and the infection treated prior to implantation of a new IDDD. This process leads to long hospital stays, interruptions in optimal medical management, and a high risk for dangerous drug withdrawals. The authors describe a technique that allows for the explantation of the infected pump and implantation of a new pump concurrently, which they have named the "Turner Switch" technique in honor of its inventor.METHODSThe authors conducted a retrospective analysis of cases of infected (...) IDDDs in which patients underwent simultaneous explantation of the infected pump and implantation of a new pump. Demographics and clinical data were collected.RESULTSData from a total of 17 patients (11 male, 6 female) who underwent simultaneous IDDD explantation and implantation to treat infections were analyzed from a 3-year period. No patients experienced infection of the newly implanted pump or catheter. Of the 17 patients, 14 (82.4%) had baclofen pumps to treat spasticity and 3 (17.6%) had

2019 Journal of Neurosurgery

122. Nuedexta - dextromethorphan hydrobromide / quinidine sulfate

medications. The most common single concomitant medication for DM/Q-exposed subjects in the Integrated Studies was riluzole (289 ALS subjects [23.3%]), followed by aspirin (278 subjects [22.5%]), tocopherol (257 subjects [20.8%]), baclofen (249 subjects [20.1%]), ascorbic acid (236 subjects [19.1%]), paracetamol (231 subjects [18.7%]), and ibuprofen (206 subjects [16.6%]). Clonazepam and gabapentin were both taken by about 12% of MS patients with PBA. In the integrated safety Pool 1 827 subjects (66.8

2013 European Medicines Agency - EPARs

124. Study presents limited assessment of pharmacotherapy for alcohol use disorders Full Text available with Trip Pro

, only 8 of 123 studies were rated as low risk of bias, and the mix of psychosocial interventions added to uncertainties of effectiveness. Unusually, numbers needed to harm are reported. The harms are generally mild: anxiety, diarrhoea and vomiting with acamprosate; dizziness and nausea with naltrexone. Withdrawal from trials was more likely with naltrexone. Limitations The overwhelming majority of studies, 80 in this analysis, relate to and support the use of naltrexone and acamprosate (...) , better designed trials of these drugs while also staging trials of promising alternatives such as baclofen, a γ-aminobutyric acid-B agonist, with similarities to benzodiazepines, which modulates dopamine neurons—clinicians believe there is a place for baclofen and other medications, though evidence to date is disappointing. Do these results change your practice and why? No, this study will not change my practice. The meta-analysis is useful and the results merit reflection with colleagues

2015 Evidence-Based Mental Health

127. Exercise-based Therapy for Multiple Sclerosis Patients

) will be considered. As an index of sympathovagal balance, we will use the LF/HF ratio. Changes in peripheral cytokine levels [ Time Frame: Changes from baseline (time 0, t0) to the end of 4 week-exercise protocol (time 1, t1) and 8 weeks after the end of exercise protocol (time 2, t2) ] Within few hours after the withdrawal, the peripheral blood will be processed to isolate plasma, serum and cells. Peripheral Blood Mononuclear Cells (PBMCs) will be isolated by Ficoll hystopaque gradient centrifugation, according (...) with comorbidities for neurological disease other than MS, included other neurodegenerative chronic diseases or chronic infections (i.e tubercolosis, infectious hepatitis, HIV/AIDS); Unstable medical condition or infections; Use of medications with increased risk of seizures (i.e. Fampridine, 4-Aminopyridine); Concomitant use of drugs that may alter synaptic transmission and plasticity (cannabinoids, L-dopa, antiepiletics, nicotine, baclofen, SSRI, botulinum toxin). Contacts and Locations Go to Information from

2018 Clinical Trials

128. Occlusion of the Ascenda Catheter in a Patient with Pump Twiddler’s Sydrome: A Case Report Full Text available with Trip Pro

, no incidences of catheter twisting or occlusion have been reported in literature prior to this case.We report a case of a 32-year old gentleman who presented to the clinic with symptoms of baclofen withdrawal 19 months after he had a programmable pump implanted for spasticity. During the diagnostic evaluation it was discovered that the patients pump had flipped in his abdominal pocket. He was taken to surgery to reorient the pump, during which time it was noted the catheter was tightly coiled on itself (...) Occlusion of the Ascenda Catheter in a Patient with Pump Twiddler’s Sydrome: A Case Report Intrathecal baclofen (ITB) therapy is an effective way to manage spasticity in numerous conditions, including multiple sclerosis, stroke, and cerebral palsy. While pump failure is a common complication of ITB, improvements in device design have led to reduction of complications. In particular, the Ascenda catheter from Medtronic, Inc. was designed to resist kinking and associated complications; indeed

2018 Anesthesiology and pain medicine

129. Altered Mental Status at High Altitude. Full Text available with Trip Pro

problems that arise later are usually from the mechanics of the pump and catheter. Pump-related complications include failure, migration, and flipping. Catheter-related complications include disconnection, occlusion, fracture, or kink. Most of these complications typically lead to baclofen withdrawal, although there are a few case reports of overdose due to mechanical causes. Here we describe 2 cases of individuals experiencing complications of excessive baclofen exposure after significant changes (...) Altered Mental Status at High Altitude. Intrathecal baclofen pumps are commonly used in pediatric patients with spastic cerebral palsy. Baclofen binds to γ-aminobutyric acid receptors to inhibit both monosynaptic and polysynaptic reflexes at the spinal cord level. The blockade stops the release of excitatory transmitters and thereby decreases muscle contraction. It is commonly used for lower limb spasticity and has been shown to improve postural ability and functional status. The US Food

2018 Pediatrics

130. Randomized Clinical Trial Evaluating BP1.3656 Versus Placebo For Alcohol Use Disorder Treatment

deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 65 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Male or female alcohol use disorder Ages 18-65 Absent or minimal alcohol withdrawal symptoms assessed 18 kg/m2 ≤ BMI ≤ 35 kg/m2 (...) Excessive alcohol use during the 2 weeks between screening and baseline Voluntarily expressed willingness to participate in the study, understanding protocol procedures and having signed and dated an informed consent prior to the start of protocol required procedures while not intoxicated (BAC<0.05). Exclusion Criteria: History of delirium tremens, epilepsy, or withdrawal seizures Clinical depression or suicidality: Beck Depression Inventory (BDI) ≥ 16 and suicidality (Item G ≠ 0) Recent illicit drug

2018 Clinical Trials

131. Comparison of the Efficiency of Two Different PPI Formula in Atypical GERD

study groups. The secondary endpoint will be the withdrawal or drop-out rate due to poor symptoms response or drug adverse effects. Data will be analyzed with SPSS Statistical Software for descriptive statistics (percentage, mean, standard error, and 95% confidence interval) and analytical statistics (chi-square test, ANOVA, and generalized estimation equation; GEE). Condition or disease Intervention/treatment Phase Compare the Response Rate of Atypical GERD After PPI Therapy Drug: dexilansoprazole (...) symptoms for more than one month and with a total Reflux Symptom Index (RSI) score ≥13 were eligible for enrollment.Patients who currently took pro-kinetic agents, baclofen, antacid, sucralfate, histamin-2 receptor antagonists, PPI, antitussive, non-steroid anti-inflammatory drugs, anxiolytics, or anti-depressants or takes aforementioned medication during study period, who have severe cardiac, pulmonary, hepatic, or renal disease, who have uncured underlying malignancy, will be excluded as are subjects

2018 Clinical Trials

132. BX-1 in Spasticity Due to MS

spasticity for at least 3 months before enrolment Spasticity in at least 2 lower limb muscles Expanded Disability Status Scale (EDSS) score ≥ 3.0 and ≤ 6.5 Previous treatment with at least two different optimized oral MS anti-spasticity therapies before inclusion which must include at least baclofen and/or oral tizanidine at both treatment attempts which can be combined with other anti-spasticity drugs. AND Patients currently receiving an optimized treatment corresponding to the last treatment attempt (...) lifestyle of the patient). Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not highly effective methods of contraception. For men: No specific contraception methods need to be used. Willingness to follow the study procedure for the whole duration of the trial and signed informed consent at screening prior to any trial-related procedure Exclusion Criteria: Any present disease other than MS that could affect spasticity (e.g. traumatic brain injury

2018 Clinical Trials

133. Current and Innovative Pharmacological Options to Treat Typical and Atypical Trigeminal Neuralgia Full Text available with Trip Pro

. Carbamazepine and oxcarbazepine are the first-choice drugs for paroxysmal pain. When sodium channel blockers cannot reach full dosage because of side effects, an add-on treatment with lamotrigine or baclofen should be considered. In patients with atypical TN, both gabapentin and antidepressants are expected to be efficacious and should be tried as an add-on to oxcarbazepine or carbamazepine. Although carbamazepine and oxcarbazepine are effective in virtually the totality of patients, they are responsible (...) for side effects causing withdrawal from treatment in an important percentage of cases. A new, better tolerated, Nav1.7 selective state-dependent, sodium channel blocker (vixotrigine) is under development. Future trials testing the effect of combination therapy in patients with TN are needed, especially in patients with concomitant continuous pain and in TN secondary to multiple sclerosis.

2018 Drugs

134. Specialist neuro-rehabilitation services

rehabilitation including inter-disciplinary assessment / multi-agency intervention to support return to work , vocational retraining, or withdrawal from work / financial planning as appropriate ? Patients may also require: ? Highly specialist clinical input e.g. for tracheostomy weaning, cognitive and/or behavioural management, low awareness states, or dealing with families in extreme distress ? ongoing investigation / treatment of complex / unstable medical problems in the context of an acute hospital (...) rehabilitation medicine/nursing care in a rehabilitative environment ? medium length rehabilitation programme required to achieve rehabilitation goals – typically 1-3 months, but up to a maximum of 6 months, providing this can be justified by measurable outcomes ? special facilities/ equipment (e.g. specialist mobility/ training aids, orthotics, assistive technology) or interventions (e.g. spasticity management with botulinum toxin or intrathecal baclofen) ? interventions to support goals such as return

2015 British Society of Rehabilitation Medicine

135. Treatment of tardive syndromes

: To make evidence-based recommendations regarding management of tardive syndromes (TDS), including tardive dyskinesias (TDD), by addressing 5 questions: 1) Is withdrawal of dopamine receptor blocking agents (DRBAs) an effective TDS treatment? 2) Does switching from typical to atypical DRBAs reduce TDS symptoms? 3) What is the efficacy of pharmacologic agents in treating TDS? 4) Do patients with TDS benefit from chemodenervation with botulinum toxin? 5) Do patients with TDS benefit from surgical therapy (...) . Amantadine and tetrabenazine might be considered as TDS treatment (Level C). Diltiazem should not be considered as TDD treatment (Level B); galantamine and eicosapentaenoic acid may not be considered as treatment (Level C). Data are insufficient to support or refute use of acetazolamide, bromocriptine, thiamine, baclofen, vitamin E, vitamin B 6 , selegiline, clozapine, olanzapine, melatonin, nifedipine, fluperlapine, sulpiride, flupenthixol, thiopropazate, haloperidol, levetiracetam, quetiapine

2013 American Academy of Neurology

138. High Drinking in the Dark (HDID) Mice Are Sensitive to the Effects of Some Clinically Relevant Drugs to Reduce Binge-like Drinking Full Text available with Trip Pro

by the NIAAA as a drinking to blood alcohol levels (BALs)>0.08% during a period of approximately 2h. To model genetic risk for binge-like drinking, we have used selective breeding to create a unique animal model, High Drinking in the Dark (HDID) mice. Behavioral characterization of HDID mice has revealed that HDID mice exhibit behavioral impairment after drinking, withdrawal after a single binge-drinking session, and escalate their intake in response to induction of successive cycles of dependence. Notably (...) receptor agonist, baclofen, based on recent pre-clinical and clinical studies demonstrating that it reduces alcohol drinking. We elected not to include disulfiram due to its more limited clinical usage. Mice were tested after acute doses of drugs in the limited-access Drinking in the Dark (DID) paradigm.HDID mice were sensitive to the effects of acamprosate and baclofen, but not naltrexone. Both drugs reduced binge-like drinking. However, naltrexone failed to reduce drinking in HDID mice. Thus, HDID

2017 Pharmacology, biochemistry, and behavior

139. A Study to Investigate the Safety and Effectiveness of Arbaclofen Extended-Release Tablets for Patients With MS

, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety and efficacy of oral AERT in MS patients with spasticity. Two doses of AERT, 40 mg and 80 mg, will be compared with placebo. The treatment groups will be randomized in a 1:1:1 ratio. Eligible patients will undergo a washout period for withdrawal of all medications used for anti-spasticity and/or muscle relaxation prior to randomization. A baseline clinical evaluation will be performed (Visit 2) to confirm (...) Tablets Drug: Arbaclofen Arbaclofen is the active R enantiomer of baclofen. Active Comparator: AERT 80 mg 80 mg Arbaclofen Extended-Release Tablets Drug: Arbaclofen Arbaclofen is the active R enantiomer of baclofen. Placebo Comparator: Placebo Placebo Drug: Placebo Placebo comparator Outcome Measures Go to Primary Outcome Measures : total numeric-transformed modified Ashworth Scale score of the most affected limb (TNmAS-MAL) [ Time Frame: 84 days ] The TNmAS is considered the primary clinical measure

2017 Clinical Trials

140. Advanced Nurses vs. General Practitioners for the Management of Outpatient Alcohol Detox: a Safety and Cost Comparison

protocol on the one hand (experimental group), and a GP-based treatment on the other hand (standard-of-care group). In the advanced nurse (AN) group, nurses manage alcohol detox using a predefined protocol based on both the Cushman and CIWA-Ar scales. Depending on the Cushman and CIWA-Ar scores, which are calculated at every consultation, advanced nurse can adjust the diazepam dosing. In case of any serious adverse event or uncontrolled withdrawal complication, an addiction specialist stands in back-up (...) (AN) The outpatient detoxication procedure will be entirely managed by an advanced nurse team, using a predefined protocol decision algorithm. The protocol allows that the AN team autonomously manages the diazepam dosing during the detox period. Addiction physicians only intervenes in case of severe withdrawal symptoms or serious adverse events. Procedure: Advanced Nurse (AN) Protocoled AN-based management of detox Active Comparator: General Practitioner (GP) The outpatient detoxication procedure is entrusted

2017 Clinical Trials

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