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[PMID]:29390378
[Au] Autor:Zhang Y; Lian Y; Xie N
[Ad] Endereço:Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
[Ti] Título:Early onset epileptic encephalopathy with a novel GABRB3 mutation treated effectively with clonazepam: A case report.
[So] Source:Medicine (Baltimore);96(50):e9273, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Early onset epileptic encephalopathy (EOEE) is one of the most serious early onset epilepsies. The etiopathology of this condition remains unclear, and recent evidence indicated that gamma-aminobutyric acid (GABA) A receptor, subunit beta 3 (GABRB3) gene mutations might be associated with EOEE. Furthermore, the therapeutic regimen for EOEE has yet to be well elucidated. Herein, we reported the clinical and genetic features of a case with GABRB3-related EOEE. PATIENT CONCERNS: A 6-year-old girl developed epileptic seizures 3 days after birth. She presented with multiple seizure types including myoclonic seizures, spasms, and absence seizures. Serial electroencephalographic examinations showed variable abnormalities, and intellectual evaluation revealed significant development retardation. Conventional antiepileptic drugs were ineffective for the seizure controlling. Genetic screening identified a novel nonsense mutation (C.5G > A, p.W2X) in the GABRB3 gene. DIAGNOSES: Early onset epileptic encephalopathy. INTERVENTIONS: We changed the antiepileptic strategy to oral clonazepam (0.5mg twice daily). The patient was followed up once a week and significant declining in the attack frequency was noted 1 week later (2-3 times daily). Subsequently, the dosage was doubled (1mg twice daily), and complete cessation of seizures was achieved 20 days later. OUTCOMES: Through a 9-month follow up,the girl remained seizure-free. LESSONS: This study identified a novel nonsensemutation (C.5G>A) in the exon 1 of GABRB3 Gene, which may be associated with EOEE. To our knowledge, this is the first report to use clonazepam in the patient with GABRB3-related EOEE with favorable outcome. Our finding suggested that clonazepam might be a choice for patient with GABRB3-related EOEE. The remarkable efficacy of clonazepam in the control of seizures indicated a potential GABRB3- or GABA-related mechanism involved in the development of EOEE.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Clonazepam/uso terapêutico
Epilepsia/tratamento farmacológico
Epilepsia/genética
Receptores de GABA-A/genética
[Mh] Termos MeSH secundário: Idade de Início
Criança
Códon sem Sentido
Análise Mutacional de DNA
Deficiências do Desenvolvimento
Eletroencefalografia
Feminino
Predisposição Genética para Doença
Testes Genéticos
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Codon, Nonsense); 0 (GABRB3 protein, human); 0 (Receptors, GABA-A); 5PE9FDE8GB (Clonazepam)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009273


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[PMID]:29352477
[Au] Autor:Bergman H; Bhoopathi PS; Soares-Weiser K
[Ad] Endereço:Cochrane Response, Cochrane, St Albans House, 57-59 Haymarket, London, UK, SW1Y 4QX.
[Ti] Título:Benzodiazepines for antipsychotic-induced tardive dyskinesia.
[So] Source:Cochrane Database Syst Rev;1:CD000205, 2018 01 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tardive dyskinesia (TD) is a disfiguring movement disorder, often of the orofacial region, frequently caused by using antipsychotic drugs. A wide range of strategies have been used to help manage TD, and for those who are unable to have their antipsychotic medication stopped or substantially changed, the benzodiazepine group of drugs have been suggested as a useful adjunctive treatment. However, benzodiazepines are very addictive. OBJECTIVES: To determine the effects of benzodiazepines for antipsychotic-induced tardive dyskinesia in people with schizophrenia, schizoaffective disorder, or other chronic mental illnesses. SEARCH METHODS: On 17 July 2015 and 26 April 2017, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (including trial registers), inspected references of all identified studies for further trials and contacted authors of each included trial for additional information. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) focusing on people with schizophrenia (or other chronic mental illnesses) and antipsychotic-induced TD that compared benzodiazepines with placebo, no intervention, or any other intervention for the treatment of TD. DATA COLLECTION AND ANALYSIS: We independently extracted data from the included studies and ensured that they were reliably selected, and quality assessed. For homogenous dichotomous data, we calculated random effects, risk ratio (RR), and 95% confidence intervals (CI). We synthesised continuous data from valid scales using mean differences (MD). For continuous outcomes, we preferred endpoint data to change data. We assumed that people who left early had no improvement. MAIN RESULTS: The review now includes four trials (total 75 people, one additional trial since 2006, 21 people) randomising inpatients and outpatients in China and the USA. Risk of bias was mostly unclear as reporting was poor. We are uncertain about all the effects as all evidence was graded at very low quality. We found no significant difference between benzodiazepines and placebo for the outcome of 'no clinically important improvement in TD' (2 RCTs, 32 people, RR 1.12, 95% CI 0.60 to 2.09, very low quality evidence). Significantly fewer participants allocated to clonazepam compared with phenobarbital (as active placebo) experienced no clinically important improvement (RR 0.44, 95% CI 0.20 to 0.96, 1 RCT, 21 people, very low quality evidence). For the outcome 'deterioration of TD symptoms,' we found no clear difference between benzodiazepines and placebo (2 RCTs, 30 people, RR 1.48, 95% CI 0.22 to 9.82, very low quality evidence). All 10 participants allocated to benzodiazepines experienced any adverse event compared with 7/11 allocated to phenobarbital (RR 1.53, 95% CI 0.97 to 2.41, 1 RCT, 21 people, very low quality evidence). There was no clear difference in the incidence of participants leaving the study early for benzodiazepines compared with placebo (3 RCTs, 56 people, RR 2.73, 95% CI 0.15 to 48.04, very low quality evidence) or compared with phenobarbital (as active placebo) (no events, 1 RCT, 21 people, very low quality evidence). No trials reported on social confidence, social inclusion, social networks, or personalised quality of life, which are outcomes designated important by patients. No trials comparing benzodiazepines with placebo or treatment as usual reported on adverse effects. AUTHORS' CONCLUSIONS: There is only evidence of very low quality from a few small and poorly reported trials on the effect of benzodiazepines as an adjunctive treatment for antipsychotic-induced TD. These inconclusive results mean routine clinical use is not indicated and these treatments remain experimental. New and better trials are indicated in this under-researched area; however, as benzodiazepines are addictive, we feel that other techniques or medications should be adequately evaluated before benzodiazepines are chosen.
[Mh] Termos MeSH primário: Ansiolíticos/uso terapêutico
Benzodiazepinas/uso terapêutico
Discinesia Induzida por Medicamentos/tratamento farmacológico
Moduladores GABAérgicos/uso terapêutico
[Mh] Termos MeSH secundário: Antipsicóticos/efeitos adversos
Clonazepam/uso terapêutico
Discinesia Induzida por Medicamentos/etiologia
Seres Humanos
Fenobarbital/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Anxiety Agents); 0 (Antipsychotic Agents); 0 (GABA Modulators); 12794-10-4 (Benzodiazepines); 5PE9FDE8GB (Clonazepam); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000205.pub3


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[PMID]:28899330
[Au] Autor:Matar E; Lewis SJ
[Ad] Endereço:Brain and Mind Centre, University of Sydney, Sydney, NSW simon.lewis@sydney.edu.au.
[Ti] Título:REM sleep behaviour disorder: not just a bad dream.
[So] Source:Med J Aust;207(6):262-268, 2017 Sep 18.
[Is] ISSN:1326-5377
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterised by the loss of the normal atonia during the REM stage of sleep, resulting in overt motor behaviours that usually represent the enactment of dreams. Patients will seek medical attention due to sleep-related injuries or unpleasant dream content. Idiopathic RBD which occurs independently of any other disease occurs in up to 2% of the older population. Meanwhile, secondary RBD is very common in association with certain neurodegenerative conditions. RBD can also occur in the context of antidepressant use, obstructive sleep apnoea and narcolepsy. RBD can be diagnosed with a simple screening question followed by confirmation with polysomnography to exclude potential mimics. Treatment for RBD is effective and involves treatment of underlying causes, modification of the sleep environment, and pharmacotherapy with either clonazepam or melatonin. An important finding in the past decade is the recognition that almost all patients with idiopathic RBD will ultimately go on to develop Parkinson disease or dementia with Lewy bodies. This suggests that idiopathic RBD represents a prodromal phase of these conditions. Physicians should be aware of the risk of phenoconversion. They should educate idiopathic RBD patients to recognise the symptoms of these conditions and refer as appropriate for further testing and enrolment into research trials focused on neuroprotective measures.
[Mh] Termos MeSH primário: Transtorno do Comportamento do Sono REM/diagnóstico
[Mh] Termos MeSH secundário: Clonazepam/uso terapêutico
Seres Humanos
Hipnóticos e Sedativos/uso terapêutico
Melatonina/uso terapêutico
Polissonografia
Transtorno do Comportamento do Sono REM/tratamento farmacológico
Transtorno do Comportamento do Sono REM/etiologia
Transtorno do Comportamento do Sono REM/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 5PE9FDE8GB (Clonazepam); JL5DK93RCL (Melatonin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE


  4 / 2421 MEDLINE  
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[PMID]:28763499
[Au] Autor:Andrade PHS; Lobo IMF; da Silva WB
[Ad] Endereço:Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil.
[Ti] Título:Risk factors for adverse drug reactions in pediatric inpatients: A cohort study.
[So] Source:PLoS One;12(8):e0182327, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The present study aims to identify the risk factors for adverse drug reactions (ADR) in pediatric inpatients. METHODS: A prospective cohort study in one general pediatric ward in a hospital in Northeast Brazil was conducted in two stages: the first stage was conducted between August 17th and November 6th, 2015, and the second one between March 1st and August 25th, 2016. We included children aged 0-14 years 11 months hospitalized with a minimum stay of 48 hours. Observed outcomes were the ADR occurrence and the time until the first ADR observed. In the univariate analysis, the time to the first ADR was compared among groups using a log-rank test. For the multivariate analysis, the Cox regression model was used. RESULTS: A total of 173 children (208 admissions) and 66 ADR classified as "definite" and "probable" were identified. The incidence rate was 3/100 patient days. The gastro-intestinal system disorders were the main ADR observed (28.8%). In addition, 22.7% of the ADR were related to antibacterials for systemic use and 15.2% to general anesthesia. Prior history of ADR of the child [hazard ratio (HR) 2.44; 95% confidence interval (CI) 1.19-5.00], the use of meglumine antimonate (HR 4.98; 95% CI 1.21-20.54), antibacterial for systemic use (HR 2.75; 95% CI 1.08-6.98) and antiepileptic drugs (HR 3.84; 95% CI 1.40-10.56) were identified risk factors for ADR. CONCLUSIONS: We identified as risk factors the prior history of ADR of the child and the use of meglumine antimonate, antibacterial for systemic use and antiepileptic drugs.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Anticonvulsivantes/efeitos adversos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
Meglumina/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Sistemas de Notificação de Reações Adversas a Medicamentos
Anestesia Geral
Brasil
Criança
Pré-Escolar
Clonazepam/efeitos adversos
Estudos de Coortes
Fibrose Cística/tratamento farmacológico
Dipirona/efeitos adversos
Feminino
Gastroenteropatias/complicações
Gastroenteropatias/tratamento farmacológico
Hospitalização
Hospitais Pediátricos
Seres Humanos
Lactente
Recém-Nascido
Pacientes Internados
Masculino
Omeprazol/efeitos adversos
Pediatria
Projetos Piloto
Modelos de Riscos Proporcionais
Análise de Regressão
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anticonvulsants); 5PE9FDE8GB (Clonazepam); 6429L0L52Y (Dipyrone); 6HG8UB2MUY (Meglumine); KG60484QX9 (Omeprazole)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182327


  5 / 2421 MEDLINE  
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[PMID]:28637937
[Au] Autor:Tsuboguchi S; Wakasugi T; Umeda Y; Umeda M; Oyake M; Fujita N
[Ad] Endereço:Department of Neurology, Nagaoka Red Cross Hospital.
[Ti] Título:Herpes simplex encephalitis presenting as stroke-like symptoms with atypical MRI findings and lacking cerebrospinal fluid pleocytosis.
[So] Source:Rinsho Shinkeigaku;57(7):387-390, 2017 07 29.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 73-year-old woman presented with sudden onset of right hemiparesis and was diagnosed as having cerebral infarction on the basis of diffusion-weighted brain MRI, which demonstrated lesions in the left parietal cortex. On the 3rd day, the patient developed right upper limb myoclonus, aphasia, and disturbance of consciousness with high fever. On the 6th day, she was transferred to our hospital with suspected viral encephalitis, and treatment with acyclovir was started. By the 6th day, the lesions detected by MRI had expanded to the gyrus cinguli, insula and thalamus, but not to the temporal lobe. At that time, the CSF cell count was 8/µl, and this later increased to 17/µl by the 13th day. Although herpes simplex virus DNA was detected in the CSF on the 6th day, there was no evidence of CSF pleocytosis or temporal lobe abnormalities demonstrable by brain MRI throughout the whole follow-up period. This was very atypical case of herpes simplex encephalitis characterized by a stroke-like episode, atypical MRI findings, and absence of cerebrospinal fluid pleocytosis. It is important to be mindful that herpes simplex encephalitis (HSE) can have an atypical presentation, and that sufficient acyclovir treatment should be initiated until HSE can be ruled out.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Encefalite por Herpes Simples/complicações
Encefalite por Herpes Simples/diagnóstico por imagem
Imagem por Ressonância Magnética
Neuroimagem
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/etiologia
[Mh] Termos MeSH secundário: Aciclovir/administração & dosagem
Idoso
Antivirais/administração & dosagem
Biomarcadores/líquido cefalorraquidiano
Clonazepam/administração & dosagem
DNA Viral/líquido cefalorraquidiano
Quimioterapia Combinada
Encefalite por Herpes Simples/líquido cefalorraquidiano
Encefalite por Herpes Simples/tratamento farmacológico
Feminino
Seres Humanos
Leucocitose/líquido cefalorraquidiano
Metilprednisolona/administração & dosagem
Piracetam/administração & dosagem
Piracetam/análogos & derivados
Simplexvirus/genética
Acidente Vascular Cerebral/líquido cefalorraquidiano
Acidente Vascular Cerebral/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiviral Agents); 0 (Biomarkers); 0 (DNA, Viral); 230447L0GL (etiracetam); 5PE9FDE8GB (Clonazepam); X4HES1O11F (Acyclovir); X4W7ZR7023 (Methylprednisolone); ZH516LNZ10 (Piracetam)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001033


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[PMID]:28482056
[Au] Autor:Ferri R; Rundo F; Silvani A; Zucconi M; Bruni O; Ferini-Strambi L; Plazzi G; Manconi M
[Ad] Endereço:Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.
[Ti] Título:REM Sleep EEG Instability in REM Sleep Behavior Disorder and Clonazepam Effects.
[So] Source:Sleep;40(8), 2017 Aug 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Study Objectives: We aimed to analyze quantitatively rapid eye movement (REM) sleep electroencephalogram (EEG) in controls, drug-naïve idiopathic REM sleep behavior disorder patients (iRBD), and iRBD patients treated with clonazepam. Methods: Twenty-nine drug-naïve iRBD patients (mean age 68.2 years), 14 iRBD patients under chronic clonazepam therapy (mean age 66.3 years), and 21 controls (mean age 66.8 years) were recruited. Power spectra were obtained from sleep EEG (central derivation), using a 2-second sliding window, with 1-second steps. The power values of each REM sleep EEG spectral band (one every second) were normalized with respect to the average power value obtained during sleep stage 2 in the same individual. Results: In drug-naïve patients, the normalized power values showed a less pronounced REM-related decrease of power in all bands with frequency <15 Hz than controls and an increase in the beta band, negatively correlated with muscle atonia; in patients treated with clonazepam there was a partial return of all bands <15 Hz toward the control values. The standard deviation values of the normalized power were higher for untreated patients in all EEG bands and were almost completely normalized in patients treated with clonazepam. Conclusions: The REM sleep EEG structure changes found in this study disclose subtle but significant alterations in the cortical electrophysiology of RBD that might represent the early expression of the supposed neurodegenerative processes already taking place at this stage of the disease and might be the target of better and effective future therapeutic strategies for this condition.
[Mh] Termos MeSH primário: Clonazepam/uso terapêutico
Transtorno do Comportamento do Sono REM/tratamento farmacológico
Transtorno do Comportamento do Sono REM/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Clonazepam/farmacologia
Eletroencefalografia
Feminino
Seres Humanos
Masculino
Polissonografia
Estudos Retrospectivos
Sono REM/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
5PE9FDE8GB (Clonazepam)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx080


  7 / 2421 MEDLINE  
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[PMID]:28427112
[Au] Autor:Setlakwe EL; Johnson AL
[Ad] Endereço:Department of Clinical Studies-New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, 19348.
[Ti] Título:Acute encephalopathy in a 2-year-old pot-bellied pig following accidental intoxication with clonazepam.
[So] Source:J Vet Emerg Crit Care (San Antonio);27(3):369-372, 2017 May.
[Is] ISSN:1476-4431
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe a case of successful management of clonazepam toxicity causing encephalopathy in a pot-bellied pig. CASE SUMMARY: A 2-year-old female pot-bellied pig weighing 13.5 kg was presented for evaluation of clinical signs of acute encephalopathy. Based on the animal's history and clinical signs, a tentative diagnosis of benzodiazepine (BZP) intoxication was made. The results of a urinary drug screening test designed to detect illicit substances in human urine indicated benzodiazepine exposure. Gas chromatography and mass spectrometry analysis later confirmed clonazepam (urinary concentration 496 ng/mL) as the intoxicating substance. The pig responded favorably to treatment which included administration of flumazenil, decontamination with enteral activated charcoal, and intravenous isotonic crystalloid administration. The pig had a rapid improvement in mentation 10 minutes following IV flumazenil administration and was considered mentally appropriate following 24 hours of hospitalization. The pig was discharged from the hospital after 48 hours of care, and was reported to be doing well 6 months later. NEW INFORMATION PROVIDED: Intoxication with prescription benzodiazepines can occur in companion animals and result in clinical signs of acute encephalopathy. Urinary drug screening tests designed for human use may provide rapid results to indicate drug intoxication and guide therapeutic intervention in veterinary species. Administration of flumazenil resulted in a rapid improvement in mentation following clonazepam intoxication in a pot-bellied pig.
[Mh] Termos MeSH primário: Encefalopatia Aguda Febril/veterinária
Clonazepam/toxicidade
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/veterinária
Doenças dos Suínos/diagnóstico
[Mh] Termos MeSH secundário: Encefalopatia Aguda Febril/diagnóstico
Encefalopatia Aguda Febril/fisiopatologia
Animais
Antídotos/uso terapêutico
Diagnóstico Diferencial
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia
Emergências/veterinária
Feminino
Flumazenil/uso terapêutico
Infusões Intravenosas/veterinária
Suínos
Doenças dos Suínos/fisiopatologia
Doenças dos Suínos/urina
Porco Miniatura
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Antidotes); 40P7XK9392 (Flumazenil); 5PE9FDE8GB (Clonazepam)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170421
[St] Status:MEDLINE
[do] DOI:10.1111/vec.12602


  8 / 2421 MEDLINE  
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[PMID]:28357703
[Au] Autor:Mitsikostas DD; Ljubisavljevic S; Deligianni CI
[Ad] Endereço:Aeginition Hospital, National & Kapodistrian University of Athens, Athens, Greece. dimosmitsikostas@me.com.
[Ti] Título:Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbiities, treatment and outcome.
[So] Source:J Headache Pain;18(1):40, 2017 Dec.
[Is] ISSN:1129-2377
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent intraoral burning without related objective findings and unknown etiology that affects elderly females mostly. There is no satisfactory treatment for BMS. We aimed to observe the long-term efficacy of high velanfaxine doses combined with systemic and topical administered clonazepam in a particular subgroup of BMS patients who do not respond to current clinical management. RESULTS: Eight (66.1 ± 6.2 years old females) out of 14 BMS patients fulfilled the inclusion criteria and were treated with venlafaxine (300 mg/d) and clonazepam (5 mg/d) for 35.4 ± 12.1 (mean ± SD) months. The average duration of the symptoms at baseline was 4.3 ± 1.4 years and the overall mean daily pain intensity score was 8.6 ± 1.3 (VAS); pain was in tongue and within the oral mucosa, accompanying by oral and facial dysesthesia. In five patients tasting was abnormal. All patients had positive history of concomitant primary headache. The average score of Hamilton Rating scale for Anxiety and Depression was 21 ± 4.2, and 26.1 ± 2.9, respectively. Previous ineffective treatments include anticonvulsants and anti-depressants. All patients responded (more than 50% decrease in VAS) after three months treatment (mean VAS 3.2 ± 2.2) with no remarkable adverse events. CONCLUSION: BMS deserves bottomless psychiatric evaluation and management when current available treatments fail. Treatment with venlafaxine combined with topical and systemic clonazepam may be effective in refractory BMS cases but further investigation in a large-scale controlled study is needed to confirm these results.
[Mh] Termos MeSH primário: Síndrome da Ardência Bucal/diagnóstico por imagem
Síndrome da Ardência Bucal/tratamento farmacológico
Dor Crônica/diagnóstico por imagem
Dor Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Anticonvulsivantes/uso terapêutico
Ansiedade/diagnóstico por imagem
Ansiedade/tratamento farmacológico
Ansiedade/epidemiologia
Síndrome da Ardência Bucal/epidemiologia
Doença Crônica
Dor Crônica/epidemiologia
Clonazepam/uso terapêutico
Comorbidade
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 5PE9FDE8GB (Clonazepam)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170331
[St] Status:MEDLINE
[do] DOI:10.1186/s10194-017-0745-y


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[PMID]:28202297
[Au] Autor:Lin CJ; Huang P
[Ad] Endereço:Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
[Ti] Título:Delayed onset diabetic striatopathy: Hemichorea-hemiballism one month after a hyperglycemic episode.
[So] Source:Am J Emerg Med;35(7):1036.e3-1036.e4, 2017 Jul.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Diabetic striatopathy is an uncommon and life threatening manifestation of diabetes mellitus. It has a tendency to occur in the elderly, female and people of Asian descent. Patients usually present with hemichorea-hemiballism caused by non-ketotic hyperglycemia. However, patients could develop diabetic striatopathy weeks after the hyperglycemic event, even when blood sugar has been well controlled. Herein, we report a case of delayed onset diabetic striatopathy and discuss the importance of detailed history and brain magnetic resonance imaging for making prompt and accurate diagnosis.
[Mh] Termos MeSH primário: Antidiscinéticos/uso terapêutico
Anticonvulsivantes/uso terapêutico
Clonazepam/uso terapêutico
Complicações do Diabetes/fisiopatologia
Discinesias/fisiopatologia
Haloperidol/uso terapêutico
Hiperglicemia/fisiopatologia
Imagem por Ressonância Magnética
[Mh] Termos MeSH secundário: Idoso
Complicações do Diabetes/diagnóstico por imagem
Complicações do Diabetes/tratamento farmacológico
Diagnóstico Diferencial
Discinesias/diagnóstico por imagem
Discinesias/etiologia
Seres Humanos
Hiperglicemia/complicações
Hiperglicemia/tratamento farmacológico
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Dyskinesia Agents); 0 (Anticonvulsants); 5PE9FDE8GB (Clonazepam); J6292F8L3D (Haloperidol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE


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[PMID]:28132976
[Au] Autor:Shimohata T; Inoue Y; Hirata K
[Ad] Endereço:Department of Neurology, Brain Research Institute, Niigata University.
[Ti] Título:Diagnosis, disease notification, and management of rapid eye movement (REM) sleep behavior disorder.
[So] Source:Rinsho Shinkeigaku;57(2):63-70, 2017 02 25.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment behavior during REM sleep. It has been demonstrated that patients with idiopathic RBD are at a significantly increased risk of developing one of the α-synucleinopathies later in life, and this is called "phenoconversion". Although some physicians argue against disclosing information that could cause patients psychological stress, the patients also have a "right to know" about their own disease. Therefore, determining when and how to disclose this information, in addition to appropriate follow-up, is important. Clonazepam is the first choice of treatment for RBD associated with α-synucleinopathies. Since RBD is one of the premotor symptoms of α-synucleinopathies, and enables its early diagnosis, a combination of RBD and other examinations may contribute to the realization of a disease-modifying therapy. It is hoped that the early establishment of biomarkers could help predict the phenoconversion from RBD to α-synucleinopathies.
[Mh] Termos MeSH primário: Transtorno do Comportamento do Sono REM/diagnóstico
Transtorno do Comportamento do Sono REM/terapia
[Mh] Termos MeSH secundário: Clonazepam/uso terapêutico
Diagnóstico Diferencial
Seres Humanos
Doenças Neurodegenerativas/diagnóstico
Doenças Neurodegenerativas/etiologia
Doenças Neurodegenerativas/metabolismo
Doenças Neurodegenerativas/terapia
Transtorno do Comportamento do Sono REM/etiologia
Transtorno do Comportamento do Sono REM/psicologia
Estresse Psicológico
Revelação da Verdade
alfa-Sinucleína/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (alpha-Synuclein); 5PE9FDE8GB (Clonazepam)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170131
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-000961



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