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[PMID]:29369202
[Au] Autor:Ju Y; Tian D; Tan Y; Fu Z
[Ad] Endereço:Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Shandong China.
[Ti] Título:Palliative care with cervical intrathecal infusion and external pump for a late-stage cancer patient with refractory pain: A case report.
[So] Source:Medicine (Baltimore);97(4):e9714, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Intrathecal therapy, with a low complication rate, has become an alternative to standard pain management for treatment of neuropathic cancer pain. PATIENT CONCERNS: Here, we reported a late-stage cancer patient with intractable neuropathic pain in his right neck, shoulder, and upper limb. DIAGNOSES: The pain started 2 years ago when the patient was diagnosed as squamous cell carcinoma with metastasis to right supraclavicular lymph nodes. INTERVENTIONS: Cervical intrathecal infusion of morphine and bupivacaine with patient control analgesia by external pump was performed. The intrathecal catheter was located at the level of C6 vertebra. The initial concentration of bupivacaine and morphine were both 1 mg/mL with infusion rate of 0.3 mL/h and bolus of 0.3 mL. Subsequently, the concentrations increased to 2 mg/mL (bupivacaine) and 1.33 mg/mL (morphine), with infusion rate to 0.6 mL/h and bolus to 0.5 ml. OUTCOMES: The pain intensity decreased from numerical rating scale 6 to 7 to 2 to 3 at rest, and from 10 to 5 to 6 of breakthrough pain. LESSONS: In conclusion, cervical intrathecal infusion requires low concentration but high doses of bupivacaine and morphine, which is safe and effective in cancer patients with refractory pain and short life expectancy.
[Mh] Termos MeSH primário: Infusão Espinal/métodos
Neuralgia/tratamento farmacológico
Manejo da Dor/métodos
Dor Intratável/tratamento farmacológico
Cuidados Paliativos/métodos
[Mh] Termos MeSH secundário: Idoso
Analgesia Controlada pelo Paciente/métodos
Analgésicos Opioides/administração & dosagem
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Carcinoma de Células Escamosas/complicações
Carcinoma de Células Escamosas/secundário
Vértebras Cervicais
Seres Humanos
Masculino
Morfina/administração & dosagem
Neoplasias Primárias Desconhecidas/complicações
Neuralgia/etiologia
Dor Intratável/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 76I7G6D29C (Morphine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009714


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[PMID]:28448392
[Au] Autor:Choi EJ; Yoo YJ; Lee PB; Kim YC; Lee SC; Moon JY
[Ad] Endereço:From the *Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital College of Medicine, Sungnam-si, Gyonggi-do, Republic of Korea; and †Integrated Cancer Management Center, Seoul National University Cancer Hospital, Seoul, Republic of Korea.
[Ti] Título:A Retrospective Study to Evaluate the Effect of Concentration of Hypertonic Saline on Efficacy and Safety of Epidural Adhesiolysis.
[So] Source:Anesth Analg;124(6):2021-2029, 2017 06.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Percutaneous epidural adhesiolysis (PEA) is a minimally invasive procedure that is performed to relieve low back and/or lower limb pain secondary to adhesions or scarring in the epidural space that is refractory to conservative treatment. The optimal concentration of hypertonic saline might be an important factor in the safety and efficacy of PEA. We evaluated differences in the efficacy and safety of 2 concentrations of hypertonic saline (5% and 10%) used in lumbar PEA at our institutions in a retrospective study. METHODS: Patients who received lumbar PEA between January 2009 and June 2014 at either of 2 large civilian teaching institutions in South Korea were assigned to the 5% or 10% groups according to the osmolality of saline. The primary outcome of this study was the difference in change in the 11-point numerical rating scale (NRS) scores of low back and leg pain from baseline to 6 months after PEA between patients in the 2 groups. The number of additional epidural injections, patients' satisfaction with PEA, and any complications that occurred within 6 months after PEA were reviewed. RESULTS: This study included 543 patients (5% group, 333; 10% group, 210). Post-PEA NRS pain scores were significantly lower compared with those at baseline in both groups; however, there were no significant differences between the 2 groups at 6 months or any time point after PEA with regard to any of the clinical characteristics, except infusion-related pain, which exhibited borderline significance for greater scores in the 10% group compared with those in the 5% group (P = .041). Multivariable linear regression analysis with adjustments for covariates, including the number of additional epidural injections, revealed no significant association between patient group and the decrease in NRS pain scores at 6 months of follow-up. Transient adverse events related to PEA were recorded in 3 patients (10% group, 2; 5% group, 1). CONCLUSIONS: In PEA, 5% hypertonic saline exhibited similar positive outcomes after 6 months of follow-up as 10% hypertonic saline, with less infusion-related pain. This result suggests that infusion of 5% hypertonic saline may be considered as an alternative to 10% hypertonic saline in lumbar PEA. Further prospective randomized studies are required to better appreciate the outcome with regard to the use of different concentrations of hypertonic saline for PEA.
[Mh] Termos MeSH primário: Dor Lombar/terapia
Vértebras Lombares/fisiopatologia
Procedimentos Ortopédicos/métodos
Solução Salina Hipertônica/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Distribuição de Qui-Quadrado
Cicatriz/complicações
Feminino
Seres Humanos
Infusão Espinal
Modelos Lineares
Dor Lombar/diagnóstico
Dor Lombar/etiologia
Dor Lombar/fisiopatologia
Masculino
Meia-Idade
Análise Multivariada
Procedimentos Ortopédicos/efeitos adversos
Concentração Osmolar
Medição da Dor
República da Coreia
Estudos Retrospectivos
Solução Salina Hipertônica/efeitos adversos
Fatores de Tempo
Aderências Teciduais
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Saline Solution, Hypertonic)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000001925


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[PMID]:28431428
[Au] Autor:Tangen KM; Leval R; Mehta AI; Linninger AA
[Ad] Endereço:From the Departments of *Bioengineering; and †Neurosurgery, University of Illinois at Chicago, Chicago, Illinois.
[Ti] Título:Computational and In Vitro Experimental Investigation of Intrathecal Drug Distribution: Parametric Study of the Effect of Injection Volume, Cerebrospinal Fluid Pulsatility, and Drug Uptake.
[So] Source:Anesth Analg;124(5):1686-1696, 2017 May.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters. The goal of this study is to demonstrate current computational capabilities to predict drug biodistribution while varying 3 parameters: (1) infusion settings, (2) drug chemistry, and (3) subject-specific anatomy and cerebrospinal fluid dynamics. We will discuss strategies to systematically optimize these 3 parameters to administer drug molecules to targeted tissue locations in the central nervous system. METHODS: We acquired anatomical data from magnetic resonance imaging (MRI) and velocity measurements in the spinal cerebrospinal fluid with CINE-MRI for 2 subjects. A bench-top surrogate of the subject-specific central nervous system was constructed to match measured anatomical dimensions and volumes. We generated a computational mesh for the bench-top model. Idealized simulations of tracer distribution were compared with bench-top measurements for validation. Using reconstructions from MRI data, we also introduced a subject-specific computer model for predicting drug spread for the human volunteer. RESULTS: MRI velocity measurements at 3 spinal regions of interest reasonably matched the simulated flow fields in a subject-specific computer mesh. Comparison between the idealized spine computations and bench-top tracer distribution experiments demonstrate agreement of our drug transport predictions to this physical model. Simulated multibolus drug infusion theoretically localizes drug to the cervical and thoracic region. Continuous drug pump and single bolus injection were successful to target the lumbar spine in the simulations. The parenchyma might be targeted suitably by multiple boluses followed by a flush infusion. We present potential guidelines that take into account drug specific kinetics for tissue uptake, which influence the speed of drug dispersion in the model and potentially influence tissue targeting. CONCLUSIONS: We present potential guidelines considering drug-specific kinetics of tissue uptake, which determine the speed of drug dispersion and influence tissue targeting. However, there are limitations to this analysis in that the parameters were obtained from an idealized healthy patient in a supine position. The proposed methodology could assist physicians to select clinical infusion parameters for their patients and provide guidance to optimize treatment algorithms. In silico optimization of intrathecal drug delivery therapies presents the first steps toward a possible care paradigm in the future that is specific to personalized patient anatomy and diseases.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/farmacocinética
Sistema Nervoso Central/metabolismo
Simulação por Computador
Modelos Anatômicos
Fluxo Pulsátil
[Mh] Termos MeSH secundário: Adulto
Analgésicos Opioides/líquido cefalorraquidiano
Sistema Nervoso Central/anatomia & histologia
Seres Humanos
Bombas de Infusão
Infusão Espinal
Imagem Cinética por Ressonância Magnética
Masculino
Modelagem Computacional Específica para o Paciente
Distribuição Tecidual
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170703
[Lr] Data última revisão:
170703
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002011


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[PMID]:28291215
[Au] Autor:Paskhin DL; Dekopov AV; Tomsky AA; Isagulyan ED; Salova EM
[Ad] Endereço:Burdenko Neurosurgical Institute, Moscow, Russia.
[Ti] Título:[Complications of intrathecal baclofen therapy].
[Ti] Título:Oslozhneniya intratekal'noi terapii baklofenom..
[So] Source:Zh Vopr Neirokhir Im N N Burdenko;81(1):63-69, 2017.
[Is] ISSN:0042-8817
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To analyze complications of intrathecal baclofen therapy and identify high-risk groups. MATERIAL AND METHODS: We implanted 52 pumps to spastic patients for chronic intrathecal baclofen infusion. Two groups of patients were distinguished: 23 patients with spinal spasticity (group 1) and 29 patients with cerebral spasticity (group 2). The mean patient age was 37.2±14.6 years in group 1 and 17.3±10.3 years in group 2. Surgery was performed according to a standard procedure. A Medstream (Codman) pump was implanted in 10 cases, and a Synchromed II (Medtronic) pump was implanted in the remaining 42 cases. RESULTS AND DISCUSSION: Complications developed in 12 (23%) patients. We divided complications into 3 groups: baclofen underdose, baclofen overdose, and others. Insufficiency of intrathecal therapy was observed in 7 cases, which was caused by catheter migration (5 cases) and pump dysfunction (2 cases). In one case, baclofen overdose was observed after air travel. Other complications included 4 cases of persistent peri-implant seroma and infectious complications. Groups with a high risk of complications were identified based on an analysis of the results. Patients with severe dystonia of the trunk muscles have an increased risk of spinal catheter migration. Pronounced communicating hydrocephalus is associated with the risk of cerebrospinal fluid leak through a catheter shaft channel. Weakness of the axial musculature can lead to progression of scoliotic deformity. CONCLUSION: In some cases, chronic intrathecal baclofen therapy can be accompanied by various complications. This technique should be carefully used in patients from high-risk groups.
[Mh] Termos MeSH primário: Baclofeno/administração & dosagem
Baclofeno/efeitos adversos
Encefalopatias/terapia
Infusão Espinal/efeitos adversos
Estenose Espinal/terapia
[Mh] Termos MeSH secundário: Adulto
Infecções do Sistema Nervoso Central/induzido quimicamente
Feminino
Seres Humanos
Masculino
Meia-Idade
Seroma/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
H789N3FKE8 (Baclofen)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE
[do] DOI:10.17116/neiro201780763-69


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[PMID]:28219590
[Au] Autor:Mistry K; Hutchins J; Leiting J; Mangalick K; Pruett T; Chinnakotla S
[Ad] Endereço:Division of Transplantation, Department of Surgery, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
[Ti] Título:Continuous Paravertebral Infusions as an Effective Adjunct for Postoperative Pain Management in Living Liver Donors: A Retrospective Observational Study.
[So] Source:Transplant Proc;49(2):309-315, 2017 Mar.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We analyzed the effectiveness of paravertebral-block for immediate postoperative pain control in living liver donors. Specifically, we sought to determine whether or not the addition of paravertebral catheters with continuous ropivacaine infusion would decrease postoperative opioid use and reduce the incidence of adverse effects and complications. We reviewed the records of 26 patients who underwent right-lobe living donor hepatectomy (RLDH): 16 with and 10 without such catheters. The primary outcome was opioid use on postoperative day (POD) 1 through 3. For each of those 3 days, we calculated each patient's opioid use in morphine equivalents (mg). We also noted pain scores, adverse effects, and complications. The rate of decrease in morphine equivalents was higher in the catheter group (rate of change = -22.72; P = .038) for POD 1 (0-24 hours) and POD 2 (25-48 hours) than in the noncatheter group. For POD 2 alone, the catheter group used, on average, 20.98 mg fewer morphine equivalents than the noncatheter group (P = .023). The catheter group had a markedly reduced pain trajectory postoperatively (P = .014) than the noncatheter group. The catheter placement procedure itself was safe.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Anestésicos Locais/administração & dosagem
Transplante de Fígado/métodos
Doadores Vivos
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Analgésicos Opioides/administração & dosagem
Cateterismo Periférico
Feminino
Hepatectomia/métodos
Seres Humanos
Infusão Espinal
Fígado/cirurgia
Transplante de Fígado/efeitos adversos
Masculino
Morfina/administração & dosagem
Bloqueio Nervoso/métodos
Medição da Dor
Dor Pós-Operatória/etiologia
Estudos Retrospectivos
Sítio Doador de Transplante/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Amides); 0 (Analgesics, Opioid); 0 (Anesthetics, Local); 76I7G6D29C (Morphine); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE


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[PMID]:28195861
[Au] Autor:Patel S; Hafez O; Sexton WJ; Edwards DA
[Ad] Endereço:From the Departments of *Anesthesiology and †Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida; and ‡Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee.
[Ti] Título:Perioperative Management of a Patient With an Intrathecal Drug Delivery Device Infusing Ziconotide: A Case Report.
[So] Source:A A Case Rep;8(4):78-80, 2017 Feb 15.
[Is] ISSN:2325-7237
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug delivery device infusing ziconotide in a patient presenting for radical cystectomy with pelvic lymphadenectomy and ileal conduit diversion.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/administração & dosagem
Anestesia Geral/métodos
Carcinoma de Células de Transição/cirurgia
Complicações Intraoperatórias/prevenção & controle
Dor Lombar/tratamento farmacológico
Neoplasias da Bexiga Urinária/cirurgia
Vasoplegia/prevenção & controle
ômega-Conotoxinas/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Dor Crônica/tratamento farmacológico
Cistectomia
Desprescrições
Seres Humanos
Bombas de Infusão Implantáveis
Infusão Espinal
Excisão de Linfonodo
Masculino
Pelve
Assistência Perioperatória/métodos
Derivação Urinária
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (omega-Conotoxins); 7I64C51O16 (ziconotide)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1213/XAA.0000000000000432


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[PMID]:28089835
[Au] Autor:Raneri F; Zella MAS; Di Cristofori A; Zarino B; Pluderi M; Spagnoli D
[Ad] Endereço:Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy; Department of Neurosurgery, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: fabran@gmail.com.
[Ti] Título:Supplementary Tests in Idiopathic Normal Pressure Hydrocephalus: A Single-Center Experience with a Combined Lumbar Infusion Test and Tap Test.
[So] Source:World Neurosurg;100:567-574, 2017 Apr.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The lumbar infusion test (LIT) and tap test (TT) have previously been described for the diagnosis and selection of appropriate surgical candidates in idiopathic normal pressure hydrocephalus (iNPH). METHODS: We retrospectively reviewed 81 consecutive patients with a clinical diagnosis of iNPH selected for supplementary testing. Clinical evaluation was scored with the Japanese Grading Scale for Normal Pressure Hydrocephalus, the Global Deterioration Score, and the modified Rankin Scale (mRS). The test protocol included a cerebrospinal fluid pressure monitoring (PMi), an LIT, and a TT. Patients were selected for surgery if outflow resistance was ≥14 mm Hg/mL/minute or if a clinical improvement was recorded after TT. RESULTS: Sixty-eight patients were selected for ventriculoperitoneal shunting; 72.8% had a positive PMi or LIT, 74.1% had a positive TT, and 63.0% were positive to both tests. Complications were all transient. Clinical evaluation at 12 months after shunting showed a global improvement in 60 patients (88.2%). Overall, 75.0% of patients had no significant disability (mRS score, 1 and 2), 20.6% had an mRS score of 3 or 4, and 4.4% had severe disability after surgery. The positive predictive value of PMi/LIT, TT, or both combined was similar (89.8, 90.0, and 88.2%); however, 21.7% of patients who improved after surgery were selected with either a positive LIT or TT alone. CONCLUSIONS: LIT and TT are complementary and they can easily be combined in sequence with a low complication rate and high probability of selecting patients with iNPH who may benefit from ventriculoperitoneal shunt surgery.
[Mh] Termos MeSH primário: Derivações do Líquido Cefalorraquidiano/métodos
Hidrocefalia de Pressão Normal/diagnóstico
Hidrocefalia de Pressão Normal/terapia
Infusão Espinal/métodos
Manometria/métodos
Punção Espinal/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Seres Humanos
Meia-Idade
Seleção de Pacientes
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE


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[PMID]:27801773
[Au] Autor:How J; Blattner M; Fowler S; Wang-Gillam A; Schindler SE
[Ad] Endereço:*Barnes-Jewish Hospital †Becker Medical Library ‡Department of Medicine, Division of Oncology §Department of Neurology, Washington University School of Medicine, St Louis, MO.
[Ti] Título:Chemotherapy-associated Posterior Reversible Encephalopathy Syndrome: A Case Report and Review of the Literature.
[So] Source:Neurologist;21(6):112-117, 2016 Nov.
[Is] ISSN:2331-2637
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: There are increasing reports of posterior reversible encephalopathy syndrome (PRES) associated with the use of chemotherapeutic agents. Recognition of PRES is crucial given its reversibility with appropriate supportive management. We report a patient presenting with PRES after treatment with Rituximab, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone (R-CHOP) and intrathecal methotrexate. We also perform a systematic review of the literature on chemotherapy-associated PRES. CASE REPORT: A 72-year-old man with recently diagnosed diffuse large B-cell lymphoma became unresponsive 4 days after initiation of R-CHOP and intrathecal methotrexate. Brain magnetic resonance imaging showed interval development of occipital and temporal fluid attenuation inversion recovery hyperintensities consistent with PRES. The patient's blood pressure was aggressively controlled and he received 5 days of high-dose methylprednisone. He subsequently regained consciousness and his mental status gradually improved. Repeat magnetic resonance imaging showed interval resolution of the bilateral fluid attenuation inversion recovery hyperintensities. REVIEW SUMMARY: We performed a systematic review of the literature and included a total of 70 unique cases involving chemotherapy-associated PRES. Platinum-containing drugs, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone/R-CHOP regimens, and gemcitabine were the agents most commonly used in patients who developed suspected chemo-associated PRES. Median onset of symptoms occurred 8 days after chemotherapy. Hypertension was the most commonly reported risk factor associated with the development of chemotherapy-associated PRES. In most cases, PRES improved with supportive management alone within 2 weeks. CONCLUSIONS: Chemotherapy-associated PRES is an increasingly encountered syndrome. Both neurologists and non-neurologists should be familiar with the most commonly implicated agents, symptoms, risk factors, and clinical course of chemotherapy-associated PRES, given its favorable prognosis with appropriate management.
[Mh] Termos MeSH primário: Antimetabólitos Antineoplásicos/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Linfoma Difuso de Grandes Células B/tratamento farmacológico
Metotrexato/efeitos adversos
Síndrome da Leucoencefalopatia Posterior/induzido quimicamente
[Mh] Termos MeSH secundário: Idoso
Anticorpos Monoclonais Murinos/efeitos adversos
Encéfalo/diagnóstico por imagem
Ciclofosfamida/efeitos adversos
Doxorrubicina/efeitos adversos
Seres Humanos
Infusão Espinal
Imagem por Ressonância Magnética
Masculino
Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem
Prednisona/efeitos adversos
Vincristina/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Murine-Derived); 0 (Antimetabolites, Antineoplastic); 0 (R-CHOP protocol); 5J49Q6B70F (Vincristine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161102
[St] Status:MEDLINE


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[PMID]:27682809
[Au] Autor:Awuor SO; Kitei PM; Nawaz Y; Ahnert AM
[Ad] Endereço:a Penn State Hershey Medical Center, Heart and Vascular Center Institute , Hershey , PA , USA.
[Ti] Título:Intrathecal baclofen withdrawal: A rare cause of reversible cardiomyopathy.
[So] Source:Acute Card Care;18(1):13-17, 2016 Mar.
[Is] ISSN:1748-295X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Baclofen is commonly used to treat spasticity of central etiology. Unfortunately, a potentially lethal withdrawal syndrome can complicate its use. This is especially true when the drug is administered intrathecally. There are very few cases of baclofen withdrawal leading to reversible cardiomyopathy described in the literature. The authors present a patient with a history of chronic intrathecal baclofen use who, in the setting of acute baclofen withdrawal, develops laboratory, electrocardiogram, and echocardiogram abnormalities consistent with cardiomyopathy. Upon reinstitution of intrathecal baclofen, the cardiomyopathy and associated abnormalities quickly resolve. Although rare, it is crucial to be aware of this reversible cardiomyopathy to ensure its prompt diagnosis and treatment.
[Mh] Termos MeSH primário: Baclofeno
Cardiomiopatias
Bombas de Infusão Implantáveis/efeitos adversos
Balão Intra-Aórtico/métodos
Quadriplegia/tratamento farmacológico
Síndrome de Abstinência a Substâncias
[Mh] Termos MeSH secundário: Adulto
Baclofeno/administração & dosagem
Baclofeno/efeitos adversos
Cardiomiopatias/induzido quimicamente
Cardiomiopatias/diagnóstico
Cardiomiopatias/fisiopatologia
Cardiomiopatias/terapia
Cateterismo de Swan-Ganz/métodos
Angiografia Coronária/métodos
Ecocardiografia/métodos
Falha de Equipamento
Seres Humanos
Infusão Espinal/instrumentação
Infusão Espinal/métodos
Masculino
Relaxantes Musculares Centrais/administração & dosagem
Relaxantes Musculares Centrais/efeitos adversos
Síndrome de Abstinência a Substâncias/diagnóstico
Síndrome de Abstinência a Substâncias/etiologia
Síndrome de Abstinência a Substâncias/fisiopatologia
Síndrome de Abstinência a Substâncias/terapia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Muscle Relaxants, Central); H789N3FKE8 (Baclofen)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160930
[St] Status:MEDLINE
[do] DOI:10.3109/17482941.2016.1174273


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[PMID]:27622849
[Au] Autor:Levy J; De Brier G; Hugeron C; Lansaman T; Bensmail D
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, AP-HP, Raymond Poincaré University Hospital, Garches, France; Inserm, University of Versailles Saint-Quentin-en-Yvelines, UMR 1179, Montigny-le-Bretonneux, France. Electronic address: levyjonathan2@gmail.com.
[Ti] Título:Takotsubo cardiomyopathy as a reversible complication of intrathecal baclofen withdrawal.
[So] Source:Ann Phys Rehabil Med;59(5-6):340-342, 2016 Dec.
[Is] ISSN:1877-0665
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Baclofeno/administração & dosagem
Relaxantes Musculares Centrais/administração & dosagem
Paraplegia/tratamento farmacológico
Síndrome de Abstinência a Substâncias/complicações
Cardiomiopatia de Takotsubo/etiologia
[Mh] Termos MeSH secundário: Seres Humanos
Infusão Espinal
Masculino
Meia-Idade
Paraplegia/etiologia
Suspensão de Tratamento
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Nm] Nome de substância:
0 (Muscle Relaxants, Central); H789N3FKE8 (Baclofen)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170322
[Lr] Data última revisão:
170322
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160914
[St] Status:MEDLINE



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