... of interest in life, and strong or inappropriate emotions). Risperidone extended-release injection is used alone or ... this medication affects you.you should know that alcohol can add to the drowsiness caused by this ...
Rosa Catalán; Rafael Penadés
Antipsychotic medication is considered the cornerstone of the treatment in elderly patients with schizophrenia. Long acting risperidone injection was the first antipsychotic available for use in this group of patients. Current scientific literature revealed that long-acting risperidone is effective in treating the positive and negative symptoms of schizophrenia and some improvements in cognition and functioning have also been found. In terms of efficacy, there is a paucity of randomized trial...
Full Text Available Dhiren Singh1,2, Daniel W OConnor11Department of Psychological Medicine, Monash University, Melbourne, Australia; 2Peninsula Mental Health Service, Melbourne, AustraliaAbstract: Antipsychotic medication is the mainstay of treatment in elderly patients with psychosis. In recent years, second generation antipsychotics have come to be preferred. Longacting risperidone is the first such antipsychotic available for use in this vulnerable group of patients and offers an attractive alternative to traditional medications. The available literature revealed that long-acting risperidone is generally well tolerated and is effective in treating both the positive and negative symptoms of schizophrenia. Despite a lack of randomized trials and head-to-head studies, it appears to be a useful addition to the treatment armory for patients with chronic psychosis who require a depot preparation. Further research into its endocrine and metabolic side effects is needed.Keywords: risperidone, long-acting injection, old age, efficacy, safety
Michael K Rainer
Full Text Available Michael K RainerMemory-Clinic and Psychiatric Department, Donauspital, Vienna, AustriaAbstract: A long-acting form of the second-generation antipsychotic drug risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern atypical antipsychotics, namely higher efficacy in the treatment of the negative symptoms of schizophrenia and reduced motor disturbances. Published clinical studies show an objective clinical efficacy (as per psychiatric symptom scores and relapse data that exceeds that of oral atypical antipsychotics when patients are switched to the long-acting injectable form, a low incidence of treatment-emergent extrapyramidal side effects, and very good acceptance by patients. Available data for maintenance treatment of bipolar disorder show equivalence with the oral form instead of superiority, but are still limited. As it seems likely that efficacy benefits are mostly due to the fact that the injectable form reduces the demand for patient compliance to one physician visit every 2 weeks instead of self-administration on a daily or twice-daily basis, additional potential could exist in other psychiatric disorders where atypical antipsychotic drugs are of benefit but where patient adherence to treatment schedules is typically low.Keywords: risperidone, schizophrenia, psychotic disorders, patient compliance; delayed-action preparations, injections, intramuscular
Rainer, Michael K
Michael K RainerMemory-Clinic and Psychiatric Department, Donauspital, Vienna, AustriaAbstract: A long-acting form of the second-generation antipsychotic drug risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern atypical antipsychotics, namely higher efficacy in the ...
Dhiren Singh; Daniel W OConnor
Dhiren Singh1,2, Daniel W OConnor11Department of Psychological Medicine, Monash University, Melbourne, Australia; 2Peninsula Mental Health Service, Melbourne, AustraliaAbstract: Antipsychotic medication is the mainstay of treatment in elderly patients with psychosis. In recent years, second generation antipsychotics have come to be preferred. Longacting risperidone is the first such antipsychotic available for use in this vulnerable group of patients and offers an attracti...
...for risperidone injection. DATES: Although...draft guidance to http://www.regulations...FDA's Web site at http://www.fda...recommendations for risperidone injection. New drug application...ANDAs for risperidone injection. It does not create...electronic comments to...
Full Text Available Yueren Zhao,13 Taro Kishi,1 Nakao Iwata,1 Manabu Ikeda3,4 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, Okehazama Hospital Fujita Kokoro Care Center, Toyoake, Aichi, Japan; 3Department of Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan; 4Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan Abstract: A recent meta-analysis showed that long-acting injectable (LAI antipsychotics were not superior to oral antipsychotics for preventing relapse in patients with schizophrenia. We therefore designed a treatment strategy combining risperidone LAI and COMPASS (COMprehensive Psycho-educational Approach and Scheme Set, an original psychoeducational program supporting treatment with risperidone LAI and evaluating subjective treatment satisfaction, transition of symptoms, and effectiveness in preventing symptomatic relapse. The aim of this study was to examine whether addition of COMPASS to risperidone LAI was more effective in preventing relapse in schizophrenia patients than risperidone LAI alone, with the latter group consisting of patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients were followed up for 6 months, with COMPASS continuously implemented from the transition to the observation phase. The primary efficacy measurements were relapse rate (rates of rehospitalization and discontinuation due to inefficacy. Secondary efficacy measurements were the Brief Psychiatric Rating Scale (BPRS and Global Assessment of Functioning (GAF scores. Of the 96 patients originally enrolled, 19 (19.8% were discontinued from all causes. During the 6-month study period, ten of the 96 patients (10.4% relapsed, compared with a 12.2% relapse rate in patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients showed significant improvements in BPRS total scores (P = 0.0031, BPRS positive (P = 0.0451, BRPS negative (P < 0.0001, and general subscale scores (P = 0.0031, and GAF (P < 0.0001 from baseline to 6 months. In conclusion, the lower relapse rate observed in patients treated with COMPASS plus risperidone LAI than in patients treated with risperidone LAI alone suggests that COMPASS may have benefits in the treatment of schizophrenia, indicating a need for randomized, controlled trials in larger numbers of patients. Keywords: adherence, risperidone long-acting injection, psychoeducation, schizophrenia
Naessens Ineke; Mannaert Erik; Zhu Young; Mahmoud Ramy A; Lasser Robert A; Gearhart Natalie C; Gharabawi Georges M; Bossie Cynthia A; Kujawa Mary; Simpson George M
Abstract Background Several clinical studies have established the efficacy, safety, and tolerability of long-acting risperidone administered once every 2 weeks in patients with schizophrenia or schizoaffective disorder. This report evaluates preliminary efficacy, safety, tolerability, and pharmacokinetic data for a novel (once-monthly) administration of long-acting injectable risperidone 50 mg in patients with schizophrenia or schizoaffective disorder. Methods Clinically stable patients parti...
Full Text Available Objectives: The 5-HT2A receptor is one of the most important serotonin receptors, serving as a major target for risperidone. Rs6311 and rs6313 polymorphisms in the HTR2A gene have been reported to be associated with response to risperidone treatment; however, many previous studies have yielded con?icting results. To confirm the importance of these polymorphisms in risperidone treatment and provide more evidence for the routine use of these pharmacogenetic biomarkers in clinical practice, we carried out an association analysis of rs6311 and rs6313 polymorphisms with risperidone efficacy in Chinese Han patients with schizophrenia. Methods: Two independent cohorts of unrelated subjects were recruited from Henan and Shanghai (95 and 113 subjects, respectively. After 4- or 8-week risperidone monotherapy, the rs6311 and rs6313 polymorphisms of these subjects were genotyped with direct DNA sequencing. Clinical improvement was measured by the reduction of the PANSS scores (including the total and subscale scores. UNIANOVA and case-control study was used to evaluate the effects of rs6311 and rs6313 polymorphisms on the therapeutic efficacy of risperidone. Results: As in previous studies, the rs6311G allele was found in complete linkage disequilibrium with the rs6313C allele. However, neither the rs6311 nor the rs6313 polymorphism significantly in?uenced clinical improvement during risperidone treatment. Neither the allele nor the genotype frequencies were significantly different between responder and non-responder subgroups. Conclusions: No significant association between HTR2A polymorphisms (rs6313 and rs6311 and risperidone efficacy was found in the present study. The relative large sample size and two independent cohorts of subjects in the present study enhance the reliability of our findings.
Umehara, Hidehiro; Iga, Junichi; Ohmori, Tetsuro
Although the effectiveness of medication in the treatment of anorexia nervosa is uncertain, atypical antipsychotics such as olanzapine and risperidone have been used empirically for decades. we describe the case of a 10-year-old boy with anorexia nervosa in whom remarkable improvement was seen following the administration of risperidone or risperidone long-acting injection and deterioration when these agents were ceased. Because this is, to the best of our knowledge, the first report describing the usefulness of risperidone long-acting injection for adolescent anorexia nervosa. PMID:24851123
Umehara, Hidehiro; Iga, Junichi; Ohmori, Tetsuro
Although the effectiveness of medication in the treatment of anorexia nervosa is uncertain, atypical antipsychotics such as olanzapine and risperidone have been used empirically for decades. we describe the case of a 10-year-old boy with anorexia nervosa in whom remarkable improvement was seen following the administration of risperidone or risperidone long-acting injection and deterioration when these agents were ceased. Because this is, to the best of our knowledge, the first report describi...
Full Text Available Abstract Background Several clinical studies have established the efficacy, safety, and tolerability of long-acting risperidone administered once every 2 weeks in patients with schizophrenia or schizoaffective disorder. This report evaluates preliminary efficacy, safety, tolerability, and pharmacokinetic data for a novel (once-monthly administration of long-acting injectable risperidone 50 mg in patients with schizophrenia or schizoaffective disorder. Methods Clinically stable patients participated in a 1-year, open-label, single-arm, multicenter pilot study. During the 4-week lead-in phase, patients received long-acting risperidone 50 mg injections every 2 weeks, with 2 weeks of oral risperidone supplementation. Injections of long-acting risperidone 50 mg every 4 weeks followed for up to 48 weeks, without oral supplementation. The primary endpoint was relapse; other assessments included PANSS, CGI-S, adverse event reports, and determination of risperidone and 9-hydroxyrisperidone plasma concentrations. Results Twelve patients in the intent-to-treat population (n = 67 met relapse criteria (17.9%. Relapse risk at 1 year was estimated as 22.4%. Non-statistically significant improvements in symptoms (PANSS and clinical status (CGI-S at endpoint were observed. The most common adverse events included schizophrenia aggravated not otherwise specified (19.5%, anxiety (16.1%, insomnia (16.1%, and headache (11.5%. There were no unexpected safety and tolerability findings. Mean plasma concentrations for risperidone and 9-hydroxyrisperidone were generally stable during the study. Conclusion Once-monthly dosing of long-acting risperidone was well tolerated, associated with a relatively low relapse rate (similar to that reported with other antipsychotics, and maintained the clinically stable baseline status of most patients. Although the results suggest that some symptomatically stable patients with schizophrenia or schizoaffective disorder might be safely managed with long-acting risperidone 50 mg once monthly, these findings alone do not identify which patients will have a sufficient therapeutic benefit nor do they quantify comparative effects of standard and altered dosing. Study limitations (the open-label pilot study design, small sample size, and lack of a concurrent biweekly treatment arm prevent broad interpretations and extrapolations of results. Controlled studies would be required to support a recommendation for alternative dosing regimens.
Full Text Available Mário Rodrigues Louzã1, Helio Elkis1, Sandra Ruschel2, Irismar Reis de Oliveira3, Rodrigo Affonseca Bressan4, Paulo Belmonte-de-Abreu5, Hamilton Grabowski6, José Carlos Appolinário71Universidade de São Paulo, São Paulo; 2Hospital Mário Kroeff, Rio de Janeiro; 3Universidade Federal da Bahia, Salvador; 4Universidade Federal de São Paulo, São Paulo; 5Universidade Federal do Rio Grande do Sul, Porto Alegre; 6Hospital Bom Retiro, Curitiba; 7Janssen-Cilag Farmaceutica Ltda, São Paulo, BrazilBackground: Long-acting injectable antipsychotics may improve medication adherence, thereby improving overall treatment effectiveness. This study aimed to evaluate the effectiveness, safety, and tolerability of risperidone long-acting injection in schizophrenic patients switched from oral antipsychotic medication.Methods: In a 12-month, multicenter, open-label, noncomparative study, symptomatically stable patients on oral antipsychotic medication with poor treatment adherence during the previous 12 months received intramuscular injections of risperidone long-acting injection (25 mg starting dose every 2 weeks. The primary endpoint was the change in Positive and Negative Syndrome Scale (PANSS total score.Results: Of the 60 patients who were screened, 53 received at least one injection (safety population, and 51 provided at least one postbaseline assessment. Mean PANSS total scores improved significantly throughout the study and at endpoint. Significant improvements were also observed in Clinical Global Impression of Severity, Personal and Social Performance, and Drug Attitude Inventory scales. Risperidone long-acting injection was safe and well-tolerated. Severity of movement disorders on the Extrapyramidal Symptom Rating Scale was reduced significantly. The most frequently reported adverse events were insomnia (22.6%, increased prolactin (17.0%, and weight gain (13.2%.Conclusion: Risperidone long-acting injection was associated with significant symptomatic improvements in stable patients with schizophrenia following a switch from previous antipsychotic medications.Keywords: patient compliance, adherence, risperidone, delayed-action preparations, schizophrenia
Full Text Available Introduction: schizophrenia is a serious and long lasting psychiatric disease. The new atypical antipsychotic drugs, introduced in the 90s, have substantially improved the effectiveness of medical treatments, compared to previous neuroleptic drugs. Nowadays they tend to be used as first choice drugs. The ddd cost of atypicals may differ by 20% and health authorities may have an incentive to deliver the less costly drug, especially if they are generic. However the various drugs show differential effectiveness rates and a rational choice should consider both cost and effectiveness.?Objective: the purpose of this analysis is to review the existing evidence on cost-effectiveness studies of olanzapine and risperidone, the two most prescribed drugs in Italy. Six published studies were identified, but attention was focused on two articles that reported consistent and methodologically sound results.?Results: most reviewed studies are cost-minimization analyses, since effectiveness indicators show no significant statistical difference between the two drugs, and are inconclusive since the results depend on the evaluation setting. However one observational retrospective study showed a significant severity reduction over 12 months for patients treated with olanzapine (-2.46 on HoNOS scale; p<0.05, compared to a smaller non significant reduction of the risperidone group (-0.57. Despite the higher drug cost, the average total cost per reduced severity score was lower for olanzapine than for risperidone patients ( 4,554 vs. 10,897. The only medical and related health care costs for risperidone patients were higher than total costs for olanzapine patients. Another study comparing cohorts of patients with similar starting severity showed a significant severity reduction and global functioning increase over 12 months for olanzapine but no significant increase for risperidone patients (-0.35, p<0.01 on CGI scale; +3.66, p <0.05 on GAF scale, compared respectively to -0.27, p<0.05 and +2.00 n.s.. Again average cost per reduced severity/increased functioning score was higher for risperidone than olanzapine patients ( 4,568 vs. 4,170 for CGI and 2,284 vs. 1,139 for GAF scales respectively.?Conclusion: the use of olanzapine in the treatment of schizophrenia is the most cost-effective alternative for the SSN (Italian National health service, as it minimizes the cost per score of severity reduction or functioning increase. Even if the price of risperidone were to be reduced by 50% (becoming a generic, total 12 months treatment costs would exceed those of olanzapine in its highest ddd (30 mg.?
... INFORMATION: I. Background In the Federal Register of May 31, 2007 (72 FR 30388), FDA announced the... its availability in the Federal Register of June 11, 2010 (75 FR 33311). This notice announces the... Risperdal Consta (risperidone) Long-Acting Injection was initially approved by FDA in October 2003....
Full Text Available Wissam El-Hage1, Simon A Surguladze21Inserm U930 ERL CNRS 3106, Université François Rabelais and Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France; 2Institute of Psychiatry, Kings College London, UKAbstract: Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or as the maintenance therapy. Risperidone long acting injection (RLAI as a monotherapy or as adjunctive therapy to lithium or valproate for the maintenance treatment of bipolar I disorder was approved by Food and Drug Administration (FDA in United States in May 2009. In this review we will consider the aspects of pharmacology, pharmacokinetics, metabolism, safety and tolerability, and clinical trials focusing on the efficacy of RLAI in bipolar disorder. The patients perspective and attitudes to long-acting injections will also be discussed.Keywords: second generation, antipsychotics, patient attitudes, lithium, valproate, monotherapy
El-Hage, Wissam; Simon A Surguladze
Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or as the maintenance therapy. Risperidone long acting injection (RLAI) as a monotherapy or as adjunctive therapy to lithium or valproate for the maintenance treatment of bipolar I disorder was approved by Food and Drug Administration (FDA) in United States in...
Lindenmayer, Jean-Pierre; Jarboe, Kathleen; Bossie, Cynthia A; Zhu, Young; Mehnert, Angelika; Lasser, Robert
Long-acting injectable antipsychotic formulations of conventional antipsychotics were developed to address the problem of partial adherence among patients with schizophrenia. Injection site pain, other skin reactions and patient satisfaction with treatment were assessed in two large, multicentre studies of long-acting injectable risperidone (Risperdal CONSTA, Janssen Pharmaceutica Products, Titusville, New Jersey, USA), the first available long-acting atypical antipsychotic agent. Patients rated injection site pain using a 100-mm Visual Analogue Scale (VAS), and investigators rated injection site pain, redness, swelling and induration. Patient satisfaction with treatment was assessed with the Drug Attitude Inventory (DAI). VAS pain ratings were low at all visits across all doses in both studies, and decreased from first to final injection. In the 12-week, double-blind study, mean +/- SD VAS scores at the first and final injections were 15.6 +/- 20.7 and 12.5 +/- 18.3 for placebo-treated patients, and 11.8 +/- 14.4 (first) and 10.0 +/- 12.4 (final) for 25 mg; 16.3+/-21.9 (first) and 13.6 +/- 21.7 (final) for 50 mg; and 16.0 +/- 17.9 (first) and 9.6 +/- 16.0 (final, P<0.01) for 75 mg of long-acting risperidone. Mean VAS scores in the 50-week, open-label study at the first and final injection were: 17.9 +/- 22.2 (first) and 9.5 +/- 16.7 (final, P<0.0001) for 25 mg; 18.1 +/- 19.7 (first) and 10.4 +/- 14.8 (final, P<0.0001) for 50 mg; and 18.5 +/- 21.6 (first) and 13.6 +/- 19.9 (final, P = 0.0001) for 75 mg of long-acting risperidone. Overall, there was no or minimal injection site pain and skin reactions were rare. Mean DAI ratings were available for the 50-week study and indicated high patient satisfaction throughout the trial (baseline = 7.30; endpoint = 7.70; P<0.0001 versus baseline). These findings may positively affect patient and clinician attitudes towards long-term therapy with long-acting injectable risperidone. PMID:15933482
Nielsen, Jimmi; Jensen, Signe O W; Friis, Rasmus Blechingberg; Valentin, Jan Brink; Correll, Christoph U
Objective: To compare in a generalizable sample/setting objective outcomes in patients receiving first-generation antipsychotic long-acting injectables (FGA-LAIs) or risperidone-LAI (RIS-LAI). Methods: Nationwide, retrospective inception cohort study of adults with International Classification of Diseases-10 schizophrenia using Danish registers from 1995 to 2009 comparing outcomes between clinician's/patient's choice treatment with FGA-LAIs or RIS-LAI. Primary outcome was time to psychiatric hos...
Alptekin, Koksal; Hafez, Jamal; Brook, Shlomo; Akkaya, Cengiz; Tzebelikos, Errikos; Ucok, Alp; El Tallawy, Hamdy; Danaci, Aysen-Esen; Lowe, Wing; Karayal, Onur N
To compare the effectiveness of a switch from haloperidol (N=99), olanzapine (N=82), or risperidone (N=104) to 12 weeks of treatment with 80-160 mg/day ziprasidone in patients with stable schizophrenia or schizoaffective disorder. Stable outpatients with persistent symptoms or troublesome side effects were switched using one of three 1-week taper/switch strategies as determined by the investigator. Efficacy was assessed using the Brief Psychiatric Rating Scale score, Clinical Global Impression, Positive and Negative Symptom Scale, Montgomery-Asberg Depression Rating Scale, and the Global Assessment of Functioning Scale, and tolerability by using standard measures of weight change, extrapyramidal symptoms, and laboratory findings. Suboptimal efficacy was the primary reason for switching. The preferred switch strategy was immediate discontinuation, and the preferred dosing regimen was 120 mg/day. Completer rates were 68, 60, and 86% in the haloperidol, risperidone, and olanzapine pre-switch groups, respectively. At week 12, a switch to ziprasidone resulted in statistically significant improvement from baseline on the Brief Psychiatric Rating Scale score, Clinical Global Impression-Improvement, Positive and Negative Symptom Scale, and Global Assessment of Functioning scales, reduction in extrapyramidal symptoms and a neutral impact on metabolic parameters. Switch from olanzapine and risperidone resulted in weight reduction and from haloperidol in some weight increase. In conclusion, oral ziprasidone of 80-160 mg/day with food was a clinically valuable treatment option for stable patients with schizophrenia or schizoaffective disorder experiencing suboptimal efficacy or poor tolerability with haloperidol, olanzapine, or risperidone. PMID:19531959
Schizophrenia is a chronic disorder, usually necessitating lifelong treatment. Although atypical antipsychotic agents have improved outcomes in schizophrenia, their clinical potential remains limited by patients' nonadherence to medication. Long-acting antipsychotics were developed in the 1960s to enhance treatment adherence and simplify the medication process. However, although conventional long-acting agents assure medication delivery, they are associated with similar side effects to their oral equivalents. The need for an agent combining the advantages of a long-acting formulation with those of an atypical antipsychotic was highlighted in 1997 by the American Psychiatric Association's Practice Guideline for the Treatment of Patients with Schizophrenia. The first long-acting injectable atypical antipsychotic, long-acting risperidone (Risperdal Consta, Johnson & Johnson), has since been developed. This article discusses the efficacy, tolerability and cost-effectiveness of long-acting risperidone in schizophrenia and bipolar disorder patients, and suggests possibilities for how its role in clinical practice may change over the next 5 years. PMID:19102665
Gefvert, Ola; Eriksson, Bo; Persson, Per; Helldin, Lars; Björner, Annika; Mannaert, Erik; Remmerie, Bart; Eerdekens, Mariëlle; Nyberg, Svante
Thirteen patients with schizophrenia received injections of 25, 50, or 75 mg of long-acting risperidone every 2 wk. Brain D2 receptor occupancy was assessed with [11C]raclopride 2 wk after the last (fifth) injection (day 71) in seven subjects and 2 wk after the third injection (day 44) in one subject. Stable plasma concentrations were reached after the third injection and steady-state concentrations of the active moiety (risperidone + 9-hydroxyrisperidone) after the fourth injection. Steady-state plasma concentrations were maintained for 4-5 wk after the last injection and then declined rapidly. After injections of 25, 50 and 75 mg on day 44 or day 71, D2 receptor occupancy ranged from 25-48%, 59-83% and 62-72% respectively, while plasma active-moiety levels ranged from 4.4-8.8, 15.0-31.1 and 22.5-26.3 ng/ml respectively. The results indicate that brain D2 receptor occupancy at steady state after injections of long-acting risperidone was in the range found in patients effectively treated with 2-6 mg of oral risperidone. PMID:15710053
Takeuchi, Katsuya; Sanjo, Katsumi; Sakai, Akio
Risperidone, a serotonin-dopamine antagonist, is effective in preventing delusions and hallucinations by D2 receptor antagonism and treating negative symptoms by 5-HT2A receptor antagonism. It is less likely to produce extrapyramidal symptoms than conventional antipsychotics, enabling safe drug therapy for schizophrenia. Paliperidone, based on 9OH-risperidone(major metabolite of risperidone), was developed to make the best use of the high therapeutic efficacy of Risperdal and enable continued treatment with lower prevalence of adverse events. Its mechanism of action as an extended-release tablet ensures slow release of the active ingredient, contributing to the lower prevalence of adverse events. With these pharmacological characteristics in mind, the two drugs can serve as safe and effective drug therapy. PMID:23678595
Full Text Available Abstract Background Data on the long-term efficacy, safety, and tolerability of risperidone in adolescents with schizophrenia are limited. The objective of this study was to evaluate the efficacy and safety of maintenance risperidone treatment in adolescents with schizophrenia. Methods This open-label study of adolescents aged 13 to 17 years with schizophrenia was a single extension study of two short-term double-blind risperidone studies and also enrolled subjects directly in open-label risperidone treatment. The risperidone dose was flexible and ranged from 2 to 6 mg/day. Most subjects enrolled for 6 months; a subset enrolled for 12 months. Assessment tools included the Positive and Negative Syndrome Scale total and factor scores, Clinical Global Impressions, Childrens Global Assessment Scale, adverse event (AE monitoring, vital signs, laboratory testing, and extrapyramidal symptom rating scales. Results A total of 390 subjects were enrolled; 48 subjects had received placebo in a previous double-blind study; 292 subjects had received risperidone as part of their participation in one of two previous controlled studies; and 50 subjects were enrolled directly for this study. A total of 279 subjects enrolled for 6 months of treatment, and 111 subjects enrolled for 12 months of treatment. Overall, 264 (67.7% subjects completed this study: 209 of the 279 subjects (75% in the 6-month group and 55 of the 111 subjects (50% in the 12-month group. The median mode dose was 3.8 mg/day. At 6 months, all three groups experienced improvement from open-label baseline in symptoms of schizophrenia as well as general assessments of global functioning. Improvements were generally maintained for the duration of treatment. The most common AEs (?10% of subjects were somnolence, headache, weight increase, hypertonia, insomnia, tremor, and psychosis. Potentially prolactin-related AEs (PPAEs were reported by 36 (9% subjects. The AE profile in this study was qualitatively similar to those of other studies in adult subjects with schizophrenia and in other psychiatric studies of risperidone in pediatric populations. Conclusions Risperidone maintenance treatment in adolescents over 6 to 12 months was well tolerated, consistent with related studies in this clinical population, and associated with continued efficacy. Clinical trials ClinicalTrials.gov registration number: NCT00246285 http://clinicaltrials.gov/ct2/show/NCT00246285?term=NCT00246285&rank=1
Masi, Gabriele; Milone, Annarita; Stawinoga, Agnieszka; Veltri, Stefania; Pisano, Simone
Although a frequent co-occurrence between bipolar disorder (BD) and conduct disorder (CD) in youth has been frequently reported, data about pharmacological management are scarce and focused on BD type I. Second generation antipsychotics are frequently used in clinical practice, but no comparative studies are available. The aim of this exploratory study was to compare efficacy and safety of risperidone and quetiapine in a sample of adolescents presenting a BD type II comorbid with CD. Twenty-two patients diagnosed with a structured interview according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (male/female ratio, 12/10; mean (SD) age 15.0 (1.4) years) were randomized in 2 treatment groups (quetiapine [n = 12] vs risperidone [n = 10]), treated with flexible doses, and followed up for 12 weeks. Efficacy measures assessed manic symptoms, aggression, anxiety, depression, global clinical severity, and impairment. Safety measures included body mass index, serum prolactin, extrapyramidal adverse effects, and electrocardiogram. At the end of the study, all patients improved in all efficacy measures. Both treatments showed similar efficacy in reducing manic symptoms and aggression. Quetiapine was more effective in improving anxiety and depressive symptoms. A change in body mass index was found, and in a post hoc analysis, it was significant only in the risperidone group. Prolactin significantly increased only in the risperidone group. In BD type II, CD comorbidity, quetiapine, or risperidone monotherapy may be effective and relatively safe, although the small sample size, the limited duration of the study, and the design (lack of a blind assessments and of a placebo group) make it difficult to draw definitive conclusions. PMID:26226481
Macfadden Wayne; Jacobs An; Crivera Concetta; Otten Patrick; Kozma Chris M; DeSouza Cherilyn; Peuskens Joseph; Olivares José M; Lambert Tim; Mao Lian; Rodriguez Stephen C; Dirani Riad; Akhras Kasem S
Abstract Background Because wide variations in mental health care utilization exist throughout the world, determining long-term effectiveness of psychotropic medications in a real-world setting would be beneficial to physicians and patients. The purpose of this analysis was to describe the effectiveness of injectable risperidone long-acting therapy (RLAT) for schizophrenia across countries. Methods This was a pragmatic analysis of data from two prospective observational studies conducted in t...
Bobo, William V; Shelton, Richard C
Poor adherence to pharmacotherapy during maintenance-phase treatment of bipolar disorder is a common occurrence, exposing patients to a high risk of illness relapses, rehospitalization and other negative outcomes. In view of this, there has been a reawakening of interest in the potential of long-acting injectable antipsychotic medications to improve treatment outcome during bipolar maintenance therapy. Indeed, long-acting injectable medications have practical advantages of assuring delivery of medication at a prescribed dose, and perhaps also making it easier to monitor adherence, at least to the long-acting drug. However, there are important limitations to the long-term use of depot typical neuroleptics in patients with bipolar disorder, including risk of extrapyramidal side effects and tardive dyskinesia, which may exceed that of patients with schizophrenia, and the potential for treatment-emergent exacerbation of depressive symptoms. Long-acting injectable risperidone (RLAI) has recently been approved for maintenance treatment in patients with bipolar I disorder. Evidence supporting the use of RLAI for this indication consists of several nonrandomized, open-label studies; one randomized, open-label trial; and two adequately powered randomized, double-blind trials. In general, these studies have shown RLAI to be effective for the prevention of relapse or hospitalization during bipolar maintenance treatment. In the double-blind studies, RLAI was associated with reduced relapse rates, increased time to relapse and greater control of clinical symptoms during maintenance treatment following initial stabilization, compared with oral medication treatment or placebo injection. RLAI appeared to be more effective for preventing manic/mixed episodes than depressive episodes. RLAI showed good tolerability across studies; however, dose-related extrapyramidal effects, sedation, weight gain and prolactin elevation may occur during long-term treatment. Responder-enriched designs and exclusion of important clinical subgroups in the double-blind trials may limit translation of these results to routine care settings. PMID:20977322
Meltzer, H Y; Lindenmayer, J-P; Kwentus, J; Share, D B; Johnson, R; Jayathilake, K
It has been suggested that atypical antipsychotic drugs (A-APDs) other than clozapine may be effective to improve positive symptoms in some patients with treatment resistant schizophrenia (TRS), if both the dose is higher, and the duration of the trial longer, than those which have been ineffective in non-TRS (NTRS) patients. This hypothesis was tested with long acting injectable risperidone (Risperdal Consta®, RLAI). One hundred sixty TRS patients selected for persistent moderate-severe delusions or hallucinations, or both, were randomized to RLAI, 50 or 100mg biweekly, in a six month, outpatient, double-blind, multicenter trial. We hypothesized that RLAI, 100mg, would be more effective than RLAI, 50mg. However, both doses produced clinically significant and equivalent improvement in PANSS Total, Positive, and Negative subscale scores, as well as key cognitive, global and functional measures, with increasing response during the course of the study, confirming the value of longer clinical trial duration for patients with TRS, but not superiority of the higher dose. The overall response rate was comparable to that previously reported for clozapine and high dose olanzapine, another A-APD, in TRS. Both doses of RLAI were equally well tolerated, producing minimal extrapyramidal side effects and few drop outs. Plasma levels of the active moiety, risperidone+9-hydroxyrisperidone, during treatment with RLAI 100mg, were comparable to those for 6-8 mg/day oral risperidone, which have not been effective in TRS. Further study of RLAI, ? 50-100mg biweekly, should compare it with clozapine and oral risperidone in TRS, with duration of treatment ? six months. PMID:24630262
Full Text Available Vishal Madaan1, Durga P Bestha2, Venkata Kolli2, Saurabh Jauhari2, Roger C Burket1 1University of Virginia Health System, Charlottesville, VA, USA; 2Creighton University Medical Center, Omaha, NE, USA Abstract: Risperidone is one of the early second-generation antipsychotics that came into the limelight in the early 1990s. Both the oral and long-acting injectable formulations have been subject to numerous studies to assess their safety, efficacy, and tolerability. Risperidone is currently one of the most widely prescribed antipsychotic medications, used for both acute and long-term maintenance in schizophrenia. Risperidone has better efficacy in the treatment of psychotic symptoms than placebo and possibly many first-generation antipsychotics. Risperidone fares better than placebo and first-generation antipsychotics in the treatment of negative symptoms. Risperidone's long acting injectable preparation has been well tolerated and is often useful in patients with medication nonadherence. Risperidone has a higher risk of hyperprolactinemia comparable to first-generation antipsychotics (FGAs but fares better than many second-generation antipsychotics with regards to metabolic side effects. In this article, we briefly review the recent literature exploring the role of risperidone formulations in schizophrenia, discuss clinical usage, and highlight the controversies and challenges associated with its use. Keywords: risperidone, schizophrenia, formulation, antipsychotic, side effects
Full Text Available "n "n Background and the purpose of the study: This investigation deals with risperidone cyclodextrin (CD complexation for parenteral administration to improve its aqueous solubility which would be beneficial over immediate and sustained release formulations available in market especially for agitated and non-cooperative psychotic patients. "nMethods: The phase solubility study of the drug with ?-CD, hydroxypropyl (HP-?-CD and ?-CD was conducted and CDs with higher stability constants were selected for complexation. The complexes of Risperidone with ?-CD and HP-?-CD were prepared by precipitation and vacuum drying methods, respectively. Fourier transform-infrared, X-ray diffraction and differential scanning calorimetry techniques were used for characterization of complexes. Drug precipitation study of complex's solution in water for injection and 100 ml of 0.1 M pH 7.4 phosphate buffer saline and stability study in accelerated condition were also carried out. "nResults: The stability constants of the CD were in the following order: ?-CD (341.953±11.87 M-1 > HP-?-CD (170.817± 5.93 M-1 > ?-CD (93.716 ± 3.25 M-1. CDs with high stability constants were selected to prepare the drug CD complex. The complexation efficiencies of ?-CD and HP-?-CD were 95.23 ± 2.27% and 97.59 ±1.97%, respectively. Both types of CDs exhibited complexation at 1:2 molar stoichiometric ratio. The drug precipitation study indicated complete solubility (100% drug dissolution without a trace of precipitate within 5 mins. The complexes were found to be stable for a period of 3 months under accelerated stability conditions. Major conclusion:Stable complexes of risperidone were successfully formulated using both ?-CD and HP-?-CD by simple and highly efficient methods of complexation for parenteral administration.
Ersland, Kari M; Skrede, Silje; Røst, Therese H; Berge, Rolf K; Steen, Vidar M
Several antipsychotics have well-known adverse metabolic effects. Studies uncovering molecular mechanisms of such drugs in patients are challenging due to high dropout rates, previous use of antipsychotics and restricted availability of biological samples. Rat experiments, where previously unexposed animals are treated with antipsychotics, allow for direct comparison of different drugs, but have been hampered by the short half-life of antipsychotics in rodents. The use of long-acting formulations of antipsychotics could significantly increase the value of rodent models in the molecular characterization of therapeutic and adverse effects of these agents. However, as long-acting formulations have rarely been used in rodents, there is a need to characterize the basic metabolic phenotype of different antipsychotics. Using long-acting olanzapine injections as a positive control, the metabolic effects of intramuscular long-acting risperidone in female rats were investigated for the first time. Like olanzapine, risperidone induced rapid, significant hyperphagia and weight gain, with concomitant increase in several plasma lipid species. Both drugs also induced weight-independent upregulation of several genes encoding enzymes involved in lipogenesis, but this activation was not confirmed at the protein level. Our findings shed light on the role of drug administration, drug dose and nutritional status in the development of rodent models for adverse metabolic effects of antipsychotic agents. PMID:26378122
Madaan V; Bestha DP; Kolli VB; Jauhari S; Burket RC
Vishal Madaan1, Durga P Bestha2, Venkata Kolli2, Saurabh Jauhari2, Roger C Burket1 1University of Virginia Health System, Charlottesville, VA, USA; 2Creighton University Medical Center, Omaha, NE, USA Abstract: Risperidone is one of the early second-generation antipsychotics that came into the limelight in the early 1990s. Both the oral and long-acting injectable formulations have been subject to numerous studies to assess their safety, efficacy, and tolerability. Risperidone is currently one...
Full Text Available Haya Ascher-Svanum1, William S Montgomery2, David P McDonnell3, Kristina A Coleman4, Peter D Feldman11Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly Australia Pty Ltd, West Ryde, New South Wales, Australia; 3Eli Lilly and Company, Cork, Ireland; 4OptumInsight, Lilyfield, New South Wales, AustraliaBackground: Little is known about the comparative effectiveness of atypical antipsychotics in long-acting injection formulation. Due to the absence of head-to-head studies comparing olanzapine long-acting injection and risperidone long-acting injection, this study was intended to make exploratory, indirect, cross-study comparisons between the long-acting formulations of these two atypical antipsychotics in their effectiveness in treating patients with schizophrenia.Methods: Indirect, cross-study comparisons between olanzapine long-acting injection and risperidone long-acting injection used 12-month treatment-completion rates, because discontinuation of an antipsychotic for any cause is a recognized proxy measure of the medication's effectiveness in treating schizophrenia. Following a systematic review of the literature, two indirect comparisons were conducted using open-label, single-cohort studies in which subjects were stabilized on an antipsychotic medication before depot initiation. The first analysis compared olanzapine long-acting injection (one study with pooled data from nine identified risperidone long-acting injection studies. The second analysis was a sensitivity analysis, using only the most similar studies, one for olanzapine long-acting injection and one for risperidone long-acting injection, which shared near-identical study designs and involved study cohorts with near-identical patient characteristics. Pearson Chi-square tests assessed group differences on treatment-completion rates.Results: Comparison of olanzapine long-acting injection data (931 patients with the pooled data from the nine risperidone long-acting injection studies (3950 patients provided almost identical 12-month treatment-completion rates (72.7% versus 72.4%; P = 0.87. When the two most similar studies were compared, the 12-month completion rate for olanzapine long-acting injection was significantly higher than for risperidone long-acting injection (81.3% versus 47.0%; P < 0.001. However, any conclusions drawn from this comparison may be limited by differences in the studies' geographic catchment areas.Conclusion: Using treatment-completion rates as a proxy measure of medication effectiveness, olanzapine long-acting injection did not differ significantly from risperidone long-acting injection when including all eligible studies. However, the findings of this exploratory analysis should be interpreted with caution, considering the methodological limitations of these indirect, cross-study comparisons.Keywords: antipsychotic drugs, intramuscular injection, olanzapine, risperidone, schizophrenia
Full Text Available Abstract Background Because wide variations in mental health care utilization exist throughout the world, determining long-term effectiveness of psychotropic medications in a real-world setting would be beneficial to physicians and patients. The purpose of this analysis was to describe the effectiveness of injectable risperidone long-acting therapy (RLAT for schizophrenia across countries. Methods This was a pragmatic analysis of data from two prospective observational studies conducted in the US (Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation [SOURCE]; ClinicalTrials.gov registration number for the SOURCE study: NCT00246194 and Spain, Australia, and Belgium (electronic Schizophrenia Treatment Adherence Registry [eSTAR]. Two separate analyses were performed to assess clinical improvement during the study and estimate psychiatric hospitalization rates before and after RLAT initiation. Clinical improvement was evaluated using the Clinical Global Impressions-Severity (CGI-S and Global Assessment of Functioning (GAF scales, and change from baseline was evaluated using paired t tests. Psychiatric hospitalization rates were analyzed using incidence densities, and the bootstrap resampling method was used to examine differences between the pre-baseline and post-baseline periods. Results The initial sample comprised 3,069 patients (US, n = 532; Spain, n = 1,345; Australia, n = 784; and Belgium, n = 408. In all, 24 months of study participation, completed by 39.3% (n = 209, 62.7% (n = 843, 45.8% (n = 359, and 64.2% (n = 262 of patients from the US, Spain, Australia, and Belgium, respectively, were included in the clinical analysis. Improvements compared with baseline were observed on both clinical assessments across countries (P P P Conclusions RLAT in patients with schizophrenia was associated with improvements in clinical and functional outcomes and decreased hospitalization rates in the US, Spain, Australia, and Belgium, despite differences in health care delivery systems.
Leatherman, Sarah M; Liang, Matthew H; Krystal, John H; Lew, Robert A; Valley, Danielle; Thwin, Soe Soe; Rosenheck, Robert A
A long-term randomized trial of unstable patients with schizophrenia found no benefit of long-acting injectable (LAI) risperidone over oral treatment in preventing or delaying time to psychiatric hospitalizations or on clinical outcomes. The initial analyses did not examine whether benefits of LAI emerged in selected subgroups.Patients with schizophrenia or schizoaffective disorder who had been hospitalized within the past 2 years or judged to be at risk for hospitalization because of increasing psychiatric service use were randomly assigned to LAI risperidone 12.5 to 50 mg per injection biweekly or to the psychiatrist's choice of oral antipsychotics and followed for up to 2 years. The primary endpoint was psychiatric rehospitalization. Symptoms, quality of life, and global functioning were assessed through blinded videoconference interviews. Cox's regression and mixed effects models were used to assess difference in treatment effect within 12 subgroups defined by hospitalization at study entry, substance abuse, race, symptom severity, quality of life, body mass index, age, race or sex, or reported medication compliance.Mixed models and Cox's regression using up to 24 months of follow-up data showed no significant differences in treatment effect in 10 of 12 subgroups on psychiatric symptoms, quality of life, or time to hospitalization. With adjustment for multiple comparisons, treatment effect differed by race on substance use outcomes, with white participants showing more benefit from LAI than other groups.LAI risperidone showed no superiority to psychiatrist's choice of oral treatment in most clinically defined subgroups, although the white patients benefited more than the other groups on substance abuse outcomes. PMID:24375206
Comparative Effectiveness of Risperidone Long-Acting Injectable vs First-Generation Antipsychotic Long-Acting Injectables in Schizophrenia : Results From a Nationwide, Retrospective Inception Cohort Study
Nielsen, Jimmi; Jensen, Signe O W
Objective: To compare in a generalizable sample/setting objective outcomes in patients receiving first-generation antipsychotic long-acting injectables (FGA-LAIs) or risperidone-LAI (RIS-LAI). Methods: Nationwide, retrospective inception cohort study of adults with International Classification of Diseases-10 schizophrenia using Danish registers from 1995 to 2009 comparing outcomes between clinician's/patient's choice treatment with FGA-LAIs or RIS-LAI. Primary outcome was time to psychiatric hospitalization using Cox-regression adjusting for relevant covariates. Secondary outcomes included time to all-cause discontinuation and psychiatric hospitalization in patients without LAI possession gap >28 days, and number of bed-days after psychiatric hospitalization. Results: Among 4532 patients followed for 2700 patient-years, 2078 received RIS-LAI and 2454 received FGA-LAIs (zuclopenthixol decanoate = 52.2%, perphenazine decanoate = 37.2%, haloperidol decanoate = 5.0%, flupenthixol decanoate = 4.4%, fluphenazine decanoate = 1.3%). RIS-LAI was similar to FGA-LAIs regarding time to hospitalization (RIS-LAI = 246.2±323.7 days vs FGA-LAIs = 276.6±383.3 days; HR = 0.95, 95% confidence interval (CI) = 0.87-1.03, P = 0.199) and time to all-cause discontinuation (RIS-LAI = 245.8±324.0 days vs FGA-LAIs = 287.0±390.9 days; HR = 0.93, 95% CI = 0.86-1.02, P = 0.116). Similarly, in patients without LAI discontinuation, RIS-LAI and FGA-LAIs did not differ regarding time to hospitalization (RIS-LAI = 175.0±268.1 days vs FGA-LAIs = 210.7±325.3 days; HR = 0.95, 95% CI = 0.86-1.04, P = 0.254). Finally, duration of hospitalization was also similar (incidence rate ratio = 0.97, 95% CI = 0.78-1.19, P = 0.744). Results were unchanged when analyzing only patients treated after introduction of RIS-LAI. Conclusions: In this nationwide cohort study, RIS-LAI was not superior to FGA-LAIs regarding time to psychiatric hospitalization, all-cause discontinuation, and duration of hospitalization. Given the cost of hospitalization and second-generation antipsychotic (SGA)-LAIs, these findings require consideration when making treatment choices, but also need to be balanced with the individual relevance of adverse effects/patient centered outcomes. In future, head-to-head trials and additional nationwide database studies including other SGA-LAIs is needed.
Rendell, JM; Geddes, JR
BACKGROUND: Risperidone, an atypical antipsychotic, is used to treat acute manic episodes, particularly when psychotic symptoms are present. Drugs used to treat mania are often continued as long-term treatment to prevent relapse. There is a need for evidence of the effectiveness and safety of risperidone as long-term treatment. OBJECTIVES: To assess the randomised evidence for the efficacy and tolerability of risperidone compared with placebo or other active pharmacological treatments as long...
Love, R C; Nelson, M W
Risperidone (Risperdal, Janssen Pharmaceutica) is a second generation antipsychotic (SGA) for the treatment of schizophrenia and other psychotic disorders. It is a potent antagonist of serotonin-2 (5-HT2) and dopamine-2 (D2) receptors in the brain. In comparison to conventional antipsychotics, risperidone demonstrates superior efficacy against the positive and negative symptoms of schizophrenia and a decreased occurrence of extrapyramidal side effects (EPS). Risperidone causes less weight gain than other marketed SGAs, but can increase prolactin levels and cause EPS in a dose-related manner. In a variety of pharmacoeconomic analyses, it has proven to be a cost-effective addition to the antipsychotic armamentarium. As the first SGA available for front line use, risperidone has established a new standard of care for the treatment of individuals with psychotic disorders. PMID:11249477
Full Text Available Richard Williams,1 Ranjith Chandrasena,2 Linda Beauclair,3 Doanh Luong,4 Annette Lam4 On behalf of the e-STAR study group 1Vancouver Island Health Authority, Victoria, BC, Canada; 2Chatham-Kent Health Alliance, Chatham, ON, Canada; 3Allan Memorial Institute, Montreal, QC, Canada; 4Janssen Inc., Toronto, ON, Canada Objective: To assess outcomes over 24 months in Canadian patients with schizophrenia initiated on risperidone long-acting injection (RLAI and participating in the electronic Schizophrenia Treatment Adherence Registry (e-STAR. Materials and methods: Patients with schizophrenia or schizoaffective disorder were enrolled from 24 sites after an independent decision to initiate RLAI. Subsequent patient management was based on usual clinical practice at each site and was not protocol-driven. Relevant data were collected retrospectively by chart review for 12 months prior to RLAI and prospectively for 24 months following RLAI initiation. Results: Patients (n=188 had a mean age of 39.2 years, were 66.3% male, and 27.7% were inpatients at baseline. Twenty-four months after initiating therapy (initial dose =28.7 mg, 34.1% (95% confidence interval 27.2%42.2% of patients had discontinued RLAI with a mean time to discontinuation of 273.4±196 days. Over the treatment period, there were significant (P<0.001 changes from baseline in Clinical Global Impression-Severity (CGI-S; 3.48 versus [vs] 4.31 at baseline, Global Assessment of Functioning (GAF; 56.1 vs 48.1, and Personal and Social Performance (PSP; 59.1 vs 46.9 scale scores. In addition, after 12 months, there were significant (P<0.001 decreases in the percentage of patients hospitalized (23.9% vs 58.5% pre-RLAI, mean length of stay (11.4 vs 30.4 days, and number of hospitalizations (0.32 vs 0.87 compared to the 12-month pre-RLAI period. Reductions in hospitalization continued into the second 12 months of therapy, when only 9% of patients were hospitalized and mean length of stay was 2.0 days. Conclusion: In a routine clinical practice setting, patients switched to RLAI showed significant improvements in clinical outcomes and in global and social functioning, and hospitalization was significantly reduced. The data confirm that RLAI provides effective long-term management of schizophrenia in Canada. Keywords: schizophrenia, Canada, risperidone long-acting injection, e-STAR
Keks, N A; Culhane, C
Risperidone (Risperdal) is a benzisoxazole derivative with a high affinity for serotonin 5-HT2 and dopamine D2 receptors, and some affinity for alpha- adrenergic, histamine H1 and dopamine D1 receptors. It has no anticholinergic effects. Early studies demonstrated risperidone to be an effective medication for psychotic symptoms, probably more so than the older neuroleptics for both positive and negative symptoms. At clinically effective doses, risperidone causes no more extrapyramidal side-effects (EPS) than placebo; at higher doses EPS frequency increases in a dose-dependent manner. Since it became available in 1994, extensive experience with the drug supports favourable early impressions of efficacy and tolerability. Minimal sedation, relatively little weight gain and absence of anticholinergic manifestations contribute to the relative tolerability of risperidone as compared to older neuroleptics. However, risperidone is associated with hyperprolactinaemia which can result in amenorrhoea and sexual dysfunction. Compared to older neuroleptics, pharmacoeconomic studies have shown that use of risperidone is associated with reduced hospitalisation and direct cost savings. A recent study found equivalent efficacy between risperidone and clozapine for treatment-resistant patients. Two studies comparing risperidone and olanzapine have yielded positive but conflicting findings. The overall positive experience with risperidone has resulted in the drug being widely recommended as a first line treatment option for psychoses. PMID:15992090
Catalano, G; Catalano, M C; Taylor, W
Risperidone (Risperdal) is a recently released novel antipsychotic medication. It is different from the conventional neuroleptics, such as haloperidol, as it has both serotinergic and dopaminergic activity. It has a more tolerable side-effect profile compared with other antipsychotic medications. We review the literature regarding the side effects of risperidone use, describe a case of overdose with risperidone, and discuss the clinical sequelae and management of such an overdose. PMID:9037577
Malla, Ashok; Chue, Pierre; Jordan, Gerald; Stip, Emmanuel; Koczerginski, David; Milliken, Heather; Joseph, Anil; Williams, Richard; Adams, Beverly; Manchanda, Rahul; Oyewumi, Kola; Roy, Marc-André
Few studies have examined effectiveness and tolerability of risperidone long-acting injections (RLAI) in the early phase of a schizophrenia spectrum (SS) disorder using a randomized controlled trial (RCT) design. Eighty-five patients in early phase of an SS disorder were randomized to receive either oral second-generation antipsychotics (SGAs; n=41) or RLAI (n=44) over two years. Analyses were conducted on eligible participants (n=77) for the stabilization (maximum 18 weeks) and maintenance phases (up to Week 104) on primary outcome measures of time to stabilization and relapse, change in symptoms and safety, and comparisons made across the two groups. Both groups showed improvement on Positive and Negative Syndrome Scale (PANSS) scores and Clinical Global Impression-Severity (CGI-S) scores. There were no time X group interactions on any of the primary outcome measures. Post hoc examination revealed that the RLAI group showed greater change on CGI-S and PANSS negative symptom scores during the stabilization phase, while the oral group reached the same level of improvement during the maintenance phase. The current exploratory study suggests that-within an RCT design-RLAI and oral SGAs are equally effective and have similar safety profiles in patients in the early phase of SS disorders. Thus, RLAI offers no advantage to patients in early phase of SS disorders, but is likely to be effective and safe for those who may have problems with adherence and may either choose to take it or be prescribed under conditions of external control such as community treatment orders. PMID:23773886
Baylé, Franck Jean; Tessier, Arnaud; Bouju, Sophie; Misdrahi, David
Background Maintaining antipsychotic therapy in psychosis is important in preventing relapse. Long-acting depot preparations can prevent covert non-adherence and thus potentially contribute to better patient outcomes. In this observational survey the main objective is to evaluate medication adherence and its determinants for oral treatment in a large sample of patients with psychosis. Methods In this cross-sectional survey medication adherence for oral treatment was assessed by patients using the patient-rated Medication Adherence Questionnaire (MAQ). Data were collected by physicians on patients with a recent acute psychotic episode before switching to long-acting injectable risperidone. Other evaluations included disease severity (Clinical Global Impression Severity), patients insight (Positive and Negative Syndrome Scale item G12), treatment acceptance (clinician-rated Compliance Rating Scale), and therapeutic alliance (patient-rated 4-Point ordinal Alliance Scale). Results A total of 399 psychiatrists enrolled 1,887 patients (mean age 36.8±11.9 years; 61.6% had schizophrenia). Adherence to oral medication was low in 53.2% of patients, medium in 29.5%, and high in 17.3%. Of patients with psychiatrist-rated active acceptance of treatment, 70% had medium or high MAQ scores (P<0.0001). Medication adherence was significantly associated with therapeutic alliance (4-Point ordinal Alliance Scale score; P<0.0001). Patient age was significantly associated with adherence: mean age increased with greater adherence (35.6, 36.7, and 38.6 years for patients with low, medium, and high levels of adherence, respectively; P=0.0007), while age <40 years was associated with low MAQ classification (P=0.0003). Poor adherence was also associated with a diagnosis of schizophrenia (P=0.0083), more severe disease (Clinical Global Impression Severity ?4; P<0.0001), and lower insight (Positive and Negative Syndrome Scale-G12 ?4; P<0.0001). Conclusion Self-reported adherence was low in most patients, with a strong positive association between self-reported adherence and psychiatrists assessment of treatment acceptance. Understanding factors associated with poor medication adherence may help physicians to better manage their patients, thereby improving outcomes. PMID:26396505
Full Text Available Franck Jean Baylé,1 Arnaud Tessier,2,3 Sophie Bouju,4 David Misdrahi2,3 1Sainte-Anne Hospital (SHU, Paris V-Descartes University, Paris, 2Hôpital Charles Perrens, Pôle de Psychiatrie Adulte, 3CNRS UMR 5287-INCIA, Bordeaux University, Bordeaux, 4Janssen-Cilag France, Issy Les Moulineaux, Paris, France Background: Maintaining antipsychotic therapy in psychosis is important in preventing relapse. Long-acting depot preparations can prevent covert non-adherence and thus potentially contribute to better patient outcomes. In this observational survey the main objective is to evaluate medication adherence and its determinants for oral treatment in a large sample of patients with psychosis.Methods: In this cross-sectional survey medication adherence for oral treatment was assessed by patients using the patient-rated Medication Adherence Questionnaire (MAQ. Data were collected by physicians on patients with a recent acute psychotic episode before switching to long-acting injectable risperidone. Other evaluations included disease severity (Clinical Global Impression Severity, patients insight (Positive and Negative Syndrome Scale item G12, treatment acceptance (clinician-rated Compliance Rating Scale, and therapeutic alliance (patient-rated 4-Point ordinal Alliance Scale.Results: A total of 399 psychiatrists enrolled 1,887 patients (mean age 36.8±11.9 years; 61.6% had schizophrenia. Adherence to oral medication was low in 53.2% of patients, medium in 29.5%, and high in 17.3%. Of patients with psychiatrist-rated active acceptance of treatment, 70% had medium or high MAQ scores (P<0.0001. Medication adherence was significantly associated with therapeutic alliance (4-Point ordinal Alliance Scale score; P<0.0001. Patient age was significantly associated with adherence: mean age increased with greater adherence (35.6, 36.7, and 38.6 years for patients with low, medium, and high levels of adherence, respectively; P=0.0007, while age <40 years was associated with low MAQ classification (P=0.0003. Poor adherence was also associated with a diagnosis of schizophrenia (P=0.0083, more severe disease (Clinical Global Impression Severity ?4; P<0.0001, and lower insight (Positive and Negative Syndrome Scale-G12 ?4; P<0.0001.Conclusion: Self-reported adherence was low in most patients, with a strong positive association between self-reported adherence and psychiatrists assessment of treatment acceptance. Understanding factors associated with poor medication adherence may help physicians to better manage their patients, thereby improving outcomes. Keywords: schizophrenia, long-acting antipsychotic, medication adherence, therapeutic alliance
Rendell, JM; Gijsman, HJ; Bauer, MS; Goodwin, GM; Geddes, GR
BACKGROUND: Risperidone, an atypical antipsychotic, is used to treat mania both alone and in combination with other medicines. OBJECTIVES: To review the efficacy and tolerability of risperidone as treatment for mania. SEARCH STRATEGY: The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies December 2004), The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAHL and PsycINFO were searched in December 2004. Reference ...
Effectiveness of long-acting antipsychotics in clinical practice : 1. A retrospective, 18-month follow up and comparison between paliperidone palmitate, risperidone long-acting injection and zuclopenthixol decanoate
Cordiner, Matthew; Shajahan, Polash; McAvoy, Sarah; Bashir, Muhammad; Taylor, Mark
Objectives: In the UK, nine different compounds are available as long-acting antipsychotic injections (LAIs). There are few clinical guidelines for determining which LAIs are most effective in specific patient groups. To measure the clinical effectiveness of LAIs we aimed to determine the now-established concept of antipsychotic discontinuation rates and measure Clinical Global Impression (CGI) outcomes. Method: The population (n was approximately 560,000) was a secondary care NHS adult mental health service in Lanarkshire, Scotland, UK. This was a retrospective, electronic case note search of LAI-naïve patients commenced on paliperidone palmitate (n = 31), risperidone long-acting injection (RLAI) (n = 102) or zuclopenthixol decanoate (n = 105), with an 18-month follow up. KaplanMeier survival statistics for discontinuation rates and hospital admission were calculated. CGI severity and improvement scores were retrospectively assigned by the investigating team. Results: Paliperidone palmitate performed less favourably than risperidone long-acting injection (RLAI) or zuclopenthixol decanoate. Paliperidone palmitate had higher discontinuation rates due to any cause, inefficacy and increased hospitalization risk. Paliperidone palmitate had the smallest proportion of patients assigned a clinically desirable CGI-I score of 1 (very much improved) or 2 (much improved). Conclusions: Paliperidone palmitate had less favourable discontinuation and CGI outcomes compared with RLAI and zuclopenthixol decanoate. This could not be adequately explained by patients in the paliperidone group being more chronically or severely unwell, nor by the presence of comorbidities such as alcohol or substance misuse, or by the use of lower mean dosages compared with RLAI or zuclopenthixol decanoate. We considered that prescribers are familiarizing themselves with paliperidone and outcomes may improve over time. PMID:26913175
Eapen, Valsamma; Gururaj, A. K.
Background: Risperidone is a novel antipsychotic drug that has been tried in the treatment of several child psychiatric disorders. In an open clinical study, we evaluated the safety and efficacy of risperidone in children with developmental disorder and behavioral problems including attention-deficit/hyperactivity disorder (ADHD).
Full Text Available AIM: To observe the clinical efficacy of adjunctive intravitreous injection with Lucentis for the treatment of neovascular glaucoma(NVG. METHODS: The retrospective case series study included 25 eyes of 25 patients who underwentintravitreous injection with Lucentis. Patients firstly received an intravitreous injection with Lucentis(0.5mg/0.05mL, after the regression of neovascularization of the iris, patients accepted different surgical treatments according to different etiopathogenesis condition. Iris, chamber angle neovascularization condition, intraocular pressure, and visual acuity were observed postoperatively. The follow-up duration was 3mo.RESULTS: After 3-7d of intravitreous Lucentis injecting, iris and chamber angle neovascularization was totally faded in 20 cases(20 eyesand was not completely faded in 5 cases(5 eyes. Additional treatments were compound trabeculectomy(14 cases, 14 eyes, vitrectomy(4 cases, 4 eyes. The patients' mean intraocular pressure was 43.42±10.99mmHg before treatment, which decreased rapidly when they came out of the hospital(14.26±7.64mmHg, PPCONCLUSION:Intravitreous injection with Lucentis can be used as an assisted treatment of NVG. According to different etiopathogenesis condition, it is an effective treatment to combine with other treatment methods for NVG.
Li, Ming; He, Wei; Mead, Alexa
The rat conditioned avoidance response model is a well-established preclinical behavioral model predictive of antipsychotic efficacy. All clinically approved antipsychotic drugs disrupt conditioned avoidance responding - a feature that distinguishes them from other psychotherapeutics. We previously showed that the typical antipsychotic drug haloperidol disrupts avoidance responding by progressively attenuating the motivational salience of the conditioned stimulus (CS) in normal rats. In this study, using two pharmacological rat models of schizophrenia [e.g. phencyclidine (PCP) or amphetamine sensitization], we examined whether atypicals such as olanzapine or risperidone disrupt avoidance responding through the same behavioral mechanism. Rats were first pretreated with PCP, amphetamine, or saline under one of two different injection schedules for either 1 or 3 weeks. They were then trained to acquire avoidance responding to two types of CS (CS1 and CS2) that differed in their ability to predict the occurrence of the unconditioned stimulus. Finally, rats were tested repeatedly under olanzapine (1.0 mg/kg, subcutaneously) or risperidone (0.33 mg/kg, subcutaneously) daily for 5 or 7 consecutive days. We found that repeated olanzapine or risperidone treatment produced a progressive across-session decline in avoidance responding to both CS1 and CS2. Olanzapine and risperidone disrupted the CS2 (a less salient CS) avoidance to a greater extent than the CS1 avoidance. Pretreatment with PCP and amphetamine did not affect the disruptive effect of olanzapine or risperidone on avoidance responding. On the basis of these findings, we suggest that the atypical drugs olanzapine and risperidone, like the typical drug haloperidol, also disrupt avoidance responding primarily by attenuating the motivational salience of the CS. PMID:19179852
Eerdekens, Mariëlle; Van Hove, Ilse; Remmerie, Bart; Mannaert, Erik
The pharmacokinetics and tolerability of long-acting risperidone (Risperdal Consta) were evaluated in a multicenter, prospective, open-label, 15-week study of 86 patients with schizophrenia. Subjects stabilized on 2, 4 or 6 mg of oral risperidone once daily for at least 4 weeks were assigned to receive i.m. injections of 25, 50 or 75 mg of risperidone, respectively, every 2 weeks for 10 weeks. The 90% confidence intervals for the i.m./oral ratios of the mean steady-state plasma-AUC, corrected for dosing interval, and of the average plasma concentration of the active moiety (risperidone plus 9-hydroxyrisperidone) were within the range of 80-125%, indicating bioequivalence of the i.m. and oral formulations. However, mean steady-state peak concentrations of the active moiety were 25-32% lower with i.m. than oral dosing (P < 0.05) and fluctuations in plasma active-moiety levels were 32-42% lower with the i.m. than oral regimen. Symptoms of schizophrenia continued to improve after switching from oral to i.m. dosing. Long-acting risperidone was well tolerated locally and systematically. Although overall bioequivalence of the two formulations was established, the differences in pharmacokinetic profiles between the two formulations indicate potential benefits for long-acting risperidone. PMID:15246468
Tüzer, Erkut; Bilgin, Zahide; Oter, Kerem; Erçin, Süleyman; Tinar, Recep
Praziquantel, which has been used in the treatment and control of canine and feline tapeworm infections for about 35 years, has not been tested against these parasites for a long period in Turkey. This study was performed to evaluate the current efficacy of praziquantel against dog and cat tapeworms. Praziquantel injectable solution was administered to 26 dogs (14 of them were infected with Dipylidium caninum, 8 with Taenia spp and 2 with Echinococcus granulosus, 2 with both Dipylidium caninum and Taenia spp) and 2 cats (infected with Joyeuxiella pasqualei) subcutaneously at a dose of 0.1 ml/kg (5.68 mg active ingredient/kg). After treatment, animals were put in individual cages and their feces were taken daily for examination. Feces were examined macroscopically for tapeworm segments and scolexes and microscopically for tapeworm eggs by Fülleborn's flotation and Teleman's sedimentation (for fatty stools). To confirm results of analysis the examinations after treatment were repeated until two subsequent fecal analyses were negative. The parasites disappeared from the feces of all infected animals in 2 or 3 days after the treatment and the drug was found to be 100% effective against both dog and cat tapeworms. No adverse reactions were observed in both dogs and cats treated. PMID:20340081
Full Text Available Abstract Background To compare the efficacy and tolerability of paliperidone extended-release (ER with risperidone immediate-release using propensity score methodology. Methods Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound. Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient populations. Scores were generated using logistic regression models, with age, body mass index, race, sex, baseline Positive and Negative Syndrome Scale (PANSS total score and baseline Clinical Global ImpressionsSeverity (CGI-S score as factors. The dosage range of paliperidone ER (6-12 mg/day was compared with 2 risperidone dosage ranges: 2-4 and 4-6 mg/day. The primary efficacy measure was change in PANSS total score at week 6 end point. Tolerability end points included adverse event (AE reports and weight. AEs with rates ?5% and with a ?2% difference between paliperidone ER and risperidone were identified. Results Completion rates for placebo-treated subjects in paliperidone ER trials (n = 95 and risperidone trials (n = 122 groups were 36.8% and 51.6%, respectively; end point changes on PANSS total scores were similar (p = 0.768. Completion rates for subjects receiving paliperidone ER 6-12 mg/day (n = 179, risperidone 2-4 mg/day (n = 113 or risperidone 4-6 mg/day (n = 129 were 64.8%, 54.0% and 66.7%, respectively (placebo-adjusted rates: paliperidone ER vs risperidone 2-4 mg/day, p = 0.005; paliperidone ER vs risperidone 4-6 mg/day, p = 0.159. PANSS total score improvement with paliperidone ER was greater than with risperidone 2-4 mg/day (difference in mean change score, -6.7; p Conclusions This indirect database analysis suggested that paliperidone ER 6-12 mg/day may be more efficacious than risperidone 2-4 mg/day and as efficacious as risperidone 4-6 mg/day. The AE-adjusted incidence rates suggest differences between treatments that may be relevant for individual patients. Additional randomized, direct, head-to-head clinical trials are needed to confirm these findings.
Full Text Available Roberto Canitano, Valeria ScandurraDivision of Child Neuropsychiatry, University Hospital of Siena, Siena, ItalyAbstract: This is a review of the clinical trials investigating the efficacy and safety of risperidone in the treatment of children with autistic spectrum disorders (ASD. The main clinical characteristics are impairment in social skills, communication difficulties, repetitive movements and behaviors, including stereotypies. Pharmacotherapy is mainly directed at the so-called target symptoms, ie, behavioral disorders and the various kinds of repetitions associated with ASD. According to the available data, risperidone seems to be moderately efficacious and safe for treating behavioral disorders. 4 double blind controlled trial. 3 reanalysis studies, and 12 open studies have documented the role of risperidone in children with ASD. Controlled studies have been thoroughly considered in this review.Keywords: autism, pervasive developmental disorders, risperidone
Fernández-Miranda, Juan J; Caramés-García, Victoria; Sánchez-García, Arantxa
Tolerability and effectiveness of antipsychotics are important to increase treatment compliance in people with schizophrenia. The aim of this study was to evaluate effectiveness, tolerability, and adherence to treatment with high doses of risperidone long-acting injectable (RLAI) in patients with severe schizophrenia.It is a 3-year prospective, observational study of patients with severe (Clinical Global Impression Severity scale [CGI-S] score of ?5) schizophrenia according to International Classification of Diseases (ICD-10) criteria. Subjects were the consecutive 60 who first underwent treatment with RLAI with doses of 75 mg or higher every 14 days to get clinical stabilization.Assessment included the following: CGI-S, World Health Organization Disability Assessment Schedule, Camberwell Assessment of Need (CAN), Medication Adherence Rating Scale, laboratory tests, weight, and hospital admissions.The mean (SD) dose of RLAI was 111.2 (9.1) mg per 14 days. Tolerability was good and there were almost no interruptions due to adverse effects or to relevant biological parameters alterations. Also, weight gain was not significant.Retention rate in treatment after 3 years was 95%. Clinical Global Impression Severity (P < 0.01) and Camberwell Assessment of Need (P < 0.01) decreased and also Disability Assessment Schedule in the 4 areas (P < 0.01). Medication Adherence Rating Scale score increased from 3.6 (0.7) to 8.9 (0.9) (P < 0.001). There were significantly few hospital admissions than during the previous 36 months (1.9 [1.3] vs 0.31 [0.2], P < 0.001).As a conclusion, we highlight that the effectiveness and tolerability of 75 mg or higher every 14 days of RLAI were high, being useful in improving treatment adherence in patients with severe schizophrenia, getting good clinical and functional outcomes. PMID:26421461
Zaky, Khaled S; Yasser M Khalifa
Purpose: To determine the efficacy of preoperative subconjunctival injection of mitomycin C a day before surgery in the management of recurrent pterygium. Materials and Methods: Randomized comparative case series. Fifty eyes with recurrent pterygium were randomly divided into two groups; the mitomycin injection group (25 eyes) and the mitomycin application group (25 eyes). The mitomycin injection group underwent preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15...
Scott, Lesley J; Dhillon, Sohita
Risperidone (Risperdal), a psychotropic atypical antipsychotic agent, is thought to act via dopamine D(2) and serotonin 5-HT(2A) receptor antagonism. The clinical efficacy of oral risperidone in the treatment of bipolar mania and schizophrenia in adult patients is well established. In the US, risperidone is also approved for the treatment of irritability associated with autistic disorder in children and adolescents aged 5-16 years, for the treatment of schizophrenia in adolescents aged 13-17 years and, as monotherapy, for the short-term treatment of acute manic and mixed episodes associated with bipolar I disorder in children and adolescents aged 10-17 years. Oral risperidone treatment was better than placebo treatment in reducing irritability and other behavioural symptoms associated with autistic disorder in children and adolescents in two well designed short-term trials, with these benefits maintained in those receiving risperidone for up to 6 months. The drug had a clinically manageable tolerability profile, with most adverse events being of mild to moderate intensity. There are some aspects of treatment, such as weight gain, somnolence and hyperglycaemia, that require monitoring, and the long-term safety of risperidone in children and adolescents with autistic disorder remains to be fully determined. With these issues in mind, risperidone offers a valuable emerging option for the treatment of irritability associated with autistic disorder in children and adolescents. PMID:18278980
Full Text Available Risperidone is one of a new generation of antipsychotic drugs with relatively fewer side effects and better efficacy. Our objects were study of relationship between the incidence of Iranian produced risperidone Extrapyramidal Side Effects (EPSE and its relationship with age, sex, dosage and duration of treatment in patients with schizophrenia or schizoaffective disorders. One-hundred patients with schizophrenia or schizoaffective disorders admitted in Razi hospital of Tabriz, which underwent treatment with risperidone were selected by convenience method and the incidence of EPSE was evaluated for 6 weeks; the results were analyzed statistically. Seventy-two percent of patients showed no complications and 28% of them affected by EPSE. The incidence of complications was not related significantly with age and sex of patients but there was significant relationship between the duration of medication and dosage of drug (pv<0.05. The most EPSE were rigidity, tremor and bradykynesia, but there were not any acute dystonic reaction. Risperidone is one of the new generation antipsychotic drugs with lower side effects and its EPSE are dose-dependent. It is recommended that the treatment be initiated with minimum effective dose.
Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR): Resultados clínicos del uso de risperidona inyectable de liberación prolongada a dos años de seguimiento / Electronic Schizophrenia Treatment Adherence Registry in Latin America (e-STAR): Clinical outcomes of long-acting injectable risperidone in a 2-year follow up
Rogelio, Apiquian; Rodrigo, Córdoba; Mario, Louzã; Ana, Fresán.
Full Text Available La esquizofrenia genera elevados costos al sistema de salud. La falta de adherencia al tratamiento es una de las principales causas de recaídas y hospitalizaciones en la esquizofrenia. Lo anterior conduce a un pobre pronóstico y deterioro funcional de los pacientes. La risperidona inyectable de libe [...] ración prolongada (RILP) ha demostrado su eficacia en el tratamiento de la esquizofrenia, ofreciendo la posibilidad de que los pacientes tengan una mayor adherencia terapéutica. Objetivo Determinar la eficacia y efecto sobre la funcionalidad y el uso de recursos hospitalarios de la RILP en una muestra de pacientes con esquizofrenia de América Latina a dos años de seguimiento. Método El Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR) es un estudio observacional del uso de la RILP en la esquizofrenia. Se reclutaron pacientes de México, Colombia y Brasil. Se registró la información clínica del paciente un año previo al inicio del tratamiento con la RILP y de forma prospectiva cada tres meses hasta cumplir los 24 meses de seguimiento. Se registraron las hospitalizaciones y el esquema de tratamiento con la RILP. La escala de Impresión Clínica Global-Gravedad (CGI-S) se utilizó como indicador de eficacia mientras que la Escala Global de Funcionamiento (GAF) y la Escala de Desempeño Personal y Social (PSP) se utilizaron para evaluar el funcionamiento. Resultados Setenta y tres pacientes completaron los dos años de seguimiento. La proporción de pacientes hospitalizados disminuyó del 16.4 al 4.1% después de dos años de tratamiento con la RILP. El 2.7% descontinuó el tratamiento debido a falta de eficacia. Se observó una mejoría significativa en cuanto a la gravedad del padecimiento y el funcionamiento global. Discusión En la práctica clínica cotidiana, la RILP resulta ser un tratamiento a largo plazo efectivo para la esquizofrenia con el beneficio adicional de una menor utilización de recursos del sistema de salud. Abstract in english Schizophrenia is a chronic psychiatric disorder associated to high healthcare costs mainly driven by inpatient care. Lack of adherence to antipsychotic treatment is a common reason for relapse and rehospitalization leading to poor prognosis and global functional impairment of patients. Risperidone l [...] ong-acting injection (RLAI) has demonstrated its efficacy in treating symptoms of schizophrenia and offers the potential to improve adherence to treatment. Objective To determine clinical and functional efficacy of RLAI and use of health resources (eg., hospitalizations) in a 2-year follow up study among patients with schizophrenia from Latin America. Method The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is an observational study of patients who start treatment with RLAI. Data from patients recruited in Mexico, Colombia and Brazil were collected retrospectively for one year prior to baseline, at baseline and every three months for 24 months. Hospitalization rates and treatment regime were registered. Efficacy was assessed using the Clinical Global Impression of Illness-Severity Scale (CGI-S), while the Global Assessment of Functioning (GAF) and the Personal and Social Performance (PSP) were used for the evaluation of functioning. Results Seventy-three patients completed the two-year follow-up. The proportion of patients hospitalized declined from 16.4% before treatment to 4.1% after 2 years of treatment with RLAI. Only 2.7% discontinued the treatment due to lack of efficacy. Significant improvements were reported in illness severity as well as in global functioning assessed by the CGI-S, GAF and PSP scales, respectively. Discussion Our results give further support of the efficacy of RLAI for the treatment of schizophrenia. Additional to symptom severity reduction and functional recovery, improved treatment adherence and reduced hospitalization rates were observed with the use of RLAI. In a real world clinical setting, RLAI offer an effective long-term treatment for patients with schiz
Fourteen young adult beagles were given an intravenous injection of either 241Am(III) citrate or 239Pu(IV) citrate (labeled with 237Pu) followed by a single intravenous injection of Ca-DTPA after an interval of 1 min, 6 min, 30 min, 150 min, 8 hr, 1 day, or 3 days. Animals were sacrificed 7 days after DTPA injection. Retention of 241Am at death was influenced strongly by early treatment. Dogs given Ca-DTPA at 1, 6, and 30 min retained about 3, 10, and 29% respectively, of the injected 241Am, while the animal treated at 150 min retained 45%. Beagles given 241Am and then DTPA at 8 hr, 1 day, and 3 days, retained 58, 73, and 72%, respectively. For 241Am contamination, the first DTPA treatment should be given as soon as possible. Total-body retention of 239+237Pu was affected less dramatically be early treatment. The dogs given DTPA at 1, 6, and 30 min retained 31, 28, and 34% at death, while the Pu retention in the animal treated at 150 min was 44%, a value similar to that in the dog given 241Am and treated also at 150 min. At the later treatment times, the retention of Pu and Am seemed to be generally the same. Dogs given Pu and then DTPA at 8 hr, 1 day, and 3 days retained52, 5[, and 7[%, respectively. Even though delays of up to 30 min seemed to have little effect upon total-body retnetion after 239Pu exposure, early treatment at 1 and 6 min had a disproportionately greater effect in reducing th Pu in trabecular bone, where most osteosarcomas arise, as compared with cortical bone. Therefore, in the event of 239Pu intake by humans, treatment should begin as soon as possible. Earlier work indicates that frequent injections of Zn-DTPA should follow the initial Ca-DTPA treatment
Gabriel, Rubio; Isabel, Martínez; Ana, Recio; Guillermo, Ponce; Francisco, López-Muñoz; Cecilio, Alamo; Miguel Ángel, Jiménez-Arriero; Tomás, Palomo.
Full Text Available Background: Substance use disorders (SUDs) are present in more than 50% of subjects diagnosed with schizophrenia. However, there are no controlled studies assessing the efficacy of antipsychotic drugs in this subgroup of patients. The aim of the present work was to compare the efficacy of risperidon [...] e and zuclopenthixol in a sample of schizophrenic subjects with dual diagnosis. Method: Thirty-three male were selected for treatment with risperidone, while another 33 were treated with zuclopenthixol. Substances most commonly used were alcohol, cannabis (both 82%) and cocaine (32%). Patients were randomized and treated for the first six months with one antipsychotic and the second six months with the other antipsychotic. Psychopathological and clinical scales were used every two months. Participants received training on how to reduce their consumption of substances (Substance Abuse Management Module, SAMM). Results: During the first six months risperidone group patients presented fewer positive urine tests and showed better compliance with the SAMM programme. In the second period the patients treated with risperidone significantly improved their scores on the PANSS-negative subscale. Differences between the CGIs indicated that the subjects who moved from risperidone to zuclopenthixol worsened, while those who moved from zuclopenthixol to risperidone significantly improved. Conclusions: Risperidone was more effective than zuclopenthixol in improving the symptoms of schizophrenia and substance use.
(1) Sedative drugs are one option when autistic or mentally disabled children have behavioural disorders that place them (or other people) in physical danger. Among the classic neuroleptics, haloperidol is the drug with the best-documented efficacy and safety. Placebo-controlled trials have also shown lithium to be effective for this use. (2) Clinical evaluation of risperidone in children with mental disabilities includes 3 placebo-controlled double-blind trials, 2 of which involved 118 and 110 children aged from 5 to 12 years who were treated for 6 weeks. All 3 trials showed a partial behavioural improvement in about 75% of children receiving risperidone, versus about 30% of children in the placebo groups. (3) Clinical evaluation of risperidone in autistic children includes 2 placebo-controlled double-blind trials involving 110 and 79 children who were treated for 8 weeks. One of these studies has been published in detail: 69% of children partially improved with risperidone, versus 12% of the children on placebo. (4) Given the absence of clinical trials comparing risperidone with haloperidol or lithium, there is no evidence that risperidone is more effective than these other treatments. (5) The principal adverse events observed in short-term trials of risperidone were drowsiness (affecting about 50% of children), weight gain (about 1.2 kg per month during the first months of treatment), and hyperprolactinaemia (affecting about 12% of children). Extrapyramidal disorders were infrequent during short-term trials, but their incidence reached about 25% after a year of risperidone treatment. (6) The impact of long-term risperidone therapy on growth and mental development is not known. (7) In France treatment is about 7 times more expensive with risperidone than with haloperidol. (8) In practice, the risk-benefit balance of risperidone in the treatment of autistic or mentally disabled children with behavioural disorders is no better overall than that of older products such as haloperidol and lithium, which, in the absence of anything better, remain the standard drugs. PMID:16602211
Risperidone and lamotrigine were successfully labeled with 125I via direct electrophilic substitution reaction at 80 deg C with maximum labeling yields of 89 ± 3.75 and 97.5 ± 1.0 %, respectively. Stability of 125I-risperidone was up to 6 h while that of 125I-lamotrigine was up to 24 h. Biodistribution studies showed that maximum uptakes of 125I-risperidone and 125I-lamotrigine in the brain of mice were 4.35 ± 0.17 and 2.51 ± 0.18 % of the injected activity/g tissue organ at 10 min post-injection, respectively. Both radioiodinated drugs showed higher brain uptake and stability compared to commercially available technetium-99m d,l-hexamethyl propyleneamine oxime. (author)
Scott, Lesley J; Dhillon, Sohita
Risperidone (Risperdal), a psychotropic atypical antipsychotic agent, is thought to act via dopamine D(2) and serotonin (5-HT [5-hydroxytryptamine])(2A) receptor antagonism. The clinical efficacy of oral risperidone in the treatment of bipolar mania and schizophrenia in adult patients is well established. In the US, risperidone is also approved for the treatment of irritability associated with autistic disorder in children and adolescents aged 5-16 years, for the treatment of schizophrenia in adolescents aged 13-17 years and, as monotherapy, for the short-term treatment of acute manic and mixed episodes associated with bipolar I disorder in children and adolescents aged 10-17 years. Oral risperidone treatment was better than placebo treatment in reducing irritability and other behavioral symptoms associated with autistic disorder in children and adolescents in two well designed short-term trials, with these benefits maintained in those receiving risperidone for up to 6 months. The drug had a clinically manageable tolerability profile, with most adverse events being of mild to moderate intensity. There are some aspects of treatment, such as weight gain, somnolence, and hyperglycemia, that require monitoring, and the long-term safety of risperidone in children and adolescents with autistic disorder remains to be fully determined. With these issues in mind, risperidone offers a valuable emerging option for the treatment of irritability associated with autistic disorder in children and adolescents. PMID:17927305
English, J. M.; Toon, O. B.; Yu, P.; Mills, M. J.; Bardeen, C.
Injection of sulfur dioxide (SO2) in the stratosphere to form reflective sulfate aerosols has been suggested as a leading solar radiation management idea to cool the planet. Studies with sectional aerosol models suggest limited efficacy due to aerosol growth; and studies with coupled models suggest possible impacts on stratospheric dynamics and chemistry. Modeling simulations to date have specified tropical SO2 injections at 18 km altitude or higher, which is above the flying ceiling of most existing aircraft. We simulate tropical SO2 injections at 13 km altitude (160 mb) and 20 km altitude (50 mb) and mid-latitude injections at 13 km altitude using the 60-level CAM5/CARMA model, which allows for detailed vertical resolution of the stratosphere, sectional aerosol bin representation, and interactions between aerosols, chemistry, radiation, and clouds. We quantify the resulting aerosol evolution, radiative effects, and surface temperature effects, as well as the impacts of SO2 injections on tropospheric clouds.
Full Text Available AIM: To observe the efficacy of first Ranibizumab intravitreal injection on macular edema caused by retinal vein occlusion(RVO. METHODS: Thirty-nine eyes of 39 patients with macular edema due to RVO were treated in our hospital during June 2014 to December 2014. Patients received intravitreal injection of 0.05mL ranibizumab. Best corrected visual acuity(BCVA, central macular thickness(CMTand cube average thickness(CATwere analyzed at 2d, 2, and 4wk after injection, respectively. RESULTS: The baseline BCVA(LogMAR, CMT and CAT were 0.82±0. 45, 541±136?m and 382±107?m before treatment. After first ranibizumab intravitreal injection, mean BVCA significantly improved at 2d(0. 56±0.35,PPPPPPPPPCONCLUSION: First intravitreal injection of ranibizumab can improve macular edema caused by RVO in short-term, but long-term effects is needed further observed.
Ascher-Svanum H; Montgomery WS; McDonnell DP; Coleman KA; Feldman PD
Haya Ascher-Svanum1, William S Montgomery2, David P McDonnell3, Kristina A Coleman4, Peter D Feldman11Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly Australia Pty Ltd, West Ryde, New South Wales, Australia; 3Eli Lilly and Company, Cork, Ireland; 4OptumInsight, Lilyfield, New South Wales, AustraliaBackground: Little is known about the comparative effectiveness of atypical antipsychotics in long-acting injection formulation. Due to the absence of head-to-h...
Jeffrey R Bishop
Full Text Available Jeffrey R Bishop1,2, Mani N Pavuluri21Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Department of Psychiatry, Pediatric Mood Disorders Program and Center for Cognitive Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Risperidone is a commonly used medication for the treatment of bipolar disorder and schizophrenia in children and adolescents. It has been studied as a monotherapy treatment in early onset schizophrenia and as both monotherapy and combination therapy for pediatric bipolar disorder. Studies to date indicate that risperidone is an effective treatment for positive and negative symptoms of schizophrenia and mania symptoms of bipolar disorder. In young patient populations, side effects such as weight gain, extrapyramidal side effects, and prolactin elevation require consideration when evaluating the risk benefit ratio for individual patients. Here we review published studies of risperidone for the treatment of bipolar disorder and schizophrenia in children and adolescents to provide practitioners with an overview of published data on the efficacy and safety of risperidone in these patient populations.Keywords: risperidone, bipolar disorder, schizophrenia, children, adolescents
Fountoulakis, Konstantinos N; Nimatoudis, Ioannis; Iacovides, Apostolos; Kaprinis, George
Introduction The current study is a short report of 3 cases of bipolar patients. Material and methods Three bipolar patients were prospectively followed up. All were partial responders to lithium therapy alone, and unresponsive to other therapies (anticonvulsants, antidepressants, typical antipsychotics, various combinations). Results All manifested complete remission of symptoms after combination therapy with lithium (plasma levels above 0.8 mEq/lt) plus 13 mg of risperidone daily. The two of them are still free of symptomatology during the maintenance period for 28 and 38 months respectively. The third patient, after several months during which she was free of symptomatology discontinued lithium against the psychiatrist's advise and received only 3 mg of risperidone daily. For the next 15 months the patient was under risperidone monotherapy and free of symptomatology. She discontinued therapy to become pregnant, the illness recurred several times during pregnancy and after the delivery the patient restarted risperidone therapy. She was free of symptoms for the following 9 months until her last follow-up. Discussion The current study provides preliminary evidence concerning the long term efficacy of risperidone in the treatment of bipolar patients PMID:15163347
Full Text Available Pain in neonates can be associated with various risks and it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but orally administered glucose solution is found to be effective. The objective of this study was to assess the efficacy of oral 30% glucose during intramuscular injection in term neonates. Sixty-four healthy term neonates were recruited for this study during 1 month. The inclusion criteria were gestational age 37-42 weeks, birth weight 2500-4000 gr, and Apgar score > 7. The intervention consists of administration of either 2 ml of oral 30% glucose or 2ml of sterile water 2 minutes before injection. The primary out come measure was the cumulative Neonatal Infant Pain Scale (NIPS score at 3 minutes after injection. Thirty-two neonates received 30% glucose and 32 neonates received sterile water. The cumulative NIPS score at 3 minutes after injection for neonates given 30% glucose was significantly (P = 0.000 lower than for neonates given sterile water. The heart rate immediately after injection for neonates given 30% glucose was significantly (P = 0.002 lower than for neonates given sterile water. Oral 30% glucose given 2 minutes before injection was effective in reducing neonatal pain following injection. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedures in term neonates.
Full Text Available ObjectiveTo analyze the efficacy of endoscopic histoacryl injection in the treatment of gastric variceal bleeding caused by regional portal hypertension. MethodsThe endoscopic features and efficacy of endoscopic histoacryl injection were examined and compared in two groups of patients admitted to our hospital from June 2012 to December 2012. One of the groups included 6 patients with gastric variceal bleeding caused by regional portal hypertension and the other group included 6 patients with gastric variceal bleeding caused by hepatitis B cirrhosis-related portal hypertension. Between-group comparison of categorical data was made by Fisher?s test. ResultsIn patients with regional portal hypertension, five of them had severe isolated gastric varices (IGV and one had severe IGV with mild esophageal varices. All six patients with hepatitis B cirrhosis-related portal hypertension had severe IGV and the endoscopic features were similar to those of patients with regional portal hypertension. Significant differences were observed between the group with regional portal hypertension and the group with hepatitis B cirrhosis related portal hypertension in short-term response rate (1/6 vs 6/6, P=0.015 and long-term response rate (0/6 vs 5/6, P=0.015. ConclusionThe gastric varices caused by regional portal hypertension has a fast progression rate and a high bleeding risk. The efficacy of endoscopic histoacryl injection in patients with this type of gastric varices is poor.
Dodig-Curkovi?, Katarina; Curkovi?, Mario; Radi?, Josipa; Radi?, Mislav
Autism is a pervasive developmental disorder characterised by impairment in social interaction and communication, with unusual behavior. In some cases the pharmacotherapy is prescribed and the most studied antipshychotic drugs include haloperidol and risperidone. In this paper we displayed the treatment of two cases of autism in boy and girl with risperidone. With the use of risperidone in girl, we have achieved reduction of psychomotor symptoms and reduction of hetero-aggressive and self-destructive behavior, and in boy we have also achieved reduction of psychomotoric symptoms, with improvement in contact with his surrounding, he had less learning problems and he has felt familiar not only with his mother, but with other persons. Research on the use of risperidone in the treatment of autistic disorders among children in Croatia are rare, given the limited use of risperidone in children younger than 15years, the question arises about the need to expand the scope of application of risperidone in younger age groups. PMID:21648351
McDougle, C J; Scahill, L; McCracken, J T; Aman, M G; Tierney, E; Arnold, L E; Freeman, B J; Martin, A; McGough, J J; Cronin, P; Posey, D J; Riddle, M A; Ritz, L; Swiezy, N B; Vitiello, B; Volkmar, F R; Votolato, N A; Walson, P
This article has reviewed the background and rationale for the choice of risperidone as the first drug to be studied by the RUPP Autism Network. Risperidone has potent effects on 5-HT and DA neuronal systems, both of which have been implicated in the pathophysiology of autism. Unlike the typical antipsychotics, haloperidol and pimozide, which have been shown to be effective for reducing many of the maladaptive behaviors associated with autism, risperidone's 5-HT2A/DA D2 ratio of receptor blockade appears to produce a lower risk of acute and chronic extrapyramidal side effects, as well as enhanced efficacy for the "negative" symptoms of autism. Indirect clinical and preclinical evidence supports the use of risperidone to treat impaired social behavior, interfering repetitive phenomena, and aggression, targets of pharmacotherapy for many patients with autism. Numerous published open-label trials in children and adolescents with autism and related PDDs and one double-blind, placebo-controlled study in adults suggest that risperidone has promise for the treatment of children and adolescents with autism. Because most of these studies have been short-term, open-label trials in small samples, however, a large-scale controlled study of risperidone in children and adolescents with autism is needed to confirm these results. Finally, because it is likely that children who demonstrate short-term benefit from risperidone will remain on the medication indefinitely, the longer-term effectiveness and safety of risperidone in this population also needs to be determined. The design of this study and the assessments used are described separately. PMID:10674197
... of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age ... ever used street drugs or large amounts of alcohol; if you have ever overused prescription medications; if ...
Full Text Available OBJECTIVE: Local injection of botulinum toxin is a highly effective treatment option for a wide range of movement disorders and there are reliable sources of information on its indications, effects and safety in clinical practice. In this study, we report our experience with botulinum toxin in the treatment of facial region disorders. METHODS: Patients who had been followed in the Botulinum Toxin Outpatient Clinic of the Neurology Department were retrospectively evaluated. Two preparations of botulinum toxin type A (BT-A were used. The efficacy of BT-A injections was rated according to the improvement in symptoms as follows: marked - 75-100% improvement, good - 50-74%, moderate - 25-49%, and insufficient - less than 25% symptom relief. RESULTS: One hundred eighty-two patients (73 male, 109 female with various facial region disorders were included. The efficacy rates for patients who had very good and good improvement were high in the treatment of blepharospasm, hemifacial spasm, facial synkinesis, and Meige syndrome and moderate for oromandibular dystonia and hypersalivation. Ptosis was the most common side effect. CONCLUSION: According to our results, botulinum toxin was very effective treatment for blepharospasm, Meige syndrome, hemifacial spasm and facial synkinesis, whereas it demonstrated good efficacy in oromandibular dystonia and hypersalivation.
Full Text Available AIM:To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema(DME.METHODS:Totally 60 eyes(60 patientswith DME were randomly divided into 2 groups: 30 eyes of simple injection group underwent intravitreal injection of ranibizumab, and 30 eyes of combined treatment group underwent intravitreal injection of ranibizumab and macular grid photocoagulation 1wk later. The best corrected visual acuity(BCVA, central macular thickness(CMTmeasured by optical coherence tomography(OCTand postoperative complications were observed.RESULTS:In simple injection group, the BCVA after operation were separately 0.390±0.075(4wk, 0.367±0.088(8wkand 0.319±0.064(12wk,the CMT after operation were separately 221.63±112.34?m(4wk, 337.73±99.56?m(8wkand 432.92±100.46?m(12wk, which were much better than pre-operation. But during follow-up, the BCVA presented down trend and the CMT was on the rise slowly. In combined treatment group, the BCVA after operation were separately 0.385±0.036(4wk, 0.382±0.079(8wkand 0.377±0.097(12wk,the CMT after operation were separately 249.77±106.55?m(4wk, 270.40±92.88?m(8wkand 275.84±97.34?m(12wk, which were satisfactory and steady during follow-up, better than simple injection group(PCONCLUSION:Intravitreal injection of ranibizumab can effectively improve visual acuity and decrease central foveal thickness for patients with DME, combining with macular grid photocoagulation can ensure therapeutic effects steady and permanent.
To evaluate the efficacy of peripheral streptomycin injection in relieving the pain of idiopathic trigeminal neuralgia Study Design: Quasi experimental study. Place and duration of Study: Oral and Maxillofacial Surgery Department, Armed Forces Institute of Dentistry Rawalpindi, from 1st June 2006 to 31st December 2007. Patients and Methods: Thirty patients of idiopathic trigeminal neuralgia were selected. They received five consecutive injections of streptomycin 1g in 3 ml of 2% Lignocaine (Septodont) with 1: 100,000 adrenaline at one week interval. Follow up was carried out at one, two and six months after the last injection. Results: Age ranged from 15-78 years (mean 44.67). Male to female ratio was 1:1.14. Right side of the face was involved in 70% and left side in 30% cases. Mandibular division of trigeminal nerve was involved in 43.3% and maxillary division in 40% of the cases. In the rest both maxillary and mandibular divisions were involved. Pain was significantly decreased from baseline to 1 month (p < 0.001). The level of pain was increased a bit but the increase was significant at two months (p = 0.006) and at 6 months (p = 0.020). Conclusion: Best treatment modality for this devastating disease is yet to evolve. Within the confines of the study it can be stated that efficacy combined with low post treatment morbidity makes streptomycin a useful treatment option. (author)
Full Text Available Local chemodenervation with botulinum toxin (BoNT injections to relax abnormally contracting muscles has been shown to be an effective and well-tolerated treatment in a variety of movement disorders and other neurological and non-neurological disorders. Despite almost 30 years of therapeutic use, there are only few studies of patients treated with BoNT injections over long period of time. These published data clearly support the conclusion that BoNT not only provides safe and effective symptomatic relief of dystonia but also long-term benefit and possibly even favorably modifying the natural history of this disease. The adverse events associated with chronic, periodic exposure to BoNT injections are generally minor and self-limiting. With the chronic use of BoNT and an expanding list of therapeutic indications, there is a need to carefully examine the existing data on the long-term efficacy and safety of BoNT. In this review we will highlight some of the aspects of long-term effects of BoNT, including efficacy, safety, and immunogenicity.
Eom, Kee Seon; Kim, Seung Ho; Rim, Han Jong
Efficacy of praziquantel (Cesocide injection) by intramuscular (I.M.) route against cestode infections was evaluated. Total 93 domestic or laboratory animals such as dogs, cats, rats, mice, goats, deers and chickens were used. Animals were infected with Dipylidium caninum, Spirometra sp., Taenia pisiformis, Taenia taeniaeformis, Hymenolepis nana, Moniezia expansa, Moniezia sp. or Raillietina sp. A single dose of praziquantel, 6 mg/kg of body weight, was highly effective (97.9%) against cestodes of various kinds disregarding the host species or their intensity of infection. At high dose above 6 mg/kg, the cure rate was 100%. All the cestodes treated were expelled from the host within 48 hours. The discharged proglottids were damaged severely except Hymenolepis nana and Moniezia expansa. Intramuscular injection of this drug evoked a brief pain response in a dog, but no other side reactions were observed. PMID:12811058
SubaÅÄ±, Volkan; ÃakÄ±r, Tuncay; ArÄ±ca, Zuhal; SarÄ±er, Rahime Nur; Bilgilisoy Filiz, Meral; KoldaÅ DoÄan, Åebnem; Toraman, Naciye FÃ¼sun
The aim of the study was to compare the efficacy of kinesiological taping and subacromial injection therapy in patients with subacromial impingement syndrome (SIS). Seventy patients diagnosed with SIS were randomly assigned to group 1 (nâ=â35, injection group) or group 2 (nâ=â35, kinesiological taping group). Betamethasone plus prilocaine was injected to subacromial space in the patients in group 1. In group 2, tape was applied three times for a period of five consecutive days with a 2-day recovery interval. A 3-month exercise program was prescribed for both groups including stretching and strengthening exercises. All patients were assessed at baseline and at 1 and 3Â months post-intervention. Assessments were made by visual analog scale (VAS) for pain, range of motion (ROM) measurements, specific tests, and Shoulder Pain and Disability Index (SPADI). Significant differences were detected in VAS and SPADI scores as well as ROM measurements in both groups when compared to baseline (pâ>â0.05). No significant differences were detected between the groups except for active flexion degree in favor of group 1 (pâ=â0.004). Both kinesiological taping and steroid injection in conjunction with an exercise program were found to be effective in the treatment of SIS. Kinesio taping may be an alternative treatment option in the rehabilitation of SIS especially when a non-invasive technique is needed. PMID:25403253
Full Text Available How to Cite This Article: Fayyazi A, Salari E, Khajeh A, Ghajarpour A. A Comparison of Risperidone and Buspirone for Treatment ofBehavior Disorders in Children with Phenylketonuria. Iran J Child Neurol. 2014 Autumn; 8(4:33-38.AbstractObjectiveMany patients with late-diagnosed phenylketonuria (PKU suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients.Materials & MethodsIn this crossover clinical trial study, patients with severe behavior disorders after medical examination were randomly divided into two groups of two 8-week crossover treatments with risperidone or buspirone. Patient behavioral disorders before and after treatment by each drug was rated by parents on the Nisonger Child Behavior Rating Form (NCBRF, and after treatment by each drug, were assessed by a physician through clinical global impression (CGI.ResultsThirteen patients were able to complete the therapy period with these two medications.The most common psychiatric diagnoses were intellectual disability accompanied by pervasive developmental disorder NOS, and intellectual disability accompanied by autistic disorder. Risperidone was significantly effective in reducing the NCBRF subscales of hyperactivity disruptive/ stereotypic, and conduct problems. Treatment by buspirone only significantly decreased the severity of hyperactivity, but other behavior aspects showed no significant differences. Assessment of the severity of behavior disorder after treatment by risperidone and buspirone showed significant differences in reducing hyperactivity and masochistic/stereotype.ConclusionAlthough buspirone is effective in controlling hyperactivity in patients with PKU, it has no preference over risperidone. Therefore, it is recommended as an alternative to risperidone.ReferencesSmith I, Nowles JK. Behaviour in early treated phenylketonuria: a systematic review. Eur J Pediatr 2000;159:89-93.Targum SD and Lang W .Neurobehavioral Problems Associated with Phenylketonuria. Psychiatry (Edgemont 2009; 7(12:29â32.Luciana M, Hanson K L,Whitley C B.A preliminary report on dopamine system reactivity in PKU: acute effects of haloperidol on neuropsychological, physiological, and neuroendocrine functions. Psychopharmacology 2004;175: 18â25.Pappadopulos E, Woolston S, Chait A, Perkins M, Connor DF, Jensen P S. Pharmacotherapy of Aggression in Children and Adolescents: Efficacy and Effect Size. J CDN ACAD Child Adolesc Psychiatry 2006; 15(1:27-39.Shea S, Turgay A, Carroll A, Schulz M, Orlik H ,Smith I and et al. Risperidone in the Treatment of Disruptive Behavioral Symptoms in Children With Autistic and Other Pervasive Developmental Disorders. Pediatrcs 2004; 114:634-641.Miral S, Gencer O, Inal-Emiroglu F.N, Baykara B, Baykara A, Dirik E. Risperidone versus haloperidol in children and adolescents with AD: a randomized, controlled, doubleblind trial. Eur Child Adolesc Psychiatry 2008; 17:1â8.Aman M.G, Hollway J.A, McDougle C.J, Scahill L, Tierney E, McCracken J.T and et al. Cognitive effects of risperidone in children with autism and irritable behavior. J. Child Adolesc. Psychopharmacol 2008; 18:227â236.Pandina G.J, Bossie C.A, Youssef E, Zhu Y, Dunbar F. Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebocontrolled trial. J Autism Dev Disord 2007; 37:367â373.Luby J, Mrakotsky C, Stalets M.M, Belden A, Heffelfinger A, Williams M and et al. Risperidone in preschool children with autistic spectrum disorders: an investigation of safety and efficacy. J. Child Adolesc. Psychopharmacol 2006; 16:575â587.Nagaraj R, Singhi P, Malhi P. Risperidone in children with autism: randomized, placebo controlled, double blind study. J. Child Neurol 2006; 21:450â455.Haas M, Karcher K, Pandina GJ. Treating Disruptive Behavior Disorders with Risperidone: A 1-Year, Open-Label Safety Study in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology 2008;18(4: 337â346.Jensen P, Buitelaar J, Pandina G, Binder C, Haas M. Management of psychiatric disorders in children and adolescents with atypical antipsychotics. Eur Child Adolesc Psychiatry 2007; 16:104â120.Pandina G, Aman M, Findling R. Risperidone in the management of disruptive behavior disorders. J Child Adolesc Psychopharmacol 2006; 16:379â392.Reyes M, Buitelaar J, Toren P, Augustyns I, Eerdekens M. A randomized, double-blind, placebo-controlled study of risperidone maintenance treatment in children and adolescents with disruptive behavior disorders. Am J Psychiatry 2006; 163:402â410.Reyes M, Croonenberghs J, Augustyns I, Eerdekens M. Long-term use of risperidone in children with disruptive behavior disorders and subaverage intelligence: Efficacy, safety, and tolerability. J Child Adolesc Psychopharmacol 2006; 16:260â272.Croonenberghs J, Fegert JM, Findling RL, De Smedt G, Van Dongen S. Risperidone Disruptive Behavior Study Group: Risperidone in children with disruptive behavior disorders and subaverage intelligence: A 1-year, openlabel study of 504 patients. J Am Acad Child Adolesc Psychiatry 2005; 44:64â72.Aman M G, Smedt G D, Derivan A, Lyons B, Findling R L.Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Disruptive Behaviors in Children With Subaverage Intelligence. Am J Psychiatry 2002; 159:1337â1346.Snyder R, Turgay A, Aman M, Binder C, Fisman S, Carroll A. Risperidone Conduct Study Group. Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQs. J Am Acad Child Adolesc Psychiatry 2002; 41:1026â1036.Gualtieri T. Buspirone for the Behavior problems of patients with Organic Brain Disorders. J Clin Psycopharmacol 1991; 11:280-281.Stanislav S, Fabre T, Crismon L, Childs A. Buspironeâs Efficacy in Organic-Induced Aggression.J Clin Psycopharmacol 1994;14:126-130.Realmuto GM, August GJ, Garfinkel BD. Clinical effect of buspirone in autistic children. J Clin Psychopharmacol 1989; 9(2:122-5.Ratey J, Sovner R, Parks A, Rogentine K. Buspirone treatment of aggression and anxiety in mentally retarded patients: a multiple-baseline, placebo lead-in study. J Clin Psychiatry 1991; 52(4:159-62.Sorensen MJ, Thomsen PH, Bilenberg N. Parent and child acceptability and staff evaluation of K-SADA-PL: a pilot Study. European Child and Adolescent Psychiatry 2007; 16(5: 293-7.Kaufman J, Brimaher B, Bren, D, Rao U, Flynn C, Moreci P and et al. Schedule for affective disorders and Schizophrenia For school âage children â present and lifetime version- (K-SADS-PL: initial reliability and validity date. Journal of the American Academy of Child and Adolescent Psychiatry 1997; 36(7:980-988.Â Aman MG, TassÃ© MJ, Rojahn J, and Hammer D: The Nisonger CBRF: a child behavior rating form for children with developmental disabilities. Research in Developmental Disabilities 1996;17:41â57.TassÃ© MJ, Aman MG, Hammer D, Rojahn J: The Nisonger Child Behavior Rating Form: age and gender effect and norms. Research in Developmental Disabilities 1996; 17:59â75.Norris M, Lecavalier L. Evaluating the validity of the Nisonger Child Behavior Rating Form â Parent Version. Research in Developmental Disabilities 2011; 32:2894â 2900.Guy W. Clinical global impressions. In: ECDEU Assessment Manual for Psychopharmacology. Rockville, MD, National Institute of Mental Health. 1976.Pp.217- 222.National Institute of Mental Health. CGI (Clinic Global Impression Scale. Psychopharmacology Bull 1985; 21:839-843.Marder S, Hurford IM, van Kammen DP: Second- Generation Antipsychotics: Biological Therapies. Sadock BJ, Sadock VA, Pedro R: Kaplan & Sadockâs Comprehensive Textbook of Psychiatry, 9th Edition. Philadelphia. Lippincott Williams & Wilkins. 2009. P.3220.
Full Text Available Hongyan Zhang1, Huafang Li2, Liang Shu1, Niufan Gu2, Gang Wang3, Yongzhen Weng3, Shiping Xie4, Xinbao Zhang4, Ting Li5, Cui Ma5, Wei Yu6, Bruce Parsons7, Manjula Schou81Institute of Mental Health, Peking University, Beijing, China; 2Shanghai Mental Health Center, Shanghai, China; 3Capital Medical University, Beijing An Ding Hospital, Beijing, China; 4Nanjing Brain Hospital, Nanjing, China; 5Guangzhou Brain Hospital, Guangzhou, China; 6Pfizer China, Beijing, China; 7Pfizer Inc, New York, NY, USA; 8Pfizer Australia, Sydney, AustraliaBackground: The aim of the study was to evaluate the efficacy and safety of ziprasidone versus risperidone in Chinese subjects with acute exacerbation of schizophrenia.Methods: In patients meeting the Chinese Classification of Mental Disorders criteria for schizophrenia and with a Positive and Negative Syndrome Scale (PANSS total score ?60 were randomly assigned to six weeks of double-blind treatment with ziprasidone 4080 mg twice daily or risperidone 13 mg bid, flexibly dosed. Noninferiority was demonstrated if the upper limit of the two-sided 95% confidence interval (CI for the difference in PANSS total score improvement from baseline in the evaluable population was smaller than the prespecified noninferiority margin of 10 units.Results: The intent-to-treat population comprised 118 ziprasidone-treated and 121 risperidone-treated subjects. Improvement (reduction from baseline to week 6 in PANSS total score was (-35.6 [95% CI: -38.6, -32.6] for ziprasidone and (-37.1 [95% CI: -39.9, -34.4] for risperidone. Noninferiority was demonstrated in the evaluable population with a difference score of 1.5 [95% CI: -2.5, 5.5]. Mean prolactin levels decreased at week 6 compared with baseline for ziprasidone (-3.5 ng/mL, but significantly increased for risperidone (61.1 ng/mL; P < 0.001. More risperidone-treated subjects (14.9% than ziprasidone-treated subjects (4.2% reported weight gain ?7%. Akathisia and somnolence in the ziprasidone group and akathisia and insomnia in the risperidone group were the most common side effects. Treatment-related/treatment-emergent adverse events were reported by 79.7% and 71.1% of ziprasidone-treated and risperidone-treated subjects, respectively.Conclusion: In Chinese subjects, ziprasidone was as effective as risperidone, with less weight gain and less prolactin elevation.Keywords: ziprasidone, risperidone, schizophrenia
The author presents an introduction to beam injection. Especially considered are single-turn injection, multi-turn injection, H- charge-exchange injection, and injection from a cyclotron into a synchrotron. Finally some novel injection schemes are briefly mentioned. (HSI)
Idalencio, Renan; Kalichak, Fabiana; Rosa, João Gabriel Santos; Oliveira, Tiago Acosta de; Koakoski, Gessi; Gusso, Darlan; Abreu, Murilo Sander de; Giacomini, Ana Cristina Varrone; Barcellos, Heloísa Helena de Alcântara; Piato, Angelo L; Barcellos, Leonardo José Gil
The presence of drugs and their metabolites in surface waters and municipal effluents has been reported in several studies, but its impacts on aquatic organisms are not yet well understood. This study investigated the effects of acute exposure to the antipsychotic risperidone on the stress and behavioral responses in zebrafish. It became clear that intermediate concentration of risperidone inhibited the hypothalamic-pituitary-interrenal axis and displayed anxiolytic-like effects in zebrafish. The data presented here suggest that the presence of this antipsychotic in aquatic environments can alter neuroendocrine and behavior profiles in zebrafish. PMID:26473477
Kalichak, Fabiana; Rosa, João Gabriel Santos; de Oliveira, Tiago Acosta; Koakoski, Gessi; Gusso, Darlan; de Abreu, Murilo Sander; Giacomini, Ana Cristina Varrone; Barcellos, Heloísa Helena de Alcântara
The presence of drugs and their metabolites in surface waters and municipal effluents has been reported in several studies, but its impacts on aquatic organisms are not yet well understood. This study investigated the effects of acute exposure to the antipsychotic risperidone on the stress and behavioral responses in zebrafish. It became clear that intermediate concentration of risperidone inhibited the hypothalamic-pituitary-interrenal axis and displayed anxiolytic-like effects in zebrafish. The data presented here suggest that the presence of this antipsychotic in aquatic environments can alter neuroendocrine and behavior profiles in zebrafish. PMID:26473477
Roberto Canitano; Valeria Scandurra
Roberto Canitano, Valeria ScandurraDivision of Child Neuropsychiatry, University Hospital of Siena, Siena, ItalyAbstract: This is a review of the clinical trials investigating the efficacy and safety of risperidone in the treatment of children with autistic spectrum disorders (ASD). The main clinical characteristics are impairment in social skills, communication difficulties, repetitive movements and behaviors, including stereotypies. Pharmacotherapy is mainly directed at the so-called target...
Full Text Available Objective: We aimed to investigate the efficacy of intradiscal steroid injection in patients with chronic low back pain due to degenerative disc disease.Materials and Methods: A total of 18 patients (9 female, 9 male with chronic low back pain of discogenic origin were enrolled in the study. The intervertebral disc level which met the diagnostic criteria for provocative discography was defined as discogenic pain level. After identification of positive disc level, 1 cc betamethasone was injected into the disc. The outcome measures (visual analog pain scale and Quebec Back Pain Disability Scale scores, finger-tip-to-floor distance and duration of sitting without pain were assessed before the treatment and at second week and third month post injection. Results: The reduction in low back pain intensity between the baseline and second week, and between the baseline and third month was statistically significant (p=0.001 and p=0.002. Besides, statistically significant improvement was observed in Quebec Disability Scores between the baseline and second week, and between the baseline and third month (p=0.001 and p=0.002. The finger-tip-to-floor distance between the baseline and second week, and between the baseline and third month showed a statistically significant improvement (p=0.002 and p=0.02. The duration of sitting without pain between the baseline and second week, and between the baseline and third month showed a statistically significant increase (p=0.001 and p=0.009. Conclusion: As a result, we suggest that intradiscal steroid injection may be effective in short-term and mid-term for reducing the intensity of spinal pain and the proportion of disability due to chronic discogenic low back pain in patients who do not respond to conservative treatment. Turk J Phys Med Rehab 2012;58:88-92.
Objective: To observe the therapeutic effects of combined use of ozone and collagenase injection in treating lumbar disc herniation and to make a comparison of therapeutic efficacy with simple ozone injection. Methods: Under DSA guidance,percutaneous puncturing of diseased lumbar disk with a gauge 9 needle was performed in 76 patient with lumbar disc herniation. After the needle position was confirmed in the right site simple ozone injection (control group, n=38) or combined use of ozone and collagenase injection (study group, n=38) was carried outs. The clinical results were evaluated and compared between two groups. Results: After the treatment, all 76 patients were followed up regularly at 1, 3 and 6 months. At 1, 3 and 6 months after the therapy, the effective rate of study group was 89.5%, 92.1% and 94.7% respectively, while the effective rate of control group was 86.8%, 84.2% and 81.6% respectively. Conclusion: For the treatment of lumbar disc herniation, the therapeutic effect of combined use of ozone and collagenase injection is much better than that by using simple ozone injection, moreover, it carries a quite stable long-term efficacy. (authors)
Huo, Ran; Wei, Zhiyun; Xiong, Yuyu; Jiang, Jie; Liu, Yichen; Yan, Yucai; Shi, Jiajun; Li, Wenqiang; Cui, Donghong; Xing, Qinghe; He, Lin; Qin, Shengying
Evidence suggests that dopamine receptor D1 (DRD1) may be involved in the pathophysiology of schizophrenia and the pharmacodynamics of antipsychotics. We conducted a comprehensive pharmacogenomics study to investigate the association of genetic polymorphisms in DRD1 with treatment response to risperidone. Two independent cohorts of Han Chinese schizophrenic patients (n = 185) from two different geographic areas treated with risperidone monotherapy for 4 weeks and four SNPs (rs5326, rs4867798, rs4532 and rs686) in the DRD1 gene were analyzed. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). The definition of risperidone response is based on a cut-off of 50% in terms of corrected percent change of PANSS score. The significant confounding effects of non-genetic factors were included as covariates for adjustment. No significant association of DRD1 polymorphisms with risperidone treatment response was found in either single marker or haplotype analysis in this study. The current results provide the first evidence that DRD1 polymorphisms may not influence the clinical efficacy of risperidone in Chinese schizophrenia patients. PMID:25179995
Wang, Gang; Zhang, Yao; Zhang, Sheng; Chen, Huijing; Xu, Zaifeng; Schottenfeld, Richard S; Hao, Wei; Chawarski, Marek Cezary
We evaluated tolerability and efficacy of aripiprazole and risperidone for treatment of methamphetamine (METH) associated psychotic symptoms in China. Patients with acute METH-associated psychotic symptoms (N=42) and with Positive and Negative Syndrome Scale (PANSS) total score between 60 and 120 were randomized to aripiprazole (initial dose 5-10mg per day followed by flexible doses 5-15mg per day) or risperidone (initial dose 2-4mg per day followed by flexible doses 4-6mg per day) from day 3 to 25 of inpatient hospital stay. Outcome measures included PANSS and Clinical Global Impressions-Severity of Illness scale (CGI-S), METH craving Visual Analogue Scale (VAS), Simpson Angus Scale (SAS), Barnes Assessments Akathasia Rating Scale (BARS), and self-reported adverse effects evaluated during treatment. Retention was evaluated using Kaplan-Meier survival analysis and the MIXED models procedure was used to compare the groups on measures of psychotic and extra-pyramidal symptoms. Patients in both aripiprazole and risperidone groups showed statistically significant reductions in psychotic symptomatology from baseline during treatment (pMETH craving reductions (p<0.001). Overall, 71% of patients completed the entire study, but the aripiprazole group had a significantly lower retention than the risperidone group (p=0.007), primarily due to medication related adverse effects. Aripiprazole-treated patients also had significantly more akathisia (p=0.03) and agitation (p=0.02) than risperidone-treated patients. Patients in both groups who tolerated their medications and completed the entire study achieved comparable reductions of psychotic symptoms. PMID:26733277
Laffont, Celine M; Gomeni, Roberto; Zheng, Bo; Heidbreder, Christian; Fudala, Paul J; Nasser, Azmi F
RBP-7000 is a long-acting formulation of risperidone designed for once-monthly subcutaneous injection for the treatment of schizophrenia. The objective was to estimate clinically effective doses of RBP-7000 based on model simulations and on the comparison with other long-acting injectable antipsychotics. A population pharmacokinetic model of RBP-7000 was developed in 90 clinically stable schizophrenic patients having received single/repeated doses of 60, 90, or 120?mg. Model simulations were conducted to compare active moiety plasma exposure after repeated RBP-7000 administrations to the published data of long-acting risperidone injection (Risperdal® Consta®) at 25 and 50?mg, and of paliperidone palmitate (Invega® Sustenna®) at 50 and 100?mg equivalent paliperidone. Predictions of dopamine D2 receptor occupancy were derived from the simulated active moiety concentrations. Simulations showed similar active moiety plasma exposure at steady-state for 90?mg of RBP-7000 and 25?mg of long-acting risperidone. In comparison to risperidone, RBP-7000 reached effective concentrations immediately after the first administration. RBP-7000 at the doses of 60 and 90?mg provided similar active moiety plasma concentrations at steady-state compared to 50 and 100?mg equivalent paliperidone, respectively. These findings provide guidance for dose selection in Phase III clinical trials and suggest potential benefits for RBP-7000 over competitors. PMID:25043337
Full Text Available Injecting phosphatidylcholine has been used in South America as a non-surgical treatment in body contouring. The objective of this study was to demonstrate the efficacy of injecting phosphatidylcholine in the reduction of localised fat deposits. 86 patients were included in the study. Patients received 1-3 treatments in localised fat deposits in various areas of the body using phosphatidylcholine. After treatment with phosphatidylcholine (250 mg / 5 ml, fat deposits show an average circumferential reduction per application of 2.70 cm. No patient showed irregularities, dimples or any serious side effect after treatment. Results remained stable during the time of follow up. All patients showed remarkable reductions of the fat deposits treated with phosphatidylcholine. Using the correct technique, injecting phosphatidylcholine may be a safe and efficacious alternative to liposuction in patients objecting to surgery.
Shao, Huikai; Zhao, Lingguo; Chen, Fuchao; Zeng, Shengbo; Liu, Shengquan; Li, Jiajia
BACKGROUND In the past decades, a large number of randomized controlled trials (RCTs) on the efficacy of ligustrazine injection combined with conventional antianginal drugs for angina pectoris have been reported. However, these RCTs have not been evaluated in accordance with PRISMA systematic review standards. The aim of this study was to evaluate the efficacy of ligustrazine injection as adjunctive therapy for angina pectoris. MATERIAL AND METHODS The databases PubMed, Medline, Cochrane Library, Embase, Sino-Med, Wanfang Databases, Chinese Scientific Journal Database, Google Scholar, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and the Chinese Science Citation Database were searched for published RCTs. Meta-analysis was performed on the primary outcome measures, including the improvements of electrocardiography (ECG) and the reductions in angina symptoms. Sensitivity and subgroup analysis based on the M score (the refined Jadad scores) were also used to evaluate the effect of quality, sample size, and publication year of the included RCTs on the overall effect of ligustrazine injection. RESULTS Eleven RCTs involving 870 patients with angina pectoris were selected in this study. Compared with conventional antianginal drugs alone, ligustrazine injection combined with antianginal drugs significantly increased the efficacy in symptom improvement (odds ratio [OR], 3.59; 95% confidence interval [CI]: 2.39 to 5.40) and in ECG improvement (OR, 3.42; 95% CI: 2.33 to 5.01). Sensitivity and subgroup analysis also confirmed that ligustrazine injection had better effect in the treatment of angina pectoris as adjunctive therapy. CONCLUSIONS The 11 eligible RCTs indicated that ligustrazine injection as adjunctive therapy was more effective than antianginal drugs alone. However, due to the low quality of included RCTs, more rigorously designed RCTs were still needed to verify the effects of ligustrazine injection as adjunctive therapy for angina pectoris. PMID:26615387
Sajatovic, Martha; Subramoniam, Madhusoodanan; Fuller, Matthew A
Atypical antipsychotic medications have assumed growing importance for the treatment of bipolar disorder, an illness that affects approximately 1.2%3.7% of the general population in a given year. Current practice guidelines for the treatment of bipolar mania support the use of atypical antipsychotic medications as monotherapy or as a component of polytherapy, and in clinical settings the use of atypical antipsychotics to treat bipolar disorder is widespread. Risperidone is an atypical antips...
Rao, Pradeep; Bhagat, Nishant; Shah, Bharat; Bazegha, Momin
The ever-increasing use of psychotropic drugs in clinical practice today is a blessing for the patient who can hope to achieve faster remission and possibly a higher rate of cure. However, the flip side is that the use of polypharmacy increases the potential for drugdrug interactions. Escitalopram is a novel antidepressant and there are several reports on its efficacy in the treatment of depression. Reports about its interactions with the cytochrome P450 (CYP 450) enzyme system are relativel...
Jeste, D V; Klausner, M; Brecher, M; Clyde, C; Jones, R
The efficacy and safety of risperidone have previously been demonstrated in controlled clinical trials in hospitalized chronic schizophrenia patients who met strict research criteria. The present study was designed to evaluate the efficacy and safety of risperidone in a heterogeneous patient population. Patients were enrolled in the study if they had a diagnosis of schizophrenia (DSM-III-R) with or without acute exacerbation. Of the 945 patients from 158 psychiatric centers who entered this phase IV study, 558 completed the 10-week trial. During week 1, the dose of risperidone was titrated to 6 mg/day, maintained there for 1 week, and then adjusted over a 4-week period as clinically necessary; the dose was then fixed for the final 4-week period. The mean dose of risperidone at endpoint was 5.9 mg/day. Patients were evaluated at baseline and at weeks 2, 6, and 10, using Clinical Global Impression scale, Psychotic Symptoms Assessment scale, and Global Assessment of Functioning scale. Significant improvement in mean scores was found on each of these measures at endpoint. Comparable results were obtained at week 10 in treatment-resistant and non-treatment-resistant patients. Risperidone was generally well tolerated and the severity of extrapyramidal symptoms was significantly reduced at endpoint. PMID:9203234
Efficacy and safety of atypical antipsychotic drugs (quetiapine, risperidone, aripiprazole and paliperidone) compared with placebo or typical antipsychotic drugs for treating refractory schizophrenia: overview of systematic reviews / Eficácia e segurança dos antipsicóticos atípicos (quetiapina, risperidona, aripiprazol, paliperidona) em comparação com um placebo ou medicamentos antipsicóticos típicos no tratamento da esquizofrenia refratária: overview de revisão sistemática
Tamara, Melnik; Bernardo Garcia, Soares; Maria Eduarda dos Santos, Puga; Álvaro Nagib, Atallah.
Full Text Available CONTEXTO E OBJETIVO: De acordo com alguns estudos de coorte, a prevalência da esquizofrenia refratária (ER) está entre 20-40%. Nosso objetivo foi avaliar a efetividade e segurança de aripiprazol, paliperidona, quetiapina e risperidona no tratamento da esquizofrenia refratária. MÉTODOS: Avaliação crí [...] tica das revisões Cochrane publicadas na Biblioteca Cochrane e complementação com referências de ensaios clínicos randomizados (ECRs) mais atualizados sobre ER. As seguintes bases de dados foram pesquisadas: Medline (Medical Literature Analysis and Retrieval System Online) (1966-2009), Ensaios Controlados da Colaboração Cochrane (2009, edição 2), Embase (Excerpta Database) (1980-2009), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) (1982-2009). Não houve restrição a idiomas. Ensaios clínicos randomizados, revisões sistemáticas e metanálises que avaliaram antipsicóticos atípicos no tratamento da esquizofrenia refratária foram incluídos. RESULTADOS: Sete revisões sistemáticas Cochrane e 10 ECRs complementares foram incluídos nessa revisão. No geral os dados demonstram pequenas diferenças entre os antipsicóticos atípicos avaliados e os típicos na melhora dos sintomas da doença, apesar da melhor adesão ao tratamento com os atípicos. A risperidona foi avaliada especificamente em pacientes com esquizofrenia refratária em uma das revisões sistemáticas incluídas, a qual demonstrou desfechos favoráveis, porém não definitivos quando comparada a drogas também com eficácia comprovada como amisulprida, clozapina e olanzapina. CONCLUSÕES: Os dados reforçam a dificuldade de tratar esses pacientes, com elevadas taxas de desistência do tratamento e padrões de melhora modestos nas avaliações de eficácia. Os antipsicóticos atípicos têm vantagens sobre os típicos principalmente pelo melhor perfil de segurança, o que leva a melhor adesão ao tratamento. A associação de antipsicóticos também pode ser uma opção em alguns pacientes refratários ao tratamento. Abstract in english CONTEXT AND OBJECTIVE: According to some cohort studies, the prevalence of refractory schizophrenia (RS) is 20-40%. Our aim was to evaluate the effectiveness and safety of aripiprazole, paliperidone, quetiapine and risperidone for treating RS. METHODS: This was a critical appraisal of Cochrane revie [...] ws published in the Cochrane Library, supplemented with reference to more recent randomized controlled trials (RCTs) on RS. The following databases were searched: Medical Literature Analysis and Retrieval System Online (Medline) (1966-2009), Controlled Trials of the Cochrane Collaboration (2009, Issue 2), Embase (Excerpta Medica) (1980-2009), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) (1982-2009). There was no language restriction. Randomized controlled trials, systematic reviews and meta-analyses evaluating atypical antipsychotics for treating RS were included. RESULTS: Seven Cochrane systematic reviews and 10 additional RCTs were included in this review. The data generally showed minor differences between the atypical antipsychotics evaluated and typical antipsychotics, regarding improvement in disease symptoms, despite better adherence to treatment with atypical antipsychotics. Risperidone was specifically evaluated in patients with RS in one of the systematic reviews included, with favorable outcomes, but without definitive superiority compared with other drugs of proven efficacy, like amisulpride, clozapine and olanzapine. CONCLUSIONS: The findings underscore the difficulty in treating these patients, with high dropout rates and treatment patterns of modest improvement in assessments of effectiveness. Atypical antipsychotics have advantages over typical antipsychotics mainly through their better safety profile, which leads to better adherence to treatment. A combination of antipsychotics may also be an option for some refractory patients.
Secher, Anna; Husum, Henriette; Holst, Birgitte; Egerod, Kristoffer Lihme; Mellerup, Erling
positively correlated with visceral fat mass. Risperidone treatment increased CB(1) receptor binding in the arcuate nucleus (40%), hippocampus (25-30%) and amygdala (35%) without concurrent alterations in the CB(1) receptor mRNA. Risperidone treatment increased adiponectin mRNA. CONCLUSION: The present study...
Brain imaging technology is becoming an important tool in both research and clinical care. Due to the sensitivity of brain imaging technology, neuroscientists are able to visualize brain structure and function from the level of individual molecules to the whole brain, recognize and diagnose neurological disorders, develop new strategies for treatment and determine how therapies work. The study aimed to take advantages from drugs that are able to cross the brain barrier for the development of potential radiopharmaceuticals for non-invasive brain imaging. Risperidone and lamotrigine were successfully labeled with 125I via direct electrophilic substitution reaction at 80 degree C. The reaction parameters affecting the preparation process were studied. 125I-risperidone and 125I-lamotrigine gave maximum labeling yield of 89 % Â± 3.75 and 97.5 % Â± 1.0 %, respectively and their stability were up to 6 and 24 h, respectively. Biodistribution studies showed that maximum uptake of 125I-risperidone and 125I-lamotrigine in the brain of mice were 4.27 % Â± 0.38 and 2.45 % Â± 0.18 of the injected activity/g tissue organ, at 10
Levy-Nissenbaum, Etgar; Khan, Wahid; Pawar, Rajendra P; Tabakman, Rinat; Naftali, Esmira; Winkler, Ilan; Kaufman, Olga; Klapper, Leah; Domb, Abraham J
Injectable biodegradable polymer poly(sebacic-co-ricinoleic acid), P(SA-RA) is currently under development for intratumoral (IT) delivery of drugs for treating solid tumors. This study presents formulation development, pharmacokinetic and efficacy studies of two anticancer drugs (cisplatin and paclitaxel) formulated with P(SA-RA) polymer. In pharmacokinetic study, systemic exposure and pharmacokinetic parameters of cisplatin/paclitaxel following single intravenous (IV) or subcutaneous (SC) doses of cisplatin/paclitaxel was compared with intramuscular (IM) or SC doses of cisplatin/paclitaxel formulated with P(SA-RA) polymer in male CD rat. Simultaneously, the tumor reduction effect and toxicity for these formulations were evaluated in human FaDu head and neck tumor xenograft subcutaneous nude mouse model. Pharmacokinetic data reflect the lower maximal concentrations and sustained release of polymer-cisplatin/paclitaxel formulations compared to standard cisplatin/paclitaxel administration. Regarding efficacy study, a single IT or near the tumor injection (NT) of polymer-paclitaxel or polymer-cisplatin formulation significantly reduced the tumor size, compared to the standard paclitaxel or cisplatin treatments. No death or toxicity and no effect on body weight as well as macroscopic and/or microscopic changes in or near the injected area were observed, proving biocompatibility and acceptability of polymer-formulations. In conclusion, the developed formulation demonstrated controlled release and significant efficacy in delivering these agents and exhibit potential for further clinical development. PMID:22732267
Intra-articular injection is effective for osteoarthritis, but the best single injection strategy is not known, nor are there established predictors of response. The objectives of this study were to assess and predict response to a single ultrasound-guided injection in moderate to severe hip osteoarthritis.
Liew, Alvin; Verma, Swapna; Lye Yin Poon; Edimansyah, Abdin; Subramaniam, Mythily; Vaingankar, Janhavi; Siow Ann Chong
This naturalistic retrospective study aims to compare effectiveness of a second-generation antipsychotic medication, risperidone, with first-generation antipsychotic medications (haloperidol and trifluoperazine) in an Asian population with first-episode schizophrenia-spectrum disorders. A total of 261 patients were assessed for time to discontinuation for any reason and specific reasons of discontinuation, controlling for baseline differences between groups. Some 90% of patients discontinued their antipsychotic medications before 18 months. Median time to discontinuation for any reason in risperidone was 69 days versus first-generation antipsychotic medications of 27 days. Specifically, the risperidone group had a longer time to discontinuation for any reason than haloperidol (HR = 0.61, p = 0.005) and trifluoperazine groups (HR = 0.63, p = 0.03), as well as a longer time to discontinuation due to intolerability of side effects than haloperidol (HR = 0.50, p = 0.008) and trifluoperazine groups (HR = 0.26, p = 0.001). There were no significant differences between medications for time to discontinuation due to lack of efficacy, patient's/family's decisions or other reasons. We conclude that there is a very high rate of discontinuation of the initial antipsychotic medications for various reasons, with risperidone having an overall longer time to discontinuation compared with first-generation antipsychotic medications. PMID:19965942
Hagman, Jennifer; Gralla, Jane; Sigel, Eric; Ellert, Swan; Dodge, Mindy; Gardner, Rick; O'Lonergan, Teri; Frank, Guido; Wamboldt, Marianne Z.
Objective: The purpose of this double-blind, placebo-controlled exploratory pilot study was to evaluate the safety and efficacy of risperidone for the treatment of anorexia nervosa. Method: Forty female subjects 12 to 21 years of age (mean, 16 years) with primary anorexia nervosa in an eating disorders program were randomized to receiveâ¦
Hagman, Jennifer; Gralla, Jane; Sigel, Eric; Ellert, Swan; Dodge, Mindy; Gardner, Rick; O'Lonergan, Teri; Frank, Guido; Wamboldt, Marianne Z.
Objective: The purpose of this double-blind, placebo-controlled exploratory pilot study was to evaluate the safety and efficacy of risperidone for the treatment of anorexia nervosa. Method: Forty female subjects 12 to 21 years of age (mean, 16 years) with primary anorexia nervosa in an eating disorders program were randomized to receive
Banks, Matthew L; Blough, Bruce E
Preclinical and human laboratory choice procedures have been invaluable in improving our knowledge of the neurobiological mechanisms of drug reinforcement and in the drug development process for candidate medications to treat drug addiction. However, little is known about the neuropharmacological mechanisms of methamphetamine vs food choice. The aims of this study were to develop a methamphetamine vs food choice procedure and determine treatment effects with two clinically relevant compounds: the monoamine uptake inhibitor bupropion and the dopamine antagonist risperidone. Rhesus monkeys (n=6) responded under a concurrent schedule of food delivery (1-g pellets, fixed-ratio (FR) 100 schedule) and intravenous methamphetamine injections (0-0.32 mg/kg/injection, FR10 schedule) during 7-day bupropion (0.32-1.8 mg/kg/h) and risperidone (0.001-0.0056 mg/kg/h) treatment periods. For comparison, effects of removing food pellets or methamphetamine injections and FR response requirement manipulations were also examined. Under saline treatment conditions, food was preferred over no methamphetamine or small unit methamphetamine doses (0.01-0.032 mg/kg/injection). Larger methamphetamine doses resulted in greater methamphetamine preference and 0.32 mg/kg/injection methamphetamine maintained near exclusive preference. Removing food availability increased methamphetamine choice, whereas removing methamphetamine availability decreased methamphetamine choice. Methamphetamine choice was not significantly altered when the FR response requirements for food and drug were the same (FR100:FR100 or FR10:FR10). Risperidone treatment increased methamphetamine choice, whereas bupropion treatment did not alter methamphetamine choice up to doses that decreased rates of operant behavior. Overall, these negative results with bupropion and risperidone are concordant with previous human laboratory and clinical trials and support the potential validity of this preclinical methamphetamine vs food choice model. PMID:25742872
Objective: To evaluate the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica. Methods: CT-guided epidural steroid injection was performed in 180 patients with sciatica from May 1998 to March 2004, and all patients had failure to previous conservative treatment. Visual analogue scale was used to evaluate the pain of the patient before and after the treatment. Results: Follow-up was taken for 112 cases during 1-6 years after the treatment, 89 patients (79.5%) had successful long-term outcome and 80 patients (71.4%) were satisfied. Conclusions: CT-guided epidural steroid injection can reduce low back pain and radical pain. It should be preferentially considered as the first choice when conservative treatments are failed. (authors)
Rapaport, Mark Hyman; Gharabawi, Georges M; Canuso, Carla M; Mahmoud, Ramy A; Keller, Martin B; Bossie, Cynthia A; Turkoz, Ibrahim; Lasser, Robert A; Loescher, Amy; Bouhours, Philippe; Dunbar, Fiona; Nemeroff, Charles B
Approximately one-third of persons with depression do not respond to antidepressant monotherapy. Studies suggest that atypical antipsychotic augmentation may benefit these patients. We investigated the longer-term efficacy of risperidone augmentation of serotonin-selective reuptake inhibitor treatment for resistant depression. In 57 in- and outpatient centers in three countries, we conducted a three-phase study with 4-6 weeks of open-label citalopram monotherapy, 4-6 weeks of open-label risperidone augmentation, and a 24-week double-blind, placebo-controlled discontinuation phase. A total of 489 patients with major depressive disorder and 1-3 documented treatment failures entered the citalopram monotherapy phase (20-60 mg/day). Patients with <50% reduction in HAM-D-17 scores entered the risperidone augmentation phase (0.25-2.0 mg/day). Patients with HAM-D-17< or =7 or CGI-S < or = 2 were randomized to risperidone or placebo augmentation. The primary outcome was time to relapse during the double-blind phase. During citalopram monotherapy, 434 patients had <50% HAM-D-17 reduction; 299 (68.9%) were fully nonresponsive (<25% reduction) and 135 were partially nonresponsive (25-49% reduction). Of the 386 nonresponders who entered the augmentation phase, 243 remitted and 241 entered the double-blind phase. Median time to relapse was 102 days with risperidone augmentation and 85 days with placebo (NS); relapse rates were 53.3 and 54.6%, respectively. In a post hoc analysis of patients fully nonresponsive to citalopram monotherapy, median time to relapse was 97 days with risperidone augmentation and 56 with placebo (p = 0.05); relapse rates were 56.1 and 64.1%, respectively (p < or = 0.05). Open-label risperidone augmentation substantially enhanced response in treatment-resistant patients, but the longer-term benefits of augmentation were not demonstrated in this study. PMID:16760927
Full Text Available Objevtive: To observe the effects of Shengmai Injection on enhancing efficacy and reducing toxicity of 5-fluorouracil (5-FU. Methods: Fifty hepatoma 22 bearing mice were randomly divided into five groups: control group, 5-Fu group, Shengmai Injection (low, medium and high dose combined with 5-FU groups. There were 10 mice in each group. Mice in the five groups were injected introperitoneally the same amount of normal saline, 5-FU (20 mg·kg?1·d?1 and Shengmai Injection (3.5 ml·kg?1·d?1, 7 ml·kg?1·d?1 and 14 ml·kg?1·d?1 combined with 5-FU respectively, once a day for 14 days. After that, all mice were killed and the tumor inhibiting rates, index of immunological function, liver and kidney function and the blood cells in the peripheral blood were observed. Results: The tumor inhibiting rates were higher in each Shengmai Injection combined with 5-FU group than that in the 5-FU group (P?0.05. The levels of CD3, CD4, CD4/CD8, IgG, IgM in 5-FU group were lower (P?0.05, while those in the three Shengmai Injection combined with 5-FU groups were higher than those in the control group (P?0.05. The level of serum alanine aminotransferase (ALT was higher and the WBC and PLT counts in the peripheral blood were lower in 5-FU group than those in the control group (P?0.05. But the levels of serum ALT in the three Shengmai Injection combined with 5-FU groups were consistent with that in the control group and the amounts of WBC decreased slightly. Conclusion: Shengmai Injection can enhance the anti-tumor effect of 5-FU. It can also improve the immunological function and reduce the adverse reactions of chemotherapy.
Battaglia, Milva; Guaraldi, Federica; Vannini, Francesca; Rossi, Giuseppe; Timoncini, Antonio; Buda, Roberto; Giannini, Sandro
Intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) represent efficacious medical treatments for osteoarthritis (OA), although no comparative study on long-term efficacy in hip OA exists. The goals of the current study were to compare the clinical efficacy of PRP vs HA at 12 months of follow-up in patients with hip OA and evaluate the influence of the type of infiltration and patient age, sex, body mass index, and degree of OA on temporal clinical evolution. One hundred patients with chronic unilateral symptomatic hip OA were consecutively enrolled and randomly assigned to 1 of 2 groups: group A received PRP and group B received HA administered via intra-articular ultrasound-guided injections. Patients were evaluated at baseline and after 1, 3, 6, and 12 months using the Harris Hip Score (HHS) and visual analog scale (VAS). An overall improvement was detected in both groups between 1- and 3-month follow-up. Despite a slightly progressive worsening between 6- and 12-month follow-up, the final clinical scores remained higher compared with baseline (P<.0005), with no significant differences between PRP and HA. Regarding clinical temporal evolution, multivariate analysis showed that HHS was not influenced by the type of infiltration, patient age, sex, body mass index, or degree of OA, whereas a significant association was detected between OA grade IV and VAS evolution (P<.0005). Intra-articular injections of PRP are efficacious in terms of functional improvement and pain reduction but are not superior to HA in patients with symptomatic hip OA at 12-month follow-up. PMID:24579221
Michael M. Copenhaver; Johnson, Blair T.; Lee, I-Ching; Harman, Jennifer J.; CAREY, MICHAEL P.
We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate behavioral HIV-risk reduction interventions targeting people who inject drugs. We included 37 RCTs evaluating 49 independent HIV-risk reduction interventions with 10,190 participants. Compared to controls, intervention participants reduced injection-and non-injection drug use, increased drug treatment entry, increased condom use, and decreased trading sex for drugs. Interventions were more successful at reducing i...
Full Text Available Background: Fractionated carbon dioxide (CO 2 lasers are a new treatment modality for skin resurfacing. The cosmetic rejuvenation market abounds with various injectable devices (poly-L-lactic acid, polymethyl-methacrylate, collagens, hyaluronic acids, silicone. The objective of this study is to examine the efficacy and safety of 10,600-nm CO 2 fractional laser on facial skin with previous volume injections. Materials and Methods: This is a retrospective study including 14 patients treated with fractional CO 2 laser and who have had previous facial volume restoration. The indication for the laser therapy, the age of the patients, previous facial volume restoration, and side effects were all recorded from their medical files. Objective assessments were made through clinical physician global assessment records and improvement scores records. Patients? satisfaction rates were also recorded. Results: Review of medical records of the 14 patients show that five patients had polylactic acid injection prior to the laser session. Eight patients had hyaluronic acid injection prior to the laser session. Two patients had fat injection, two had silicone injection and one patient had facial thread lift. Side effects included pain during the laser treatment, post-treatment scaling, post-treatment erythema, hyperpigmentation which spontaneously resolved within a month. Concerning the previous facial volume restoration, no granulomatous reactions were noted, no facial shape deformation and no asymmetry were encountered whatever the facial volume product was. Conclusion: CO 2 fractional laser treatments do not seem to affect facial skin which had previous facial volume restoration with polylactic acid for more than 6 years, hyaluronic acid for more than 0.5 year, silicone for more than 6 years, or fat for more than 1.4 year. Prospective larger studies focusing on many other variables (skin phototype, injected device type are required to achieve better conclusions.
The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.
Yoon, Ji Young; Kwon, Jong Won; Yoon, Young Cheol [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jong Seok [School of Business Administration, Hallym University, Chuncheon (Korea, Republic of)
The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.
Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo; Jacobsen, Søren Knak; Stengaard-Pedersen, Kristian; Junker, Peter; Lottenburger, Tine; Hansen, Ib Tønder; Andersen, Lis Smedegaard; Tarp, Ulrik; Svendsen, Anders Jørgen; Pedersen, Jens Kristian; Skjødt, Henrik; Ellingsen, Torkell Juulsgaad; Lindegaard, Hanne; Pødenphant, Jan; Hørslev-Petersen, Kim
To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early rheumatoid arthritis (RA).
To investigate the effects of magnitude of initial DTPA injection upon chelation efficacy, five young adult beagles were each given an intravenous injection of 237+239Pu(IV) citrate + 241Am(III) citrate, followed by a single intravenous injection of Ca-DTPA 0.5 hr later. Amounts of this chelating agent administered were 3, 10, 30, 100, and 300 ?mole Ca-DTPA/kg body mass. Animals were sacrificed 7 days later. Total-body retention of both plutonium and americium was influenced strongly by the amount of DTPA administered, although the removal of Pu by DTPA was less pronounced than that of Am; and in the range of 30 ?mole/kg, an increase of DTPA administration by a factor of 2 resulted in only a 25% decrease in residual body content. Plutonium retention at 7 days was reduced from about 77% in the dog given 3 ?mole/kg to 14% in the animal injected with 300 ?mole/kg. Corresponding values for americium were 40 and 9%. Also, liver content of both Pu and Am was reduced significantly by larger amounts of administered DTPA, decreasing from 18 to 2% for Pu with increasing levels of DTPA, and from 21 to 1% for Am. If there is a level of Ca-DTPA administration at 30 min after injection in a beagle at which no additional chelation of Pu or Am is produced with increasing dosage, it is greater than 300 ?mole/kg. In a 70-kg human, this would be equivalent to the injection of 10 g Ca-DTPA
Full Text Available Introduction: Suffering from de Quervain's tenosynovitis due to repetitive and routine activities leads to considerable referrals to orthopedic clinics and increasing health care costs and wasting of patients' time. The present study aimed to compare the efficacy of local injection of methylprednisolone with and without splint for treatment of patients suffering from de Quervain's tenosynovitis. Methods: In a clinical trial study, 72 patients with de Quervain's tenosynovitis were selected in 2010 and were randomly divided into two groups. Therapeutic intervention in the first group was injection of 40 mg methylprednisone and 1 ml lidocaine with splint, and in the second group it was injection 40 mg methylprednisone and 1ml lidocaine without splint. Both groups followed this treatment for three periods(21 day. The related data were collected by visual analogue scale. Then data was analyzed by SPSS (ver. 16 using Fisher exact test and t test. Results: The findings of this study revealed that after the 3-week period of treatment the mean reduced pain intensity and improvement in the first group was significantly lower than the second group(p<0/05. Conclusion: Therefore, local injection of methylprednisone and lidocaine with splint is an effective method in the treatment of de Quervain's tenosynovitis.
Secher, Anna; Husum, Henriette; Holst, Birgitte; Egerod, Kristoffer Lihme; Mellerup, Erling
BACKGROUND/AIMS: Body weight gain is a common side effect of treatment with antipsychotics, but the mechanisms underlying this weight gain are unknown. Several factors may be involved in antipsychotic-induced body weight gain including the cannabinoid receptor 1 (CB(1)), the serotonin receptor 2C......, the ghrelin receptor, neuropeptide Y, adiponectin and proopiomelanocortin. We investigated whether the expression of these factors was affected in rats chronically treated with the antipsychotic risperidone. METHODS: Male Sprague-Dawley rats were treated with risperidone (1.0 mg/kg/day) or vehicle (20...... positively correlated with visceral fat mass. Risperidone treatment increased CB(1) receptor binding in the arcuate nucleus (40%), hippocampus (25-30%) and amygdala (35%) without concurrent alterations in the CB(1) receptor mRNA. Risperidone treatment increased adiponectin mRNA. CONCLUSION: The present study...
Secher, Anna; Husum, Henriette; Holst, Birgitte; Egerod, Kristoffer Lihme; Mellerup, Erling
BACKGROUND/AIMS: Body weight gain is a common side effect of treatment with antipsychotics, but the mechanisms underlying this weight gain are unknown. Several factors may be involved in antipsychotic-induced body weight gain including the cannabinoid receptor 1 (CB(1)), the serotonin receptor 2C......, the ghrelin receptor, neuropeptide Y, adiponectin and proopiomelanocortin. We investigated whether the expression of these factors was affected in rats chronically treated with the antipsychotic risperidone. METHODS: Male Sprague-Dawley rats were treated with risperidone (1.0 mg/kg/day) or vehicle (20...... positively correlated with visceral fat mass. Risperidone treatment increased CB(1) receptor binding in the arcuate nucleus (40%), hippocampus (25-30%) and amygdala (35%) without concurrent alterations in the CB(1) receptor mRNA. Risperidone treatment increased adiponectin mRNA. CONCLUSION: The present study...
Lee, Jung Hwan; Lee, Sang-Ho
Transforaminal (TF) approach is preferred by physician to interlaminar (IL) approach because it can deliver injectates directly around nerve root and dorsal root ganglion, which is regarded as main pain sources. Axial neck pain is originated from sinuvertebral nerve located in ventral epidural spaces, which has been described to be related to central or paramedian disc herniation. It is very questionable that TF injection is also more effective than IL injection in the patients with axial neck or interscapular pain. This study was to evaluate clinical efficacy of cervical epidural injection in patients with axial pain due to cervical disc herniation and to compare the clinical outcomes between TF and IL approaches. Fifty-six and 52 patients who underwent IL and TF epidural injections, respectively, for axial neck/interscapular pain due to central or paramedian cervical disc herniation were included. Numeric Rating Scale (NRS) and Neck Disability Index (NDI) were compared between both groups at 2 and 8 weeks after treatment. Successful pain relief was defined if a 50% or more reduction of NRS score was achieved in comparison with pretreatment one. Successful functional improvement was defined if at least a 40% reduction of NDI was obtained. Overall, 79 (73.1%) and 57 (52.8%) among 108 patients showed successful pain relief at 2 and 8 weeks, respectively. Seventy-six (70.4%) and 52 (48.1%) had successful functional improvement at 2 and 8 weeks, respectively. The IL and TF groups showed no significant difference in proportion of successful results of NRS 2 weeks (73.2% vs 67.3%) and 8 weeks (48.2% vs 48.1%). Also, no significant difference was obtained in proportion of successful NDI between 2 groups at 2 weeks (75.0% vs 71.2%) and 8 weeks (53.6% vs 51.9%). Cervical epidural injection showed favorable results in 2 weeks and moderate results in 8 weeks in patients with axial pain due to cervical disc herniation. IL and TF showed no significant difference in clinical efficacy. Considering TF was relevant to more serious side effects, IL was more recommendable in these patients. PMID:26825899
Stoustrup, Peter; Kristensen, Kasper D
OBJECTIVE: To determine the current level of evidence for the use of intra-articular corticosteroid injections (IACI) against temporomandibular joint (TMJ) arthritis in patients with juvenile idiopathic arthritis (JIA) with a particular focus on clinical and radiological improvements and safety profile. METHODS: A comprehensive electronic search strategy was performed in all major medical databases in February 2012. Studies were selected independently by two reviewers in accordance with a pre-specified protocol and a risk of bias assessment for all included studies. RESULTS: Ninety-four unique citations were identified of which seven remained after the inclusion criteria were applied and all of these were assessed to have a high risk of bias. The current limited level of evidence suggests potential beneficial properties of IACI in patients with TMJ arthritis-related symptoms and/or MRI-verified signs of TMJ inflammation. Currently, no scientific evidence substantiates the effect of IACI in terms of (I) improving maximal mouth opening capacity significantly, (II) reducing radiological disease progression, (III) normalising/improving mandibular growth, and (IV) increasing efficacy upon repeated injections. CONCLUSION: The current level of evidence allows only very limited conclusions on the effect of IACI therapy in patients with TMJ arthritis. Knowledge on the long-term impact of IACI on mandibular growth is not available. Future studies designed in accordance with evidence-based standards are needed to allow a more general conclusion on efficacy and safety of this treatment modality in patients with TMJ arthritis.
Full Text Available Backgroud and Objective: Congenital esotropia is one of most common ocular disorder in children with genetic origin. Amblyopia, decreased streopsis and cosmetic problems are its complication that affect person's fate in terms of career psychological issues. The aim of this study was to determine the effect of botulinum toxin A (Dysport injection in subconjunctival space near medial rectus insertion of both eyes for treatment of congenital esotropia.Subjects and Methods: Thirty babies (aged 6-54 months with congenital esotropia who were otherwise systemically and neurologically normal were enrolled in this study. Ten units of toxin (Dysport were injected (under sedation into the subconjunctival space near medial rectus insertion of both eyes. The angle of deviation was measured six times: after 3 days, 1 week, 1, 3, 6 and 12 months after injection.Results: Twelve months after injection ,angle of deviation decreased from 52 ± 17 PD to 27.8 ± 21.29 PD in 86.3% of patients . Success of treatment achieved in 23.3% of patients ( P=0.008 .In seventeen cases (56.6% with angle of deviation? 45 PD (before injection improvement was better (p=0.030, 41.1% of this group after 1 month , 70% after 3 months , 76% after 6 months, and 41.1% after 12 months follow up achieved orthophoria.Conclusion: Botulinum toxin A injection into subconjunctival space near medial rectus insertion is a safe method that is not only effective transiently for eye alignment but also can reduce total deviation. Long term improvement seems to be achievable in cases with small angle deviation (equal or less than of 45 PD. Sci Med J 2011; 10(2:179-186
Galynker Igor I
Full Text Available Abstract Background Because a large proportion of patients with panic attacks receiving approved pharmacotherapy do not respond or respond poorly to medication, it is important to identify additional therapeutic strategies for the management of panic symptoms. This article describes a randomized, rater-blind study comparing low-dose risperidone to standard-of-care paroxetine for the treatment of panic attacks. Methods Fifty six subjects with a history of panic attacks were randomized to receive either risperidone or paroxetine. The subjects were then followed for eight weeks. Outcome measures included the Panic Disorder Severity Scale (PDSS, the Hamilton Anxiety Scale (Ham-A, the Hamilton Depression Rating Scale (Ham-D, the Sheehan Panic Anxiety Scale-Patient (SPAS-P, and the Clinical Global Impression scale (CGI. Results All subjects demonstrated a reduction in both the frequency and severity of panic attacks regardless of treatment received. Statistically significant improvements in rating scale scores for both groups were identified for the PDSS, the Ham-A, the Ham-D, and the CGI. There was no difference between treatment groups in the improvement in scores on the measures PDSS, Ham-A, Ham-D, and CGI. Post hoc tests suggest that subjects receiving risperidone may have a quicker clinical response than subjects receiving paroxetine. Conclusion We can identify no difference in the efficacy of paroxetine and low-dose risperidone in the treatment of panic attacks. Low-dose risperidone appears to be tolerated equally well as paroxetine. Low-dose risperidone may be an effective treatment for anxiety disorders in which panic attacks are a significant component. Trial Registration ClinicalTrials.gov Identifier: NCT100457106
Yamaguchi, Daisuke; Tsuruoka, Nanae; Sakata, Yasuhisa; Shimoda, Ryo; Fujimoto, Kazuma; Iwakiri, Ryuichi
Botulinum toxin injection is an accepted treatment modality for esophageal achalasia in western countries. This pilot study aimed to clarify the effectiveness of botulinum toxin injection for esophageal achalasia in Japanese patients. We enrolled 10 patients diagnosed with esophageal achalasia between 2008 and 2014. A total of 100 U botulinum toxin A was divided into eight aliquots and injected around the esophagogastric junction. We compared the lower esophageal sphincter pressure before and 1 week after treatment. Scores of subjective symptoms for esophageal achalasia were assessed using a visual analog scale (VAS) before and after 1 week of follow-up of treatment. Barium passage was improved in barium esophagography and passage of contrast agent was also improved. Mean Eckardt score was reduced from 5.5 to 1.6 after treatment (p<0.001). By esophageal manometric study, mean lower esophageal sphincter pressure was reduced from 46.9 to 29.1 mmHg after treatment (p = 0.002). One week after treatment, mean VAS score was reduced from 10 to 3.9 (p<0.001). There were no side effects in any cases. Botulinum toxin injection for esophageal achalasia was safe and effective with few complications. Therefore, botulinum toxin could be used as minimally invasive therapy for esophageal achalasia in Japan. PMID:26566311
Full Text Available Delia BisharaPharmacy Department, South London and Maudsley NHS Foundation Trust, London, United KingdomAbstract: Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activity as an antagonist at ?1- and ?2 adrenergic receptors and H1 histaminergic receptors, but has virtually no affinity for cholinergic receptors. Paliperidone palmitate has been shown to be effective in reducing Positive and Negative Syndrome Scale total scores in four short-term trials in acute schizophrenia. It was also effective as maintenance therapy in a long-term trial in which time to recurrence of symptoms was significantly longer in paliperidone-treated patients compared with placebo. In addition, paliperidone was shown to be noninferior to risperidone long-acting injection in one study, but this noninferiority was not established in another longer study comparing the two drugs. Treatment should be initiated with 234 mg on day 1 and 156 mg on day 8, followed by a recommended monthly maintenance dose of 39234 mg based on efficacy and tolerability. Paliperidone palmitate is generally well tolerated, although it can cause weight gain and a rise in prolactin levels, which is generally greater in women than in men. Overall, paliperidone palmitate may have advantages over other currently available long-acting injections, and therefore may be a useful alternative for the treatment of schizophrenia, although further long-term trials comparing it with active treatments are warranted.Keywords: paliperidone palmitate, injection, schizophrenia, long-acting
Fine needles with an end hole or multiple side holes have traditionally been used for percutaneous ethanol injection (PEI) of hepatomas. This study retrospectively evaluates the safety and efficacy of PEI of unresectable medium-to-large (3.5-9 cm) hepatomas using a multipronged needle and with conscious sedation. Twelve patients, eight men and four women (age 51-77 years; mean: 69) received PEI for hepatomas, mostly subcapsular or exophytic in location with average tumor size of 5.6 cm (range: 3.5-9.0 cm). Patients were consciously sedated and an 18G retractable multipronged needle (Quadrafuse needle; Rex Medical, Philadelphia, PA) was used for injection under real-time ultrasound guidance. By varying the length of the prongs and rotating the needle, the alcohol was widely distributed within the tumor. The progress of ablation was monitored by contrast-enhanced ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) after each weekly injection and within a month after the final (third) injection and 3 months thereafter. An average total of 63 mL (range: 20-154 ml) of alcohol was injected per patient in an average of 2.3 sessions. Contrast-enhanced CT, ultrasound, or MRI was used to determine the degree of necrosis. Complete necrosis was noted in eight patients (67%), near-complete necrosis (90-99%) in two (16.7%), and partial success (50-89%) in two (16.7%). Follow-up in the first 9 months showed local recurrence in two patients and new lesions in another. There was no mortality. One patient developed renal failure, liver failure, and localized perforation of the stomach. He responded to medical treatment and surgery was not required for the perforation. One patient had severe postprocedural abdominal pain and fever, and another had transient hyperbilirubinemia; both recovered with conservative treatment. PEI with a multipronged needle is a new, safe, and efficacious method in treating medium-to-large-sized hepatocellular carcinoma under conscious sedation. Its survival benefits require further investigations
Rama Raj, Palaniraj; Lewis, Matthew; Macfarlane, Stephen
We present detailed data on the efficacy and safety profile of paliperidone palmitate once-monthly long acting injectable (PP1M-LAI) in the treatment of schizophrenia in an elderly Caucasian woman. PP1M-LAI was initiated with starting doses of 150 and 100?mg on treatment days 1 and 8, respectively. Subsequent 100?mg doses of PP1M-LAI were then administered at 4-weekly intervals. The primary efficacy variable was the change in Positive and Negative Syndrome Scale (PANSS) total score from baseline. Safety assessment variables included assessment of treatment emergent adverse events, clinical laboratory tests, vital sign measurements, ECG, Calgary Depression Scale for Schizophrenia (CDSS), mini-mental status examination, Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Simpson-Angus Scale for the Assessment of Extrapyramidal Side Effects (SAS) and WHO Quality of Life-BREF (WHO-QOL-BREF). The aforementioned variables were all monitored for changes from baseline over a period of 28?weeks. A reduction of PANSS total score was noted over the 28?weeks, demonstrating the efficacy of PP1M-LAI for the treatment of schizophrenia in our patient. Improvements were also noted in the BARS score, SAS score and WHO-QOL-BREF. Negative findings were observed with regard to several pre-established safety variables such as blood glucose levels, prolactin levels, QTC intervals and weight. Overall, the addition of PP1M-LAI to the treatment regime improved the control of psychotic symptoms. However, iatrogenic consequences arising from the use of PP1M-LAI need to be considered and balanced against the primary efficacy of the medication. PMID:26311017
Full Text Available Abstract Background Efficacy studies indicate anti-depressive effects of at least some second generation antipsychotics (SGAs. The Bergen Psychosis Project (BPP is a 24-month, pragmatic, industry-independent, randomized, head-to-head comparison of olanzapine, quetiapine, risperidone and ziprasidone in patients acutely admitted with psychosis. The aim of the study is to investigate whether differential anti-depressive effectiveness exists among SGAs in a clinically relevant sample of patients acutely admitted with psychosis. Methods Adult patients acutely admitted to an emergency ward for psychosis were randomized to olanzapine, quetiapine, risperidone or ziprasidone and followed for up to 2 years. Participants were assessed repeatedly using the Positive and Negative Syndrome Scale - Depression factor (PANSS-D and the Calgary Depression Scale for Schizophrenia (CDSS. Results A total of 226 patients were included. A significant time-effect showing a steady decline in depressive symptoms in all medication groups was demonstrated. There were no substantial differences among the SGAs in reducing the PANSS-D score or the CDSS sum score. Separate analyses of groups with CDSS sum scores > 6 or ?6, respectively, reflecting degree of depressive morbidity, revealed essentially identical results to the primary analyses. There was a high correlation between the PANSS-D and the CDSS sum score (r = 0.77; p Conclusions There was no substantial difference in anti-depressive effectiveness among olanzapine, quetiapine, risperidone or ziprasidone in this clinically relevant sample of patients acutely admitted to hospital for symptoms of psychosis. Based on our findings we can make no recommendations concerning choice of any particular SGA for targeting symptoms of depression in a patient acutely admitted with psychosis. Trial Registration ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/: NCT00932529
Full Text Available Objective: To evaluate the clinical effects of Shengmai Injection in treating coronary heart disease (CHD based on correct syndrome differentiation and incorrect syndrome differentiation.Methods: The patients' information was collected by a system of individual diagnosis and treatment of CHD. The score of main symptoms was calculated and recorded during the treatment. Patients were divided into two groups (incorrect syndrome and correct syndrome groups on the basis of syndrome differentiation treatment or not. The clinical therapeutic effects of the two treatments were evaluated based on statistic theory combined with random walk method.Results: There were 273 patients in the correct syndrome group and 4 patients died (case-fatality rate was 1.47%. There were 297 patients in the incorrect syndrome group and 7 patients died (case-fatality rate was 2.36%. In the correct syndrome group, random fluctuation peak of comprehensive evaluation index, walk steps, positive growth rate of walk, ratio, random fluctuation power-law, increase rate and record times of comprehensive evaluation index were 1 472, 13 617, 0.108 1, 9.25, 0.674 2, 0.470 6 and 3 128 respectively, while in the incorrect syndrome group, 1 030, 14 588, 0.070 6, 14.16, 0.660 6, 0.312 8 and 3 293 respectively. The random fluctuation power-law in both groups exceeded 0.5.Conclusion: There is a long-range correlation between the comprehensive evaluation index and therapeutic method as the CHD patients were treated with Shengmai Injection. The clinical therapeutic effects of Shengmai Injection under correct syndrome differentiation are better than the effects of Shengmai Injection under incorrect syndrome differentiation.
Full Text Available Objective: To investigate the effect of lumbar epidural steroid injection in patients with radiculopathy Materials-Methods: 37 patients with radiculopathy were recruited retrospectively in the study. Radicular, low back pain and paresthesia intensity were evaluated using visual analog scale (VAS; the evidence of nerve stretch was evaluated by straight leg rising (SRL, disability levels were evaluated using the Oswestry Disability Index (ODI and the quality of life was evaluated by SF-36. Results: A significant improvement was observed in VAS-radicular and lomber pain levels at the 24th hours post-injection (p0.01, at the 1st week (p0.01, at 1st month(p 0.01 and 3rd month (p0.05. Recovery rate of straight leg raising test was found to be 88% (p0.05. A statistically significant improvement was found in the ODI levels and the quality of life as assessed by the SF-36 at the1st week (p0.01 and after 3 months of the treatment (p0.05. Conclusion: During the first 3 months of treatment, lumbar epidural corticosteroid injections were effective in patients with radiculopathy
Full Text Available Objective: The aim of the present study was to evaluate the efficacy and safety of pemetrexed chemotherapy combined with intrapleural injection of pemetrexed and bevacizumab in the treatment of malignant pleural mesothelioma (MPM-mediated malignant pleural effusion, and analyze the objective response rate (ORR, the median progression-free survival (PFS and the median overall survival (OS. Methods: We analyzed the clinical data of 23 MPM patients with pleural effusion who were treated with a combination chemotherapy of pemetrexed at 500 mg/m 2 , on day 1 plus cisplatin (DDP at 20 mg/m 2 on day 1-5 of each 21 days cycle, and concurrently, intrapleural injection of pemetrexed 0.5 g and bevacizumab 300 mg was administered on day 3 or day 4 after complete effusion drainage. ELISA test was applied to detect the vascular endothelial growth factor (VEGF level in the pleural effusion and serum, and assess the ORR and survival. Results: In the 23 evaluable patients, the VEGF level in the pleural effusion and serum was significantly decreased, P < 0.01, pleural effusion of 20 patients (86.96% was controlled effectively. There were 8 complete responses, 7 partial responses, 5 stable disease and 3 progressive disease, the ORR was 65.21%, the disease control rate was 86.96%, the median PFS was 6 months, the median OS was 14.5 months, and the 1-year survival rate was 41.22%. Toxicities were generally mild and manageable; the major toxicities included myelosuppression, fatigue, and anemia, mainly were grade 1-2 which could be managed by symptomatic treatments. Conclusion: The combination of pemetrexed chemotherapy with intrapleural injection of pemetrexed and bevacizumab is efficacious and safe for MPM pleural effusion, and results of the present study demonstrate some improvement in the PFS and OS. The expression of VEGF in the pleural effusion and serum plays a guiding role in monitoring the efficacy of bevacizumab in the treatment of malignant pleural effusion.
Full Text Available Objective?To evaluate the clinical efficacy and safety of motherwort injection and oxytocin in preventing postpartum hemorrhage after vaginal delivery. Methods?Data of randomly controlled trials (RCTs of motherwort injection and oxytocin in preventing postpartum hemorrhage after vaginal delivery were collected by searching PubMed (1980-2013.9, Wiley Online Library (1990-2013.9, Embase (1990-2013.9, CNKI (1990-2013.9, VIP database (1990-2013.9 and WanFang Data (1990-2013.9. The amount and incidence of postpartum hemorrhage and quantity of blood loss, as well as the incidence of postpartum morbidity were then collected in those puerperal women treated with motherwort injection and oxytocin. The quality of included studies was assessed according to Cochrane Systematic Review, and Meta-analysis was conducted by RevMan 5.1 software. Results?A total of 13 studies involving 2186 patients were included. Compared with oxytocin group, motherwort and oxytocin decreased the amount of vaginal bleeding within 2 hours after delivery and 24 hours after delivery. Furthermore, motherwort and oxytocin significantly decreased the incidence of postpartum hemorrhage (RR=0.30, 95%CI 0.19-0.47, P<0.00001. No difference was found between the two groups in the postpartum adverse reaction rate (RR=0.63, 95%CI 0.37-1.05, P=0.08. Conclusions?Motherwort injection and oxytocin are effective in preventing postpartum hemorrhage after vaginal delivery, and they can effectively reduce incidence of postpartum hemorrhage and the amount of blood loss without increasing the side effects in patients. DOI: 10.11855/j.issn.0577-7402.2015.10.11
Full Text Available Viktor Mrav?ík,1,2 Lisa Strada,3 Josef tolfa,4,5 Vladimir Bencko,6 Teodora Groshkova,7 Jens Reimer,3 Bernd Schulte3 1National Monitoring Centre for Drugs and Drug Addiction, 2Department of Addictology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 3Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany; 4Department of General Practice, Institute for Postgraduate Medical Education in Prague, 5Department of General Practice, Second Faculty of Medicine, 6Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 7European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal Introduction and methods: Hepatitis C virus (HCV infections are highly prevalent amongst people who inject drugs (PWID. Despite well documented evidence of its effectiveness, suggested cost-effectiveness, and potential to reduce HCV prevalence rates, the uptake of antiviral HCV treatment by PWID is low. This nonsystematic literature review describes factors associated with the uptake, adherence, and efficacy of HCV treatment among PWID and discusses strategies to increase their uptake of treatment. Results: Low HCV treatment uptake among PWID is associated with a number of patient-related and provider-related barriers. Beliefs and fears about low efficacy and adverse effects on the patients part are common. A substantial number of factors are associated with the chaotic lifestyle and altered social functioning of PWID, which are often associated with decompensation or relapsing into drug addiction. This may lead to perceived low adherence with treatment and low efficacy on the providers part too, where lack of support, inadequate management of addiction, and other drug-related problems and poor treatment of side effects have been described. Practical issues such as the accessibility of treatment and finances also play a role. Strategies to improve the HCV treatment rate among PWID involve pretreatment management and assessment, a multidisciplinary approach, management of side effects, and enhanced education and counseling. Conclusion: Specific factors are associated with poorer treatment outcomes in PWID on the side of both the patient and the treatment system. However, given that PWID can achieve treatment adherence and sustained virologic response rates comparable with those in nondrug users, drug use per se should not be considered a criterion for exclusion from treatment. Further development of measures leading to higher uptake of treatment and adherence in PWID and appropriate adaptation of HCV treatment guidelines represent important tools in this regard. Keywords: hepatitis C virus, people who inject drugs, treatment uptake, adherence, efficacy
Crespo-Facorro, Benedicto; Pérez-Iglesias, Rocío; Mata, Ignacio; Ramirez-Bonilla, Mariluz; Martínez-Garcia, Obdulia; Pardo-Garcia, Gema; Caseiro, Olalla; Pelayo-Terán, Jose Maria; Vázquez-Barquero, José L
The aim of this study was to investigate the long-term effectiveness and efficacy of haloperidol, risperidone and olanzapine in first-episode schizophrenia-spectrum disorders. This was a prospective, randomized, open-label study. Data for the present investigation were obtained from a large epidemiological and 3-year longitudinal intervention programme of first-episode psychosis conducted at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy-four patients were randomly assigned to haloperidol (N?=?56), olanzapine (N?=?55), or risperidone (N?=?63) and followed up for 1 year. The primary effectiveness measure was all causes of treatment discontinuation. Effectiveness analyses were based on intend-to-treat populations. In addition, an analysis based on per protocol populations was conducted in the analysis for clinical efficacy. The treatment discontinuation rate for any cause was higher with haloperidol than with risperidone and olanzapine (?(2)?=?8.517; p?=?0.014). The difference in discontinuation rate between risperidone and olanzapine was not significant (?(2)?=?0.063; p?=?0.802). There were no significant advantages of any of the three treatments in reducing the severity of psychopathology. Risperidone and olanzapine demonstrated higher effectiveness relative to haloperidol, but the three antipsychotics were equally effective in reducing the severity of psychopathology. Specific clinical programmes and the use of second-generation antipsychotics may enhance the effectiveness of antipsychotic treatments. PMID:21292922
Full Text Available Abstract Background This observational study was designed to collect treatment outcomes data in patients using the electronic Schizophrenia Treatment Adherence Registry (e-STAR. Methods Patients with schizophrenia or schizoaffective disorder in Australia who were prescribed risperidone long-acting injection (RLAI between 2003 and 2007 were assessed 12-months retrospectively, at baseline and 24-months prospectively at 3-monthly intervals. The intent-to-treat population, defined as all patients who received at least one dose of RLAI at baseline, was used for the efficacy and safety analyses. Results At total of 784 patients (74% with schizophrenia, 69.8% male with a mean age of 37.1 ± 12.5 years and 10.6 ± 9.5 years since diagnosis were included in this Australian cohort. A significant improvement in mean Clinical Global Impression - severity score was observed at 24-months (4.52 ± 1.04 at baseline, 3.56 ± 1.10 at 24-months. Most of this improvement was seen by 3-months and was also reflected in mean Global Assessment of Functioning score, which improved significantly at 24-months (42.9 ± 14.5 at baseline, 59 ± 15.4 at 24-months. For patients still receiving RLAI at 24-months there was an increase from a mean baseline RLAI dose of 26.4 ± 5 mg to 43.4 ± 15.7 mg. Sixty-six percent of patients discontinued RLAI before the 24-month period--this decreased to 46% once patients lost to follow-up were excluded. Conclusion Over the 24-month period, initiation of RLAI was associated with improved patient functioning and illness severity in patients with schizophrenia or schizoaffective disorder. Improved outcomes were observed early and sustained throughout the study. Trial Registration Clinical Trials Registration Number, NCT00283517.
Full Text Available A simple, specific, accurate, and precise reverse phase liquid chromatographic method was developed and validated for the estimation of risperidone in tablet dosage forms. A Phenomenex Gemini C-18, 5 µm column having 250x4.6 mm i.d. in isocratic mode, with mobile phase containing methanol: acetonitrile: 50 mM potassium dihydrogen orthophosphate (80:10:10 v/v was used. The flow rate was 1.3 ml/min and effluents were monitored at 234 nm. Clozapine was used as an internal standard. The retention time of risperidone and clozapine were 2.5 min and 3.3 min, respectively. The method was validated for linearity, accuracy, precision, specificity, limit of quantification, limit of detection, robustness and stability. The limit of detection and limit of quantification for estimation of risperidone was found to be 500 ng/ml and 990 ng/ml, respectively. Recovery of risperidone was found to be in the range of 99.02-101.68%. Proposed method was successfully applied for the quantitative determination of risperidone in tablet formulations.
Full Text Available Intravesical onabotulinumtoxinA (BoNT-A injection can relieve symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS, but lacks sustainability. Repeated injections have been shown to provide a superior outcome to a single injection, but data on long-term efficacy and safety is limited. In this prospective study, we enrolled patients with refractory IC/BPS, and treated them with 100 U of BoNT-A injection plus hydrodistention followed by repeated injections every six months for up to two years or until the patient wished to discontinue. A âtop-upâ dose was offered after the fourth injection. Of these 104 participants, 56.7% completed four BoNT-A injections and 34% voluntarily received the fifth injection due to exacerbated IC symptoms. With a follow-up period of up to 79 months, OâLeary-Sant symptom and problem indexes (ICSI, ICPI, OSS, pain visual analogue scale (VAS functional bladder capacity, frequency episodes, and global response assessment (GRA all showed significant improvement (p < 0.0001. Those who received repeated injections had a better success rate during the long-term follow-up period. The incidence of adverse events did not rise with the increasing number of BoNT-A injections. A higher pre-treatment ICSI and ICPI score was predictive for successful response to repeated intravesical BoNT-A injections plus hydrodistention.
Braune, Stefan; Lang, M; Bergmann, A
Although fingolimod is registered in Europe for treatment of relapsing-remitting multiple sclerosis (RRMS) if earlier disease modifying therapy (DMT) has failed, no data regarding its efficacy in this patient group are available. This observational cohort study of the NeuroTransData network includes German RRMS outpatients with failure of earlier therapy with injectable DMT (iDMT), therefore switching to either another iDMT (n = 133) or to fingolimod (n = 300). Statistical comparison of clinical baseline characteristics showed more severely affected patients in the fingolimod group. A propensity-score matched group comparison was performed (n = 99 in each group) covering more than 2-year observation time. Fingolimod showed statistically significant superior efficacy in comparison to iDMT regarding annualized relapse rate (0.21 versus 0.33 per year), time-to-relapse and likelihood of relapse (iDMT hazard ratio 1.7), proportion and likelihood of patients with EDSS progression (15.10 versus 31.00 %; iDMT hazard ratio 1.7), persistence on medication and likelihood of discontinuation (iDMT hazard ratio 3.0). Significantly more patients were free of relapse and EDSS progression with fingolimod than with their second iDMT (64.4 versus 46.5 %, p < 0.03). This real-life evidence in German RRMS outpatients support data from controlled clinical studies and can quantitatively support clinical decision finding processes if iDMT therapy fails in RRMS. PMID:26645389
Ravindran, Arun V; Bradbury, Cheryl; McKay, Martha; da Silva, Tricia L
Risperidone has been shown to be a safe and effective atypical antipsychotic agent. It was initially approved for the treatment of schizophrenia, and now, in many countries, is used to treat other conditions, including bipolar disorder, dementia and behavior problems in a range of age groups. Yet, frequent off-label use by clinicians to treat other mood and anxiety disorders and behavioral disorders is common and requires an examination of the risks and benefits in such populations. A review of the literature provides varying levels of evidence supporting its use in a range of depressive and anxiety disorders, and in special populations, including children and the elderly. Most reports are based on short-term studies and include its use both as monotherapy and as an augmenting agent to other psychotropics, and in a range of doses. Further randomized controlled trials are needed to confirm the efficacy and tolerability of risperidone, both short- and long-term, in many of these conditions. The published evidence is summarized, with recommendations and suggestions for its use. PMID:17685886
Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo; Jacobsen, Søren; Stengaard-Pedersen, Kristian; Junker, Peter; Lottenburger, Tine; Hansen, Ib Tønder; Andersen, Lis Smedegaard; Tarp, Ulrik; Svendsen, Anders; Pedersen, Jens Kristian; Skjødt, Henrik; Ellingsen, Torkell; Lindegaard, Hanne; Pødenphant, Jan; Hørslev-Petersen, Kim
OBJECTIVE: To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early rheumatoid arthritis (RA).METHODS: During 2 years of follow-up in the CIMESTRA trial, 160 patients received intra-articular betamethasone in up to four swollen joints/visit in combination with disease-modifyi...
Full Text Available Objectives: The aim of this study was to investigate efficacyand safety of subtenon triamcinolone (ST in combinationwith focal laser photocoagulation in diabetic macularedema (DME.Materials and methods: Medical records of patients withDME, treated with 40 mg subtenon injection of triamcinoloneacetonid prior to focal laser photocoagulation wereretrospectively analyzed. Seventeen eyes of 17 patientswith DME were enrolled in the study. All patients underwenta comprehensive ophthalmological examinationbefore the treatment. Efficacy of the treatment after STinjection was evaluated by visual acuity and flouresceinangiography (FA. Follow-up visits were performed at 1st,3rd, 6th and 12th months. Repeated measures ANOVA wasused for statistical analysis.Results: The mean age was 61.5 ± 8.7 years and themean visual acuity in the study eyes was 0.22 ± 0.13 beforethe treatment, 0.39 ± 0.15 at 1st month, 0.36 ± 0.18at 3rd month, 0.33 ± 0.15 at 6th month and 0.34 ± 0.16 at12th month. The differences in the visual acuity before thetreatment and follow-up visits were significant (p ?0.05.Visual acuity was increased in 13 (%76,4 patients, decreasedin 1 (%5,8 and unchanged in 3 (%17,6.Conclusion: Injection of 40 mg of triamsinolon via subtenonroute combined with focal laser photocoagulation isa safe and beneficial treatment in cases of DME
Palmieri, Beniamino; Coacci, Alessandro
Objective: Facial aging is characterized by skin laxity and loss of skin elasticity. Hyaluronic acid, a biological component of the extracellular matrix, whose level decreases during aging, plays structural, rheological, and physiological roles in the skin. Hyaluronic acid may possess different molecular weights: low-molecular-weight hyaluronic acid (from 50 kDa) and high-molecular-weight hyaluronic acid (just up to 2 million kDa). This monocentric, retrospective, observational study investigates the efficacy, security, and tolerability of a new injective low- and high-molecular-weight hyaluronic acid for facial skin rejuvenation. Methods: Eleven women received once a month, for 2 months, 2 mL of the product in the subcutaneous layer of the right and left malar/submalar areas. Facial skin echography, facial skin hydration, elasticity, and transepidermal water loss were assessed before (T0), after 1 month (T1), and after 3 months of treatment (T2). The injective features of the product, physician subjective satisfaction, and patient satisfaction were also reported. Results: Facial face hydration, elasticity, and transepidermal water loss values significantly improved at T1 and T2 (P < .01). Patients were very satisfied at the end of the treatment, and the compound's profit evaluated by the physician was optimal in the absence of local side effects. Conclusions: This treatment represents a good treatment option to restore vitality and turgidity of skin presenting the signs of aging in the absence of intolerance symptoms. PMID:26491508
Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone) is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activity as an antagonist at ?1-and ?2 adrenergic receptors and H1 histaminergic receptors, but has virtually no affinity for cholinergic receptors. Paliperidone palmitate has been shown to be effective in reducing Positive and Negative Syndrome Scale total scores in four short-term trials in acute schizophrenia. It was also effective as maintenance therapy in a long-term trial in which time to recurrence of symptoms was significantly longer in paliperidone-treated patients compared with placebo. In addition, paliperidone was shown to be noninferior to risperidone long-acting injection in one study, but this noninferiority was not established in another longer study comparing the two drugs. Treatment should be initiated with 234 mg on day 1 and 156 mg on day 8, followed by a recommended monthly maintenance dose of 39234 mg based on efficacy and tolerability. Paliperidone palmitate is generally well tolerated, although it can cause weight gain and a rise in prolactin levels, which is generally greater in women than in men. Overall, paliperidone palmitate may have advantages over other currently available long-acting injections, and therefore may be a useful alternative for the treatment of schizophrenia, although further long-term trials comparing it with active treatments are warranted. PMID:20856919
Dorchies, P; Jacquiet, P; Bergeaud, J P; Duranton, C; Prévot, F; Alzieu, J P; Gossellin, J
A study was conducted to evaluate the therapeutic efficacy of doramectin administered intramuscularly at a dose rate of 200 microg/kg to sheep harbouring naturally acquired infections of gastrointestinal nematodes and Oestrus ovis in the southwestern region of France. On day 0, 24 sheep were selected on the basis of positive faecal egg counts (>100 EPG) and positive assessment of O. ovis infection (including positive O. ovis antibody level and positive clinical score). The sheep were randomly allocated to a non-medicated control group (T1) or a doramectin-treated group (T2) of 12 animals each. On day 0, sheep in group T2 received a single intramuscular injection of doramectin (200 microg/kg), whereas those in group T1 received an intramuscular injection of saline solution (sodium chloride, 0.02ml/kg). Individual faecal egg counts were performed on days 0, 1, 2, 3, 4, 5, 6, 7, and 14. Between days 14 and 16, all sheep were slaughtered, and worm and O. ovis burdens were determined. In doramectin-treated sheep, faecal egg counts had decreased to zero by day 4 for all recovered types of nematode eggs: strongyles, Nematodirus sp., Trichuris sp., and Rhabditidae sp. For strongyles, Nematodirus sp., and Rhabditidae, the percentage reductions in faecal egg counts (geometric means) of doramectin-treated sheep, compared to the non-medicated control sheep were 100% from days 4-7. For Trichuris sp., they were 100, 99.7, 99.9, and 100% on days 4, 5, 6, and 7, respectively. On day 14, percentage reductions were 100% for Nematodirus sp. and Rhabditidae, and 99.8 and 99.1% for strongyles and Trichuris sp., respectively. At necropsy, only adult nematodes and mainly first-stage O. ovis larvae were recovered. Doramectin was highly efficacious against the adult stages of Teladorsagia circumcincta (100%), Nematodirus battus (100%), Nematodirus filicollis (99.9%), Oesophagostomum venulosum (99.8%), and Trichuris sp. (99.3%). It was also 100% efficacious against first-stage larvae of O. ovis. No abnormal clinical signs or adverse reactions in any of the sheep treated with doramectin were observed. PMID:11230921
Matsuoka, Priscila Katsumi; Locali, Rafael Fagionato; Pacetta, Aparecida Maria; Baracat, Edmund Chada; Haddad, Jorge Milhem
To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were identified. However, only fourteen eligible trials fulfilled the prerequisites. Altogether, the review included 1814 patients in trials of eight different types of bulking agents, and all studies were described and analyzed. The measured outcomes were evaluated using a large variety of instruments. The most common complications of the bulking agents were urinary retention and urinary tract infection. Additionally, there were certain major complications, such as one case of death after use of autologous fat. However, the lack of adequate studies, the heterogeneous populations studied, the wide variety of materials used and the lack of long-term follow-up limit guidance of practice. To determine which substance is the most suitable, there is a need for more randomized clinical trials that compare existing bulking agents based on standardized clinical outcomes. PMID:26934239
Fenton, Caroline; Scott, Lesley J
Risperidone (Risperdal) is an atypical antipsychotic with high affinity for 5-hydroxytryptamine (5-HT)2A, dopamine D2 and alpha1- and alpha2-adrenergic receptors. Risperidone is now approved in the UK and the US for use in bipolar mania. Risperidone < or =6 mg/day, as monotherapy or adjunctive therapy with first-line mood stabilisers, significantly improves moderate and severe bipolar mania and improves global functioning over 3 weeks. Improvements in Young Mania Rating Scale (YMRS) scores in double-blind trials were greater with risperidone than with placebo over 3 weeks, and similar to those with haloperidol over 3 and 12 weeks. Risperidone was reasonably well tolerated. Limited data are available on the combination of risperidone and carbamazepine. Risperidone, as monotherapy or combined therapy with lithium or valproate semisodium, is an effective treatment option in bipolar mania. PMID:15907153
Williams, Susan K.; Scahill, Lawrence; Vitiello, Benedetto; Aman, Michael G.; Arnold, L. Eugene; McDougle, Christopher J.; McCracken, James T.; Tierney, Elaine; Ritz, Louise; Posey, David J.; Swiezy, Naomi B.; Hollway, Jill; Cronin, Pegeen; Ghuman, Jaswinder; Wheeler, Courtney; Cicchetti, Domenic; Sparrow, Sara
Objective: To evaluate the impact of risperidone on adaptive behavior in children with autistic disorder who have serious behavior problems and to examine different methods of scoring the Vineland Adaptive Behavior Scales to measure change. Method: Forty-eight children (5 years to 16 years, 5 months) who showed behavioral improvement during acute
Purpose: To verify the efficacy of ultrasound (US)-guided injection of large amounts of ethanol into large or multiple liver lesions, in a single session under general anesthesia (one-shot PEI) for percutaneous ablation of hepatic tumors. Methods: Twenty-nine patients (27 with 51 hepatocellular carcinoma (HCC) nodules on cirrhosis, diameter range 1.0-9.0 cm; two patients with a single metastasis from the gastroenteric tract, 5.0 and 9.0 cm, respectively, in diameter) were treated with one-shot PEI. Results: The total volume of alcohol delivered per patient ranged from 16 to 210 ml. Mean ethanol volume in all patients was 49 ml. Dynamic computed tomography (CT) examination showed complete necrosis in 41 of 50 lesions. Two patients died of hypovolemic shock due to massive upper gastrointestinal bleeding, 3 and 7 days, respectively, after the interventional procedure. All the remaining patients are alive (follow-up 5-14 months) except one who died of liver failure 5 months after. New HCC nodules occurred in six patients within 6 months and one intralesional relapse was recorded. Conclusion: In this preliminary experience, one-shot PEI is as effective in inducing liver tumor necrosis as traditional PEI; its advantages are shorter treatment time and the capability of treating larger and multiple liver lesions
Hongkaew, Yaowaluck; Ngamsamut, Nattawat; Puangpetch, Apichaya; Vanwong, Natchaya; Srisawasdi, Pornpen; Chamnanphon, Montri; Chamkrachchangpada, Bhunnada; Tan-kam, Teerarat; Limsila, Penkhae; Sukasem, Chonlaphat
Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD) during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females) aged 319 years with ASD received risperidone treatment (0.106.00 mg/day) for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90%) subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.3029.20) of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.6522.30) and low (11.70, IQR 7.5116.50) doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with risperidone. This study suggests that risperidone treatment causes prolactin elevations and the effects of risperidone on prolactin are probably dose-related in pediatric patients. PMID:25653528
Full Text Available JP LindenmayerDepartment of Psychiatry, New York University School of Medicine, New York NY, USAAbstract: Medication non-adherence in patients with schizophrenia continues to be a significant problem and threatens successful treatment outcomes. Medication non-adherence is often associated with negative consequences, including symptom exacerbation, more frequent emergency room visits, re-hospitalizations and relapse. Long-acting injectable (LAI forms of antipsychotics allow for rapid identification of non-adherence, obviate the need for the patient to take the medication on a daily basis and increase adherence to some significant degree. Eli Lilly has developed a long-acting depot formulation of olanzapine, olanzapine pamoate, which has recently been approved by the FDA for the US market, and which will be reviewed here. Olanzapine LAI appears to be an effective antipsychotic at dosages of 210 mg every 2 weeks, 300 mg every 2 weeks and 405 mg every 4 weeks in patients with acute schizophrenia, and at 150 mg every 2 weeks, 300 mg every 2 weeks and at 405 mg every 4 weeks for the maintenance treatment of stable patients. Oral supplementation appears not to be needed, particularly not at the onset of treatment with the LAI as is necessary with risperidone LAI. Its efficacy is in general comparable to the efficacy seen with oral olanzapine at a corresponding dose. The side effect profile is also comparable to the side effects observed with oral olanzapine, including lower rates of extrapyramidal symptoms, prolactin elevation and cardiovascular side effects, but significant metabolic effects. The latter include significant weight gain, lipid abnormalities and glucose dysregulation. While the injection site adverse events are overall mild, the most significant serious adverse event is the post-injection delirium sedation syndrome (PDSS. While rare, this syndrome results from inadvertent intravascular injection of olanzapine LAI and can cause a range of olanzapine overdose-type of symptoms. Olanzapine LAI needs therefore to be administered by trained personnel in settings where a post-injection observation period for at least 3 hours by medical personnel is available. The overall use of olanzapine LAI will probably be limited by the possibility of a PDSS event. Patients who have a history of good response to oral olanzapine and are in need of assured medication administration may present a good indication for its use, provided that the appropriate mental health delivery setting is available.Keywords: olanzapine, risperidone, schizophrenia
Davoudi, Amin; Rismanchian, Mansour; Akhavan, Ali; Nosouhian, Saeid; Bajoghli, Farshad; Haghighat, Abbas; Arbabzadeh, Farahnaz; Samimi, Pouran; Fiez, Atiyeh; Shadmehr, Elham; Tabari, Kasra; Jahadi, Sanaz
Dental anxiety and fear of needle injection is one of the most common problems encountered by dental practitioners, especially in the pediatric patient. In consequences, it might affect the patient's quality of life. Several methods are suggested to lower the discomfort of local anesthesia injection during dental procedures. Desensitization of injection site is one of the recommended strategies. Among chemical anesthetic topical agents that are effective but might have allergic side effects, using some nonpharmacological and safe techniques might be useful. This study aimed to overview the efficacy of using cooling techniques, mostly by ice or popsicles, warming or pH buffering of drug, and using modern devices to diminish the discomfort of local anesthesia injection during dental procedures.
Clinical result of intra-arterial lymphocyte injection therapy for treatment of lymphedema and the evaluation of the efficacy of the therapy. Quantitative analysis by an injection of 111In-labeled lymphocytes and by MR imaging
We have employed the intra-arterial lymphocytes injection therapy for treatment of lymphedema of the limbs with various causes. In the present study, we observed the clinical outcome of our therapy in 38 patients with lymphedema of the limbs. Results showed that the therapy was effective in 26 of 38 patients (68% of the total). Moreover, a marked efficacy was obtained in 13 of 38 patients (34% of the total). In the latest 5 patients, to evaluate the efficacy of our therapy, we examined the distribution of the 111In-oxine labeled lymphocytes injected into the proximal artery of the affected limb. The radioactivities of the affected limbs were apparently higher than that of the healthy limbs in effective cases. Moreover, MR imaging showed that the reduction of STIR ratio and T2 ratio well correlate with the results of clinical course. Thus, the efficacy of the lymphocyte injection therapy is able to be evaluated by radiolabeled lymphocytes and MR imaging. (author)
B.Vishnu Vardhan Reddy; G. Dinesh Babu; A.Premswaroop; M. Chandra Sekhar; Ramya.Y
The present study was carried out to formulate Risperidone mini tablets filled into hard gelatin capsule, as it is administered for the treatment of psychosis. The preformulation studies of Risperidone were carried out and drug polymer compatibility studies were performed by FT-IR spectra analysis. The precompression parameters revealed that all the 6 formulations had good flow Carrs index, Hausners ratio and angle of repose within the limit. Risperidone is formulated with different concen...
Hongkaew, Yaowaluck; Ngamsamut, Nattawat; Puangpetch, Apichaya; Vanwong, Natchaya; Srisawasdi, Pornpen; Chamnanphon, Montri; Chamkrachchangpada, Bhunnada; Tan-kam, Teerarat; Limsila, Penkhae; SUKASEM, Chonlaphat
Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD) during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females) aged 319 years with ASD received risperidone treatment (0.106.00 mg/day) for up to 158 weeks. Prolactin levels were measured by chemiluminescen...
Rajamani, Anto Praveen Rajkumar; Jebaraj, P
Risperidone and ziprasidone are commonly used as first line drugs for the treatment of psychotic disorders and overdose with these agents is increasingly being reported. Relatively few of these reports have involved co-ingestion of multiple psychotropic agents. We report a case of overdose with risperidone, ziprasidone, valproate, trihexyphenidyl and clonazepam in a 25 years female, who recovered uneventfully with supportive management. Notwithstanding the benign outcome in this instance, age, co-ingested drugs, active metabolites and medical co-morbidity are critical issues in overdose with atypical antipsychotics. As prescription of these drugs continues to increase in developing countries, systematic studies evaluating their clinical toxicity and management are necessary. The issues associated with overdose of multiple psychotropic agents and appropriate management policies are highlighted.
Huynh Le Maux, Amélie; Pignol, Bernadette; Behr-Roussel, Delphine; Blachon, Jean-Luc; Chabrier, Pierre-Etienne; Compagnie, Sandrine; Picaut, Philippe; Bernabé, Jacques; Giuliano, François; Denys, Pierre
Intradetrusor injections of Botulinum toxin A-currently onabotulinumtoxinA-is registered as a second-line treatment to treat neurogenic detrusor overactivity (NDO). The common clinical practice is 30 × 1 mL injections in the detrusor; however, protocols remain variable and standardization is warranted. The effect of reducing the number of injection sites of Dysport(®) abobotulinumtoxinA (aboBoNTA) was assessed in the spinal cord-injured rat (SCI). Nineteen days post-spinalization, female rats received intradetrusor injections of saline or aboBoNTA 22.5 U distributed among four or eight sites. Two days after injection, continuous cystometry was performed in conscious rats. Efficacy of aboBoNTA 22.5 U was assessed versus aggregated saline groups on clinically-relevant parameters: maximal pressure, bladder capacity, compliance, voiding efficiency, as well as amplitude, frequency, and volume threshold for nonvoiding contractions (NVC). AboBoNTA 22.5 U significantly decreased maximal pressure, without affecting voiding efficiency. Injected in four sites, aboBoNTA significantly increased bladder capacity and compliance while only the latter when in eight sites. AboBoNTA significantly reduced NVC frequency and amplitude. This preclinical investigation showed similar inhibiting effects of aboBoNTA despite the number of sites reduction. Further studies are warranted to optimize dosing schemes to improve the risk-benefit ratio of BoNTA-based treatment modalities for NDO and further idiopathic overactive bladder. PMID:26694464
Lin Chih-Hsun; Hsu Chih-Wei; Tsao Tang-Yi; Chou Jason
Abstract Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8120093785928228
Bogetto, Filippo; Rocca, Paola; MONTEMAGNI, Cristiana
Purpose: Acute agitation is a common presentation in emergency departments and is often secondary to an underlying psychotic condition. The aim of this study was to compare the effectiveness of three second generation antipsychotics (risperidone, olanzapine, quetiapine) versus haloperidol in the treatment of psychotic agitation for up to 72 h. General Methods: We recruited 101 patients with acute psychosis who were admitted at the Mental Health Department 1 South of Turin, Psychiatric Eme...
Full Text Available Introduction. Endoscopic injection therapy of epinephrine is safe and effective in the treatment of bleeding peptic ulcer, but with high risk of rebleeding. The combination therapy of epinephrine and hemoclips could lead to a reduction of rebleeding and a potential reduction in mortality. Objective. To investigate the efficacy and safety of epinephrine injection therapy and combination therapy with epinephrine and hemoclips in treating bleeding peptic ulcers. Methods. A prospective randomized study included 58 patients with bleeding gastric or duodenal ulcer. In 30 patients endoscopic injection therapy with diluted epinephrine was applied (group I, while in 28 patients combination therapy of epinephrine and hemoclips was applied (group II. Results. Initial haemostasis was achieved in most patients treated with epinephrine injection therapy (93.3% and patients treated with combination therapy of epinephrine and hemoclips (96.4%. After initial haemostasis was achieved rebleeding was significantly more frequent in the patients treated with epinephrine (28.5% than in the patients treated with combination therapy (3.7%, p<0.05. Two patients treated with epinephrine injection therapy were subjected to surgical intervention, whereas no patient treated with combination therapy needed surgery. Lethal ending occurred in one patient treated with epinephrine and in one patient treated with combination therapy. The difference between the two groups of patients in need for surgical intervention and mortality was not statistically significant. Conclusion. Combination therapy with epinephrine and hemoclips is more efficient than epinephrine alone in the treatment of bleeding peptic ulcers.
Carlson, Teri; Reynolds, Charles A.; Caplan, Rochelle
This case report describes two children who developed hyperammonemia together with frank manic behavior during treatment with a combination of valproic acid and risperidone. One child had been maintained on valproic acid for years and risperidone was added. In the second case, valproic acid was introduced to a child who had been treated with
Rey, Michel; Rodriguez-Lecompte, Juan; Undi, Michael; Joseph, Tomy; Morrison, Jason; Yitbarek, Alex; Wittenberg, Karin; Tremblay, Robert; Crow, Gary; Ominski, Kim
This study compared needle-free and needle-based injection devices for vaccination of calves against Clostridium chauvoei in warm and cold conditions. Both devices elicited comparable antibody responses in calves. Needle-free injection devices can be used to vaccinate calves provided appropriate precautions are taken in cold weather. PMID:25829562
Full Text Available Khaldoon Bashaireh,1 Ziad Naser,2 Khaled Al Hawadya,2 Sorour Sorour,2 Rami Nabeel Al-Khateeb3 1Department of Orthopedics Surgery, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan; 2Private Clinic, 3Elaf Medical Supplies Company, Amman, Jordan Purpose: The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine® Gel over a 9-month period.Materials and methods: The study was a post-marketing phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 14 in the tibiofemoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection.Main outcome measure(s: An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated.Main results: The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3.36, the stiffness score was 0.42, and the physical performance score was 11.5. All side effects were local and transient, and included pain, swelling, and redness of the knee. Most side effects were treated.Conclusion: Hyaluronan should be encouraged as an alternative or adjunct treatment to oral analgesics to reduce their required doses, and delay potential future surgical intervention. Keywords: osteoarthritis, hyaluronic acid, intra-articular injection, Crespine® Gel
Full Text Available Background: The goal of this study was to compare the efficacy of botulinum toxin type A (BTX-A injection in the hamstring and calf muscles with and without ankle serial casting in the improvement of gait in children with cerebral palsy (CP.Methods : This double-blind prospective clinical trial was performed on 25, 2 to 8-year-old children with hemiplegic or diplegic CP in Tehran, Iran in 2010. The participants were chosen by simple randomized sampling and were matched for age, gross motor function classification system (GMFCS and type of CP and were randomly divided into two groups: children in the first group (13 only received BTX-A injection, but the second group (12 received BTX-A and serial foot casting starting one week after the injection.Results : Comparison of the gross motor function, right and left knee spasticities and passive ROM of both knees between the two groups before and 1, 3, 6 and 12 months after the injections were not statistically significant (P>0.1. Furthermore, comparison of the right and left ankle spasticities and passive ROM before the injections and in1 and 3-month follow-ups did not show a statistically significant difference (P>0.1, but the differences were significant in 6 and 12-month follow-ups (P<0.05.Conclusion: BTX-A injection with serial foot casting vs. BTX-A alone was more effective in decreasing spasticity and improving passive ROM in the ankle of children with CP, but such injections in the hamstrings were not useful in these regards.
Grubisha, Melanie J; Brennan, Jessica L; Douaihy, Antoine
The second generation antipsychotic risperidone is generally considered to have low cardiac adverse events, with an increased risk of ventricular arrhythmias being reported only rarely in literature. We report here the case of a patient with a significant history of alcohol dependence, yet with no previous cardiac history, who had previously tolerated risperidone well, but had experienced isolated sinus tachycardia in the post detox period, following the reinitiation of risperidone therapy. The Naranjo Adverse Drug Reaction (ADR) probability scale rating for this being a medication adverse event (AE) was 4, thus indicating that this patient's AE was associated with risperidone therapy. This case report will contribute to the limited evidence of adverse cardiac events associated with risperidone therapy, with particular emphasis on the susceptibility of patients in a state of autonomic hypersensitivity. PMID:25709354
Melanie J Grubisha
Full Text Available The second generation antipsychotic risperidone is generally considered to have low cardiac adverse events, with an increased risk of ventricular arrhythmias being reported only rarely in literature. We report here the case of a patient with a significant history of alcohol dependence, yet with no previous cardiac history, who had previously tolerated risperidone well, but had experienced isolated sinus tachycardia in the post detox period, following the reinitiation of risperidone therapy. The Naranjo Adverse Drug Reaction (ADR probability scale rating for this being a medication adverse event (AE was 4, thus indicating that this? patient?s AE was associated with risperidone therapy. This case report will contribute to the limited evidence of adverse cardiac events associated with risperidone therapy, with particular emphasis on the susceptibility of patients in a state of autonomic hypersensitivity.
Full Text Available Major depression occurs in up to 10% of the human population, and all the currently used antidepressant drugs (ADs are effective as a monotherapy in ca. 60-70% of patients. Among agents that are expected to potentiate the efficacy of ADs there are atypical antypsychotics (e.g., olanzapine, risperidone. Several clinical reports have postulated a beneficial effect of an additional low dose of risperidone in the ongoing treatment with ADs. The latter drug is ca. 10-20 times more potent in its binding to serotonin 5-HT2A receptors than to dopamine D2 ones; moreover, it produces minimal extrapyramidal side-effects compared to classical antipsychotics. To understand the mechanism of the clinical efficacy of an AD and an atypical antipsychotic (a combination therapy in treatment-resistant depression, in the present study we examined the effect of co-treatment with ADs belonging to different pharmacological groups and a low dose of risperidone, given separately or jointly, on the behavioral reactivity of the central 5-HT1A and 5-HT2A or dopamine systems in male C57BL/6J mice. The obtained results showed that repeated citalopram, fluoxetine or mirtazapine (but not desipramine, co-administered with risperidone (0.1 mg/kg, induced a more potent inhibition of the behavioral syndrome evoked by 5-HT1A and 5-HT2A receptor agonists (8-OH-DPAT and DOI, respectively, but did not change the action of amphetamine (a dopamine agent compared to the treatment with either drug alone. The presented results indicate that a low dose of risperidone enhances the action of citalopram, fluoxetine or mirtazapine, and that central 5-HT1A and 5-HT2A receptors may play some role in these effects. Furthermore, they may be of importance to the pharmacotherapy of drug-resistant depression. Funding: Supported by grant POIG. 01.01.02-12-004/09-00 from the European Regional Development Fund.
Yamaguchi, Takeshi; Ochiai, Nobuyasu; Sasaki, Yu; Kijima, Takehiro; Hashimoto, Eiko; Sasaki, Yasuhito; Kenmoku, Tomonori; Yamazaki, Hironori; Miyagi, Masayuki; Ohtori, Seiji; Takahashi, Kazuhisa
This study evaluated dorsal root ganglia from C3-C7, analyzed gait, and compared the expression of calcitonin gene-related peptide (CGRP) which was a marker of inflammatory pain in a rat rotator cuff tear model in which the supraspinatus and infraspinatus tendons were detached; comparisons were made to a sham group in which only the tendons were exposed. Fluorogold was injected into the glenohumeral joint 21 days after surgery in both groups, and saline, steroids, or hyaluronic acid was injected into the glenohumeral joint in the rotator cuff tear group 26 days after surgery. The proportions of CGRP-immunoreactive neurons were higher and the gait parameters were impaired in the rotator cuff tear group compared to in the sham group. However, the CGRP expression was reduced and the gait was improved with steroid or hyaluronic acid injection compared to saline, suggesting that both hyaluronic acid and steroid injections suppressed of inflammation which thought to be provided pain relief. While there were no significant differences, the suppression of CGRP expression and the improved gait after hyaluronic acid and steroid injections suggested that both methods were effective for rat rotator cuff tear model. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1861-1867, 2015. PMID:26147720
Dos Santos-Júnior, Amilton; Henriques, Taciane Barbosa; de Mello, Maricilda Palandi; Della Torre, Osmar Henrique; Paes, Lúcia Arisaka; Ferreira-Neto, Adriana Perez; Sewaybricker, Letícia Esposito; Fontana, Thiago Salum; Celeri, Eloisa Helena Rubello Valler; Guerra-Júnior, Gil; Dalgalarrondo, Paulo
Objective. To identify the frequency of obesity and metabolic complications in child and adolescent users of risperidone. Potential associations with clinical parameters and SNPs of the HTR2C, DRD2, LEP, LEPR, MC4R, and CYP2D6 genes were analyzed. Methods. Samples from 120 risperidone users (820 years old) were collected and SNPs were analyzed, alongside assessment of chronological and bone ages, prescribed and weight-adjusted doses, use of other psychotropic drugs, waist circumference, BMI z-scores, blood pressure, HOMA-IR index, fasting levels of serum glucose, insulin, cholesterol, triglycerides, transaminases, and leptin. Results. Thirty-two (26.7%) patients were overweight and 5 (4.2%) obese. Hypertension was recorded in 8 patients (6.7%), metabolic syndrome in 6 (5%), and increased waist circumference in 20 (16.7%). The HOMA-IR was high for 22 patients (18.3%), while total cholesterol and triglycerides were high in 20 (16.7%) and 41 (34.2%) patients, respectively. SNP associations were found for LEP, HTR2C, and CYP2D6 with BMI; CYP2D6 with blood pressure, ALT, and HOMA-IR; HTR2C and LEPR with leptin levels; MC4R and DRD2 with HOMA-IR; HTR2C with WC; and LEP with ALT. Conclusions. Although not higher than in the general pediatric population, a high frequency of patients was overweight/obese, with abnormalities in metabolic parameters and some pharmacogenetic associations.
D'Souza, Susan; Faraj, Jabar; DeLuca, Patrick
The purpose of this study was to develop a parenteral delivery system of Risperidone that would provide initial and extended drug release and thereby avoid the need for co-administration of oral tablets. Key formulation parameters utilized to achieve desired therapeutic levels in vivo were particle size and drug loading. Three poly (D,L-lactide-co-glycolide) (PLGA) microsphere formulations (Formulations A, B, and C) that encapsulated Risperidone were prepared by varying particle size (19-49 ?m) and drug loading parameters (31-37%) but with a uniform bulk density (0.66-0.69)g/cc and internal porosity, utilizing the solvent extraction/evaporation method. The microspheres were characterized for drug content by HPLC, particle size by laser diffractometry, surface morphology by scanning electron microscopy (SEM), and in vivo drug release. In vivo studies were performed in male Sprague-Dawley rats, and levels of the active moiety (Risperidone and its metabolite, 9-hydroxyrisperidone) were assessed. In vivo release profiles from the three microsphere formulations were dependent on particle size and drug loading. The smaller sized microspheres (Formulation A) exhibited a large initial burst and a shorter duration of action, while the larger particles exhibited a smaller initial burst (Formulations B and C) but released drug for a much longer period in vivo. Extended duration of drug release was ascribed to higher drug content in the microspheres. A biweekly simulation of multiple dosing revealed that Formulation C, the selected formulation, with a high load and large particle size would provide adequate initial and maintenance levels of the active moiety (Risperidone and its metabolite, 9-hydroxyrisperidone). A comparison of biweekly dosing in vivo of Formulation C with the marketed product showed that at steady state, though average concentrations for both preparations were similar, the time taken to achieve steady state was much faster for Formulation C. The delay in attaining steady state with Risperdal Consta® was attributed to the 3 week latency in drug release from the microspheres and was in accordance with previous studies indicating a good corroboration with clinical findings. Calculated cumulative AUC (area under the curve) levels for Formulation C were similar to the Risperdal Consta®, though there were marked differences in AUC levels at the early time points. Comparison of Risperidal Consta® and Formulation C by multiple dosing in vivo experiments revealed that the marketed preparation demonstrated a substantial delay in providing an initial loading dose, continuous circulating levels, and attainment of steady state; all of which were observed rapidly with Formulation C. Findings from the current study strongly suggest that a microsphere dosage form of Risperidone can be formulated with an optimum particle size and drug loading to provide an initial bolus followed by maintenance levels, thereby eliminating combination therapy and improving patient compliance. PMID:23892159
Atool Chandra Bhuyan
Full Text Available Introduction: Pain management remains the utmost important qualifying criteria in minimizing patient agony and establishing a strong dentist-patient rapport. Symptomatic irreversible pulpitis is a painful condition necessitating immediate attention and supplemental anesthetic techniques are often resorted to in addition to conventional inferior alveolar nerve block. Aim: The purpose of the study was to evaluate the anesthetic efficacy of X-tip intraosseous injection in patients with symptomatic irreversible pulpitis, in mandibular posterior teeth, using 4% Articaine with 1:100,000 adrenaline as local anesthetic, when the conventional inferior alveolar nerve block proved ineffective. Materials and Methods: X-tip system was used to administer 1.7 ml of 4% articaine with 1:100,000 adrenaline in 30 patients diagnosed with irreversible pulpitis of mandibular posterior teeth with moderate to severe pain on endodontic access after administration of an inferior alveolar nerve block. Results: The results of the study showed that 25 X-tip injections (83.33% were successful and 5 X-tip injections (16.66% were unsuccessful. Conclusion: When the inferior alveolar nerve block fails to provide adequate pulpal anesthesia, X-tip system using 4% articaine with 1:100,000 adrenaline was successful in achieving pulpal anesthesia in patients with irreversible pulpitis.
C, Purchase; J, Picard; R, McDonald; S P R, Bisschop.
Full Text Available This study was undertaken to establish whether the Onderstepoort Biological Products Fowl Typhoid (OBPft) vaccine registered as an injectable vaccine was effective and safe when administered orally to commercial layers. Its efficacy and duration of protection were compared with application by intram [...] uscular injection. Commercial brown layer hens were used as they were found to be highly susceptible to Salmonella gallinarum infections. In the vaccine safety trial birds were euthanased at timed intervals spanning 4 weeks postvaccination. Necropsies were performed and samples were taken and tested. No clinical signs or mortalities could be attributed to the OBPft vaccine nor could active shedding of the vaccine strain be detected. Slight pathological changes were noted with both routes of vaccination; however, these changes were transient, returning to normal within the observation period. The injected groups showed a better serological response with the rapid serum plate agglutination (RSPA) test than the orally vaccinated groups. In the duration of protection trial, birds were challenged at 3-8-week intervals post-vaccination. All unvaccinated birds died. Protection 8 and 16 weeks after vaccination was above 60 %, by 24 weeks after challenge, the vaccine protection was below 30 %. It was found that there was no significant difference (P
Siafaka, Panoraia I; Barmpalexis, Panagiotis; Lazaridou, Maria; Papageorgiou, George Z; Koutris, Efthimios; Karavas, Evangelos; Kostoglou, Margaritis; Bikiaris, Dimitrios N
In the present study a series of biodegradable and biocompatible poly(?-caprolactone)/poly(propylene glutarate) (PCL/PPGlu) polymer blends were investigated as controlled release carriers of Risperidone drug (RISP), appropriate for transdermal drug delivery. The PCL/PPGlu carriers were prepared in different weight ratios. Miscibility studies of blends were evaluated through differential scanning calorimetry (DSC) and X-ray diffractometry (XRD). Hydrolysis studies were performed at 37°C using a phosphate buffered saline solution. The prepared blends have been used for the preparation of RISP patches via solvent evaporation method, containing 5, 10 and 15wt% RISP. These formulations were characterized using FT-IR spectroscopy, DSC and WAXD in order to evaluate interactions taking place between polymer matrix and drug, as well as the dispersion and the physical state of the drug inside the polymer matrix. In vitro drug release studies were performed using as dissolution medium phosphate buffered saline simulating body fluids. It was found that in all cases controlled release formulations were obtained, while the RISP release varies due to the properties of the used polymer blend and the different levels of drug loading. Artificial Neural Networks (ANNs) were used for dissolution behaviour modelling showing increased correlation efficacy compared to Multi-Linear-Regression (MLR). PMID:26159838
EyÃ¼p Sabri ERCAN; Kutlu, AysÌ§e; ÃÄ±koÄlu, Sibel; VeznedaroÄlu, Baybars; ErermiÅ, Serpil; Varan, Azmi
Background: Risperidone is one of the most commonly used atypical antipsychotic drugs in the treatment of children and adolescents. However, the data about its use in children and adolescents with conduct disorder (CD) are limited.
Detke Holland C
Full Text Available Abstract Background To treat acute schizophrenia, a long-acting injectable antipsychotic needs a rapid onset of action and therapeutic profile similar to that of oral agents. The present post-hoc analyses compared results from a randomized, double-blind, placebo-controlled trial of olanzapine long-acting injection (LAI for acute schizophrenia with those observed in similarly designed trials of oral olanzapine. Methods Six-week results from the olanzapine LAI study (N?=?404 were compared with those of 3 oral studies (study 1: olanzapine vs. haloperidol vs. placebo [N?=?335]; study 2: olanzapine vs. haloperidol vs. low-dose olanzapine [N?=?431]; study 3: olanzapine vs. placebo vs. low-dose olanzapine [N?=?152]. All patients had baseline Brief Psychiatric Rating Scale (BPRS scores ?24 (06 scale. Six-week effect sizes were calculated. Efficacy onset, pharmacokinetics, discontinuations, weight gain, and extrapyramidal symptoms were also assessed. Results At 6?weeks, mean BPRS scores decreased by 14 to 15 points for olanzapine LAI (405?mg/4?weeks, 210 or 300?mg/2?weeks, by 8 to 16 for oral olanzapine (10?±?2.5 or 15?±?2.5?mg/day, and by 12 to 13 for haloperidol (15?±?5?mg/day. For those same dose groups, effect sizes vs. placebo for the BPRS were 0.7 to 0.8 for olanzapine LAI, 0.5 to 0.7 for oral olanzapine, and 0.6 for haloperidol. The first statistically significant separation from placebo on the BPRS occurred at 3?days for the olanzapine LAI groups and at 1?week for oral olanzapine and haloperidol (15?±?5?mg/day in oral study 1 although as late as week 6 for the 10-mg/day olanzapine dose in oral study 3. Olanzapine concentrations were similar across studies. Weight gain ?7% of baseline occurred in up to 35% of olanzapine LAI and oral patients versus up to 12% of haloperidol and placebo patients. Extrapyramidal symptoms were lowest in the olanzapine LAI groups and significantly greater in the haloperidol groups. No post-injection delirium/sedation syndrome events occurred in the olanzapine LAI study. Conclusions Patients treated acutely with olanzapine LAI showed a similar pattern of improvement to that seen historically with oral olanzapine. With the exception of injection-related adverse events, the efficacy and tolerability profile of olanzapine LAI is similar to oral olanzapine. Trial registration ClinicalTrials.gov ID; URL: http://http//www.clinicaltrials.gov/: NCT00088478; ClinicalStudyResults.org ID; URL: http://www.clinicalstudyresults.org/: 917, 978, 982, and 5984.
Full Text Available Yaowaluck Hongkaew,1,2 Nattawat Ngamsamut,3 Apichaya Puangpetch,1,2 Natchaya Vanwong,1,2 Pornpen Srisawasdi,4 Montri Chamnanphon,1,2 Bhunnada Chamkrachchangpada,3 Teerarat Tan-kam,3 Penkhae Limsila,3 Chonlaphat Sukasem1,2 1Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, 2Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC, Ramathibodi Hospital, Mahidol University, 3Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, 4Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Abstract: Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females aged 319 years with ASD received risperidone treatment (0.106.00 mg/day for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90% subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.3029.20 of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.6522.30 and low (11.70, IQR 7.5116.50 doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with risperidone. This study suggests that risperidone treatment causes prolactin elevations and the effects of risperidone on prolactin are probably dose-related in pediatric patients. Keywords: prolactin level, risperidone, autism spectrum disorders, Thai, hyperprolactinemia
Sravanti L. Sanivarapu; Krishnamurthy CN
Risperidone is an atypical antipsychotic agent used primarily to treat schizophrenia. It is a dopamine antagonist with antiserotonergic, antihistaminergic and antiadrenergic properties. Antipsychotic discontinuation symptoms have been described in the literature following abrupt or rapid reduction in the dose. This unusual case demonstrates that sudden withdrawal of even a modest dose of risperidone may cause significant discontinuation symptoms in susceptible individuals. Hence, there is a n...
Margari, Lucia; Matera, Emilia; Petruzzelli, Maria G; Simone, Marta; Lamanna, Anna L.; Pastore, Adriana; Vincenzo O. Palmieri 58; Margari, Francesco
The aim of this prospective observational study was to investigate the variations of serum prolactin hormone (PRL) in a sample of 34 drug-naive patients (mean age 13 years) who started risperidone therapy assuming that several factors may favor the increase in serum PRL. Serum PRL and hyperprolactinemia clinical signs were examined at baseline (T0) and after almost 3 months of treatment (T1). We considered sex, pubertal status, risperidone dosage, psychiatric diagnosis, and any personal/famil...
Shen, Jie; Choi, Stephanie; Qu, Wen; Wang, Yan; Burgess, Diane J
The objective of the present study was to determine whether an in vitro-in vivo correlation (IVIVC) can be established for polymeric microspheres that are equivalent in formulation composition but prepared with different manufacturing processes. Risperidone was chosen as a model therapeutic and poly(lactic-co-glycolic acid) (PLGA) with similar molecular weight as that used in the commercial product Risperdal® Consta® was used to prepare risperidone microspheres. Various manufacturing processes were investigated to produce the risperidone microspheres with similar drug loading (approx. 37%) but distinctly different physicochemical properties (e.g. porosity, particle size and particle size distribution). In vitro release of the risperidone microspheres was investigated using different release testing methods (such as sample-and-separate and USP apparatus 4). In vivo pharmacokinetic profiles of the risperidone microsphere formulations following intramuscular administration were determined using a rabbit model. Furthermore, the obtained pharmacokinetic profiles were deconvoluted using the Loo-Riegelman method and the calculated in vivo release was compared with the in vitro release of these microspheres. Level A IVIVCs were established and validated for the compositionally equivalent risperidone microspheres based on the in vitro release data obtained using USP apparatus 4. The developed IVIVCs demonstrated good predictability and were robust. These results showed that the developed USP apparatus 4 method was capable of discriminating PLGA microspheres that are equivalent in formulation composition but with manufacturing differences and predicting their in vivo performance in the investigated animal model. PMID:26423236
Sinha, Preeti; Vandana, V P; Lewis, Nikita Vincent; Jayaram, M; Enderby, Pamela
Speech subsystems are susceptible to the effects of several factors including medications. The atypical antipsychotics can also adversely affect the speech because of its action on serotonin and dopamine neurotransmitters. The present study aims to analyze the speech characteristics associated with atypical antipsychotic risperidone. Speech of 92 patients on risperidone with or without trihexyphenidyl and/or clonazepam were compared with that of 31 persons who were not on any psychotropic medicines. Compared to control group, maximum phonation duration, sequential motion rate of diadochokinesia was reduced by about 3s and 1syllable/s respectively and s/z ratio was increased by 0.16 in patients with risperidone. Performance of larynx, lips and tongue sub-system and intelligibility of speech were also significantly reduced in risperidone group. Risperidone did impact the phonation and articulation sub-systems of speech mildly, which was independent of tardive dyskinesia and extrapyramidal symptoms. Randomized controlled prospective study looking into impact on speech and related effect on drug adherence, functioning and quality of life needs to be conducted with risperidone and other atypical antipsychotics. PMID:26013669
Full Text Available INTRODUCTION: Plantar fasciitis is a common condition causing misery to lot of patients. The etiology and treatment of plantar fasciitis are poorly understood. The results from such treatments vary considerably, and there is no consensus of opinion on the best method. MATERIAL AND METHODS: We conducted a controlled trial in our institute to compare the results of local steroid injections & the use of Extra-corporeal shock wave therapy (ESWT for managing plantar fasciitis. 200 patients with 240 painful heels were evaluated. All patients with moderate to severe heel pain who had already taken ten days of unsatisfactory treatment with oral NSAIDS were divided in two main groups. Group A of 100 patients received 1000 impulses of shock waves in three sessions at weekly interval. In Group B of 100 patients up to three local injections of 40 mg methyl prednisone mixed with 1 ml. of 2% lignocaine were given at biweekly interval. Pain assessment was done using VAS scale and the results were evaluated at six weeks, three months and six months after the completion of the therapy. CONCLUSIONS: There was a significant difference between two groups of patients being treated. The group B patients had significantly greater improvement in pain scale and early return to daily activities
To assess and compare the efficacy of lignocaine anesthesia of vocal cords by spray as you go through a bronchoscope with lignocaine injection through the cricothyroid membrane. Study Design: Quasi experimental study. Place and Duration of Study:This study was done in Combined Military Hospital Peshawar form May 2009 to June 2010. Material and method: Thirty patients in each group were given local anesthesia to the vocal cords. With lignocaine either via intratracheal instillation through the cricothyroid membrane or through a fibreoptic bronchoscope spray as you go. A cough score was calculated by recording the number of coughs as the bronchoscope was advanced through the cords into the trachea. A twenty point unpleasantness score was marked by the patient 2 hours after the procedure. Result: Cough score and unpleasantness score was compared among the two groups using SPSS version 19. Median unpleasantness score was 6 (Inter quartile range (IQR) 4-8) whereas median cough score was 2(IQR 0-3). The difference was statistically significant among the two groups for both cough and unpleasant scores (p< 0.001 and p< 0.001 respectively). Conclusion: Intratracheal injection of lignocaine is more comfortable for the patient. It induces much less cough and irritability to the patient than the spray as you go technique. (author)
Full Text Available Introduction: Traumatic ulcers are one of the most common causes of referral to emergency wards and interfere with wound healing. Even in a complete sterile condition, all of the ulcers may be contaminated with bacteria, but a few of them progress and cause clinical manifestations. There is a controversy on the use prophylactic antibiotics in traumatic ulcers. In this study we compare the efficacy of oral and injectable forms of antibiotics in prophylaxis of infection. Methods: In this clinical trial study, 237 cases suffering from grade II traumatic ulcers were selected by simple random method and divided into 2 groups; first group was administered 1 gram cephazoline prior to suturing and received no other antibiotics , while the second group received 500 mg cephalexin capsule before suturing and continued the treatment for 24 hours. (500 mg QID .Patients were followed up on day 7, 10 and 30 after discharge from hospital for infection of the wounds. The collected data was analyzed by SPSS 11 software using Chi-squire and Fisher exact tests. Results: According to the findings, confounding variables such as sex, age, width of the wound, traumatic cause and site and also the time course until referral to the emergency ward were similar in both groups. Prevalence of infection in the group receiving oral and injection forms of antibiotic was 2.5% and 1.7%, respectively, difference of which was not significant.(P=0.683 Conclusion: As the prevalence of wound infection is similar in both groups, oral forms of antibiotics can be used instead of injectable forms for wound infection prophylaxis.
Schneider, Serge; Sibille, Estelle; Yegles, Michel; Neels, Hugo; Wennig, Robert; Mühe, Annette
Risperidone (RSP) is a second generation anti-psychotic drug used for the treatment of schizophrenia and anxiety disorders. In the last decades, clinical applications of hair analysis have received an increasing attention, because of its wide surveillance window. In this work, we describe a simple and fast method for detection and quantification of RSP and its major metabolite, 9-OH-risperidone (9-OH-RSP), in human hair. The validated method (cv of interday precision, intraday precision and accuracy0.98, limit of detection (LOD) was 0.90 pg/mg hair (RSP) and 1.52 pg/mg hair (9-OH-RSP), the lower limit of quantification (LLOQ) were 1.8 and 4.56 pg/mg, respectively, extraction yield were 86.9% for RSP and 86.7% for 9-OH-RSP) was successfully applied to quantify both substances in the hair of psychiatric patients treated with RSP. After washing, pulverisation, incubation in an ultrasound bath and liquid/liquid extraction of the hair samples, quantification was performed using LC/MS-MS in selected reaction monitoring mode with methaqualone as internal standard. Concentrations for RSP and its major metabolite ranged from 36 to 4765 pg/mg and from 14 to 57 pg/mg, respectively in the different hair segments. These preliminary results indicate a better relationship between the administered dose and hair concentration for 9-OH-RSP than for the parent drug. Furthermore, the RSP/9-OH-RSP ratio varied from 1 to 83. PMID:19595645
Full Text Available Alex C Vidaeff, Michael A BelfortDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USAAbstract: Prevention of preterm delivery is a major desiderate in contemporary obstetrics and a societal necessity. The means to achieve this goal remain elusive. Progesterone has been used in an attempt to prevent preterm delivery since the 1970s, but the evidence initially accumulated was fraught by mixed results and was based on mostly underpowered studies with variable eligibility criteria, including history of spontaneous abortion as an indication for treatment. More recent randomized controlled clinical trials restimulated the interest in progesterone supplementation, suggesting that progesterone may favorably influence the rate of preterm delivery. Preterm delivery is a complex disorder and consequently it is unlikely that one generalized prevention strategy will be effective in all patients. Further, an additional impediment in accepting progesterone as the "magic bullet" in the prevention of preterm delivery is that its mechanism of action is not fully understood and the optimal formulations, route of administration, and dose have yet to be established. We have concerned ourselves in this review with the most recent status of 17 alpha-hydroxyprogesterone caproate (17OH-PC supplementation for prevention of preterm delivery. Our intention is to emphasize the efficacy, safety, and patient acceptability of this intervention, based on a comprehensive and unbiased review of the available literature. Currently there are insufficient data to suggest that 17OH-PC is superior or inferior to natural progesterone. Based on available evidence, we suggest a differential approach giving preferential consideration to either 17OH-PC or other progestins based on obstetric history and cervical surveillance. Progestin therapy for risk factors other than a history of preterm birth and/or a short cervix in the current pregnancy is not currently supported by the published evidence. The experience to date with 17OH-PC indicates that there are population subgroups that may be harmed by administration of 17OH-PC. Therefore, extending the use of 17OH-PC to unstudied populations or for indications that are not evidence-based is inadvisable outside of a research protocol.Keywords: preterm delivery, prevention, 17 alpha-hydroxyprogesterone caproate, efficacy, safety, acceptability
Deiana, Serena; Watanabe, Akihito; Yamasaki, Yuki; Amada, Naoki; Kikuchi, Tetsuro; Stott, Colin; Riedel, Gernot
Deficiencies in social activities are hallmarks of numerous brain disorders. With respect to schizophrenia, social withdrawal belongs to the category of negative symptoms and is associated with deficits in the cognitive domain. Here, we used the N-methyl-D-aspartate receptor antagonist dizocilpine (MK-801) for induction of social withdrawal in rats and assessed the efficacy of several atypical antipsychotics with different pharmacological profiles as putative treatment. In addition, we reasoned that the marijuana constituent cannabidiol (CBD) may provide benefit or could be proposed as an adjunct treatment in combination with antipsychotics. Hooded Lister rats were tested in the three-chamber version for social interaction, with an initial novelty phase, followed after 3?min by a short-term recognition memory phase. No drug treatment affected sociability. However, distinct effects on social recognition were revealed. MK-801 reduced social recognition memory at all doses (>0.03?mg/kg). Predosing with aripiprazole dose-dependently (2 or 10?mg/kg) prevented the memory decline, but doses of 0.1?mg/kg risperidone or 1?mg/kg olanzapine did not. Intriguingly, CBD impaired social recognition memory (12 and 30?mg/kg) but did not rescue the MK-801-induced deficits. When CBD was combined with protective doses of aripiprazole (CBD-aripiprazole at 12?:?1 or 5?:?2?mg/kg) the benefit of the antipsychotic was lost. At the same time, activity-related changes in behaviour were excluded as underlying reasons for these pharmacological effects. Collectively, the combined activity of aripiprazole on dopamine D2 and serotonin 5HT1A receptors appears to provide a significant advantage over risperidone and olanzapine with respect to the rescue of cognitive deficits reminiscent of schizophrenia. The differential pharmacological properties of CBD, which are seemingly beneficial in human patients, did not back-translate and rescue the MK-801-induced social memory deficit. PMID:26287433
Csomor, Philipp A; Preller, Katrin H; Geyer, Mark A; Studerus, Erich; Huber, Theodor; Vollenweider, Franz X
Despite advances in the treatment of schizophrenia spectrum disorders with atypical antipsychotics (AAPs), there is still need for compounds with improved efficacy/side-effect ratios. Evidence from challenge studies suggests that the assessment of gating functions in humans and rodents with naturally low-gating levels might be a useful model to screen for novel compounds with antipsychotic properties. To further evaluate and extend this translational approach, three AAPs were examined. Compounds without antipsychotic properties served as negative control treatments. In a placebo-controlled, within-subject design, healthy males received either single doses of aripiprazole and risperidone (n=28), amisulpride and lorazepam (n=30), or modafinil and valproate (n=30), and placebo. Prepulse inhibiton (PPI) and P50 suppression were assessed. Clinically associated symptoms were evaluated using the SCL-90-R. Aripiprazole, risperidone, and amisulpride increased P50 suppression in low P50 gaters. Lorazepam, modafinil, and valproate did not influence P50 suppression in low gaters. Furthermore, low P50 gaters scored significantly higher on the SCL-90-R than high P50 gaters. Aripiprazole increased PPI in low PPI gaters, whereas modafinil and lorazepam attenuated PPI in both groups. Risperidone, amisulpride, and valproate did not influence PPI. P50 suppression in low gaters appears to be an antipsychotic-sensitive neurophysiologic marker. This conclusion is supported by the association of low P50 suppression and higher clinically associated scores. Furthermore, PPI might be sensitive for atypical mechanisms of antipsychotic medication. The translational model investigating differential effects of AAPs on gating in healthy subjects with naturally low gating can be beneficial for phase II/III development plans by providing additional information for critical decision making. PMID:24801767
S. Jaber Mousavi
Full Text Available "n Objective: "nSexual dysfunction in patients who take antipsychotics causes adecline in their quality of life and medication acceptance. Considering the restrictions in cross sectional design of many earlier researches, we used a clinical trial aimed at assessing sexual dysfunction by substituting Risperidone, an atypical antipsychotic drug, with Haloperidol, a typical one . "n "n "nMethod: This clinical trial was conducted on 51 patients who had been using Risperidone with a minimum dose of 2 mg/daily for at least 2 months. The patients were randomly divided into 2 groups. The first group continued taking Risperidone, whereas the second group was given Haloperidol. Sexual function prior to and after the drug substitution was assessed using a sexual questionnaire designed to assess four stages of sexual function . "nResults: Compared to those who changed their medication to Haloperidol, the patients who remained on Risperidone therapy suffered from more sexual dysfunction, especially in their tendency towards having sexual activities (P= 0.01, post menstrual sexual activity (P= 0.002, and reaching orgasm in their sexual activities (P= 0.04; however in the Haloperidol group, no significant difference was observed before and after the change in medication . "nConclusion: Although Risperidone and Haloperidol can both disturb patients'sexual function, the side effects of Risperidone are stronger. Hence toprevent the decline of medication acceptance or irregular consumption by patients which may lead to possible relapse, substitution of Risperidone withanother drug with fewer side effects on sexual activities is definitely to the advantage of the patients .
Full Text Available Selective estrogen receptor modulators (SERMs such as raloxifene have already shown beneficial effects on negative, positive and general psychopathology symptoms in postmenopausal women with schizophrenia. The purpose of the present investigation was to assess the efficacy of raloxifene as an adjuvant agent in the treatment of men with chronic schizophrenia in an 8-week double-blind and placebo-controlled trial. In a randomized, double-blind and placebo-controlled study, forty-six male patients diagnosed with schizophrenia (DSM-IV-TR, were randomized to either raloxifene (120 mg/day or placebo in addition to risperidone (6 mg/day for eight weeks. The assessment was performed using the positive and negative symptom scale (PANSS at baseline, and at weeks 2, 4, 6 and 8. Extrapyramidal symptom rating scale (ESRS at baseline, weeks 1, 2, 4, 6, 8 and Hamilton depression rating scale (HDRS at baseline and week 8 were also used to assess extrapyramidal symptoms and depression simultaneously. Forty-two patients completed the trial. The raloxifene group showed significantly greater improvement on the negative subscale (P<0.001, the general psychopathology subscale (P=0.002 and total PANSS score (P<0.001 in comparison to the placebo group at the endpoint. There was no significant difference in the reduction of positive symptoms score between the two group (P=0.525. Extrapyramidal symptom rating scale and Hamilton depression rating scale and frequency of other adverse effects were comparable between two groups.This study indicates raloxifene as a potential adjunctive treatment strategy for chronic schizophrenia in men.
Full Text Available . *AbstractBackground and purpose: Knee arthroscopy is an approved technique for the diagnosis and treatment of intra-articular lesions. Moderate to severe pain is experienced after surgery; thus, relieving pain post arthroscopy, will help patients in performing their daily activities as soon as possible. Many studies have been performed for reducing pain after arthroscopy. The aim of this study is to compare the efficacy of intra-articular injection of morphine with marcaine in patients for pain relief after arthroscopy.Materials and Methods: 30 patients were considered for arthroscopic surgery, due to the tearing of the menisci. In this simple non-probability trial, patients were divided in two groups. The first group received 7cc intra-articular marcaine at 0.5% and the second group received 10mg of intra-articular morphine after the arthroscopy. The response was measured by VAS in hours 6, 12, 18, 24 postoperatively and by flexion, extension and walking.Results: The results showed that there was no significant statistical difference between the two groups, except in hour 6 after surgery, indicating marcaine is more effective than morphine. There were no side effects experienced within the two groups. Age, gender, height and weight also had no effect in reducing the pain in patients.Conclusion: Intra-articular Injection of marcaine is more effective than morphine six hours after surgery; however, there are no differences between them after that time frame. More research is needed in order to reduce pain after arthroscopy. Key words:
Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis : impact of joint area, repeated injections, MRI findings, anti-CCP, IgM-RF and CRP
Hetland, Merete Lund; Østergaard, Mikkel
OBJECTIVE: To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early rheumatoid arthritis (RA).METHODS: During 2 years of follow-up in the CIMESTRA trial, 160 patients received intra-articular betamethasone in up to four swollen joints/visit in combination with disease-modifying antirheumatic drugs. Short-term efficacy was assessed by EULAR good response. Long-term efficacy by Kaplan-Meier plots of the joint injection survival (ie, the time between injection and renewed flare). Potential predictors of joint injection survival were tested.RESULTS: 1373 Unique joints (ankles, elbows, knees, metacarpophalangeal (MCP), metatarsophalangeal, proximal interphalangeal (PIP), shoulders, wrists) were injected during 2 years. 531 Joints received a second injection, and 262 a third. At baseline, the median numbers of injections (dose of betamethasone) was 4 (28 mg), declining to 0 (0 mg) at subsequent visits. At weeks 2, 4 and 6, 50.0%, 58.1% and 61.7% had achieved a EULAR good response. After 1 and 2 years, respectively, 62.3% (95% CI 58.1% to 66.9%) and 55.5% (51.1% to 60.3%) of the joints injected at baseline had not relapsed. All joint areas had good 2-year joint injection survival, longest for the PIP joints: 73.7% (79.4% to 95.3%). 2-Year joint injection survival was higher for first injections: 56.6% (53.7% to 59.8%) than for the second: 43.4% (38.4% to 49.0%) and the third: 31.3% (25.0% to 39.3%). Adverse events were mild and transient. A high MRI synovitis score of MCP joints and anti-CCP-negativity were associated with poorer joint injection survival, whereas IgM-RF and C-reactive protein were not.CONCLUSION: In early RA, intra-articular injections of betamethasone in small and large peripheral joints resulted in rapid, effective and longlasting inflammatory control. The cumulative dose of betamethasone was low, and the injections were well tolerated.
Daniel, Josiane Souza Pereira; Veronez, Isabela Pianna; Rodrigues, Larissa Lopes [Laboratório de Análise e Caracterização de Fármacos LACFar, Instituto de Química, Universidade Federal de Alfenas, Alfenas, Minas Gerais (Brazil); Trevisan, Marcello G. [Laboratório de Análise e Caracterização de Fármacos LACFar, Instituto de Química, Universidade Federal de Alfenas, Alfenas, Minas Gerais (Brazil); National Institute of Bioanalytics Science and Technology INCTBio, Institute of Chemistry UNICAMP, 13084-653, Campinas, São Paulo (Brazil); Garcia, Jerusa Simone, E-mail: firstname.lastname@example.org [Laboratório de Análise e Caracterização de Fármacos LACFar, Instituto de Química, Universidade Federal de Alfenas, Alfenas, Minas Gerais (Brazil)
Highlights: DSC was used to characterize Risperidone and study its compatibility with excipients. FT-IR associated with PCA was used to complement DSC data. LC analyzes confirmed the DSC and FT-IR/PCA results. Risperidone was incompatible with three among five excipients evaluated. - Abstract: A full solid-state characterization of risperidone was conducted using differential scanning calorimetry (DSC), thermogravimetry (TG), powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) to examine its physicochemical properties and polymorphism. The primary aim of this work was to study the compatibility of risperidone with pharmaceutical excipients using DSC to obtain and compare the curves of the active pharmaceutical ingredient (API) and the excipients with their 1:1 (w/w) binary mixtures. These same binary mixtures were turned to room temperature and analyzed by FT-IR combined with principal component analysis (PCA) to evaluate solid-state incompatibilities. The chemical incompatibilities of these samples were verified using a stability-indicating liquid chromatography (LC) method to assay for the API and evaluate the formation of degradation products. All of these methods showed incompatibilities between risperidone and the excipients magnesium stearate, lactose and cellulose microcrystalline.
Vaisburd, Sinaya; Shemer, Zeev; Yeheskel, Adva; Giladi, Eliezer; Gozes, Illana
Mutated disrupted in schizophrenia 1 (DISC1), a microtubule regulating protein, leads to schizophrenia and other psychiatric illnesses. It is hypothesized that microtubule stabilization may provide neuroprotection in schizophrenia. The NAP (NAPVSIPQ) sequence of activity-dependent neuroprotective protein (ADNP) contains the SxIP motif, microtubule end binding (EB) protein target, which is critical for microtubule dynamics leading to synaptic plasticity and neuroprotection. Bioinformatics prediction for FDA approved drugs mimicking SxIP-like motif which displace NAP-EB binding identified Risperidone. Risperidone or NAP effectively ameliorated object recognition deficits in the mutated DISC1 mouse model. NAP but not Risperidone, reduced anxiety in the mutated mice. Doxycycline, which blocked the expression of the mutated DISC1, did not reverse the phenotype. Transcripts of Forkhead-BOX P2 (Foxp2), a gene regulating DISC1 and associated with human ability to acquire a spoken language, were increased in the hippocampus of the DISC1 mutated mice and were significantly lowered after treatment with NAP, Risperidone, or the combination of both. Thus, the combination of NAP and standard of care Risperidone in humans may protect against language disturbances associated with negative and cognitive impairments in schizophrenia. PMID:26553741
Highlights: DSC was used to characterize Risperidone and study its compatibility with excipients. FT-IR associated with PCA was used to complement DSC data. LC analyzes confirmed the DSC and FT-IR/PCA results. Risperidone was incompatible with three among five excipients evaluated. - Abstract: A full solid-state characterization of risperidone was conducted using differential scanning calorimetry (DSC), thermogravimetry (TG), powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) to examine its physicochemical properties and polymorphism. The primary aim of this work was to study the compatibility of risperidone with pharmaceutical excipients using DSC to obtain and compare the curves of the active pharmaceutical ingredient (API) and the excipients with their 1:1 (w/w) binary mixtures. These same binary mixtures were turned to room temperature and analyzed by FT-IR combined with principal component analysis (PCA) to evaluate solid-state incompatibilities. The chemical incompatibilities of these samples were verified using a stability-indicating liquid chromatography (LC) method to assay for the API and evaluate the formation of degradation products. All of these methods showed incompatibilities between risperidone and the excipients magnesium stearate, lactose and cellulose microcrystalline
To evaluate the therapeutic efficacy and safety of percutaneous ethanol injection (PEI) alone and combined with radiofrequency ablation (RFA) for hepatocellular carcinomas (HCCs) in high risk locations. We performed PEI for HCCs in RFA-high risk locations, either alone or in combination with RFA. There were 20 HCCs (1.7 ± 0.9 cm) in 20 patients (PEI group: n = 12; PEI + RFA group: n = 8). We evaluated technical success, local tumor progression and complications in both groups. Technical success was achieved in all HCCs in both groups. During follow-up, local tumor progression was found in 41.7% (5/12) in the PEI group, whereas 12.5% (1/8) for the PEI + RFA group (p = 0.32). Bile duct dilatation was the most common complication, especially when the tumors were in periportal locations; 55% (5/9) in the PEI group and 50% (2/4) in the PEI + RFA group (p = 1.00). One patient in the PEI group developed severe biliary stricture and upstream dilatation that resulted in atrophy of the left hepatic lobe. One patient treated with PEI + RFA developed cholangitis and an abscess. Combined PEI and RFA treatment has a tendency to be more effective than PEI alone for managing HCCs in high risk locations, although the difference is not statistically significant. Even though PEI is generally accepted as a safe procedure, it may cause major biliary complications for managing HCCs adjacent to the portal vein
Cha, Dong Ik; Lee, Min Woo; Rhim, Hyunchul; Choi, Dongil; Kim, Young-sun; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)
To evaluate the therapeutic efficacy and safety of percutaneous ethanol injection (PEI) alone and combined with radiofrequency ablation (RFA) for hepatocellular carcinomas (HCCs) in high risk locations. We performed PEI for HCCs in RFA-high risk locations, either alone or in combination with RFA. There were 20 HCCs (1.7 ± 0.9 cm) in 20 patients (PEI group: n = 12; PEI + RFA group: n = 8). We evaluated technical success, local tumor progression and complications in both groups. Technical success was achieved in all HCCs in both groups. During follow-up, local tumor progression was found in 41.7% (5/12) in the PEI group, whereas 12.5% (1/8) for the PEI + RFA group (p = 0.32). Bile duct dilatation was the most common complication, especially when the tumors were in periportal locations; 55% (5/9) in the PEI group and 50% (2/4) in the PEI + RFA group (p = 1.00). One patient in the PEI group developed severe biliary stricture and upstream dilatation that resulted in atrophy of the left hepatic lobe. One patient treated with PEI + RFA developed cholangitis and an abscess. Combined PEI and RFA treatment has a tendency to be more effective than PEI alone for managing HCCs in high risk locations, although the difference is not statistically significant. Even though PEI is generally accepted as a safe procedure, it may cause major biliary complications for managing HCCs adjacent to the portal vein.
Ennis, Zandra Nymand; Damkier, Per
To review available data on first-trimester exposure to olanzapine, quetiapine, risperidone and aripiprazole and risk of congenital malformations. We performed a systematic literature search in accordance with PRISMA guidelines identifying studies containing original data on first......-trimester exposure and pregnancy outcome with respect to congenital malformations. Cumulated data for olanzapine were 1090 first-trimester-exposed pregnancies with 38 malformations resulting in a malformation rate of 3.5%. The corresponding numbers for quetiapine, risperidone and aripiprazole were 443/16 (3.6%), 432...... congenital malformation. Data for quetiapine and risperidone do not suggest a substantially increased risk, while the risk estimate for aripiprazole remains imprecise owing to a low amount of data....
Delia BisharaPharmacy Department, South London and Maudsley NHS Foundation Trust, London, United KingdomAbstract: Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone) is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activi...
Full Text Available Abstract Background Most clinical trials of antipsychotics in children are brief, failing to address their long-term safety, particularly when taken concurrently with other psychotropics. This hypothesis-generating analysis evaluates potential correlates of weight gain in children receiving extended risperidone treatment. Methods Medically healthy 717?year-old patients treated with risperidone for six months or more were enrolled. Anthropometric measurements were conducted. Developmental and medication history was obtained from the medical record. Information related to birth weight, dietary intake, physical activity, and parental weight was collected. Mixed regression analyses explored the contribution of various demographic and clinical factors to age- and sex-adjusted weight and body mass index (BMI z scores over the treatment period. Results The sample consisted of 110 patients (89% males with a mean age of 11.8?years (sd?=?2.9 upon enrollment. The majority had an externalizing disorder and received 0.03?mg/kg/day (sd?=?0.02 of risperidone, for 2.5?years (sd?=?1.7, to primarily target irritability and aggression (81%. Polypharmacy was common with 71% receiving psychostimulants, 50% selective serotonin reuptake inhibitors (SSRIs, and 32% ?2-agonists. Weight and BMI z score were positively correlated with baseline weight at the start of risperidone, treatment duration, and the weight-adjusted dose of risperidone but inversely associated with the weight-adjusted dose of psychostimulants and the concurrent use of SSRIs and ?2-agonists. The effect of risperidone dose appeared to attenuate as treatment extended while that of psychostimulants became more significant. The rate of change in weight (or BMI z score prior to and within the first 12?weeks of risperidone treatment did not independently predict future changes neither did birth weight, postnatal growth, dietary intake, physical activity, or parental weight. Conclusions This comprehensive analysis exploring correlates of long-term weight (or BMI change in risperidone-treated youths revealed that pharmacotherapy exerts significant but complex effects. Trial Registration Not applicable.
Sravanti L. Sanivarapu
Full Text Available Risperidone is an atypical antipsychotic agent used primarily to treat schizophrenia. It is a dopamine antagonist with antiserotonergic, antihistaminergic and antiadrenergic properties. Antipsychotic discontinuation symptoms have been described in the literature following abrupt or rapid reduction in the dose. This unusual case demonstrates that sudden withdrawal of even a modest dose of risperidone may cause significant discontinuation symptoms in susceptible individuals. Hence, there is a need for caution while taking a patient off antipsychotic medications in view of the vulnerable subgroup. [Int J Basic Clin Pharmacol 2014; 3(1.000: 233-234
Sarah M. Bahr
Full Text Available Risperidone is a second-generation antipsychotic that causes weight gain. We hypothesized that risperidone-induced shifts in the gut microbiome are mechanistically involved in its metabolic consequences. Wild-type female C57BL/6J mice treated with risperidone (80 ?g/day exhibited significant excess weight gain, due to reduced energy expenditure, which correlated with an altered gut microbiome. Fecal transplant from risperidone-treated mice caused a 16% reduction in total resting metabolic rate in naïve recipients, attributable to suppression of non-aerobic metabolism. Risperidone inhibited growth of cultured fecal bacteria grown anaerobically more than those grown aerobically. Finally, transplant of the fecal phage fraction from risperidone-treated mice was sufficient to cause excess weight gain in naïve recipients, again through reduced energy expenditure. Collectively, these data highlight a major role for the gut microbiome in weight gain following chronic use of risperidone, and specifically implicates the modulation of non-aerobic resting metabolism in this mechanism.
Bahr, Sarah M.; Weidemann, Benjamin J.; Castro, Ana N.; Walsh, John W.; deLeon, Orlando; Burnett, Colin M.L.; Pearson, Nicole A.; Murry, Daryl J.; Grobe, Justin L.; Kirby, John R.
Risperidone is a second-generation antipsychotic that causes weight gain. We hypothesized that risperidone-induced shifts in the gut microbiome are mechanistically involved in its metabolic consequences. Wild-type female C57BL/6J mice treated with risperidone (80 ?g/day) exhibited significant excess weight gain, due to reduced energy expenditure, which correlated with an altered gut microbiome. Fecal transplant from risperidone-treated mice caused a 16% reduction in total resting metabolic rate in naïve recipients, attributable to suppression of non-aerobic metabolism. Risperidone inhibited growth of cultured fecal bacteria grown anaerobically more than those grown aerobically. Finally, transplant of the fecal phage fraction from risperidone-treated mice was sufficient to cause excess weight gain in naïve recipients, again through reduced energy expenditure. Collectively, these data highlight a major role for the gut microbiome in weight gain following chronic use of risperidone, and specifically implicates the modulation of non-aerobic resting metabolism in this mechanism.
Wang, Sheng-Min; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A; Masand, Prakash S.; Pae, Chi-Un
Improving medication adherence is critical to improving outcomes in patients with schizophrenia. A long-acting injectable (depot) antipsychotic is one of the most effective methods for improving treatment adherence and decreasing rehospitalization rates in patients with schizophrenia. Until recently, only three second-generation antipsychotics were available in a long-acting injectable formulation (risperidone, paliperidone, and olanzapine). In this respect, the emergence of long-acting aripi...
William, Otero R; Alejandro, Concha M; Martín, Gómez Z.
Full Text Available La polipectomía de colon es el más importante instrumento para detener la secuencia adenoma-cáncer. La técnica de inyectar y cortar ha demostrado eficacia y seguridad en estudios realizados en otros países. En nuestro país no se han reportado datos sobre el desempeño de esta técnica por lo que se ha [...] ce necesario describir la experiencia de una unidad de gastroenterología de un centro universitario. Objetivos: Describir las características demográficas y operativas de la polipectomía endoscópica de colon por medio de la técnica de inyectar y cortar. Materiales y métodos: Se incluyeron todos los pacientes a quienes se les realizó polipectomía endoscópica colon en la unidad de gastroenterología de la Clínica Fundadores de Bogotá, desde enero de 2003 hasta septiembre de 2011; los datos se procesaron en el paquete estadístico PASW statistics 18 versión 18,8 (SPSS-IBM). Resultados: A 420 pacientes se les realizó polipectomía con un total de 548 pólipos resecados. Promedio de edad 56,3años (14-93), 201 masculinos y 219 femeninos. Localización más común en colon izquierdo (238/64,4%), promedio de tamaño 1,6 cm, 83,8% pediculados, 13,3% sésiles y 2,85% planos. Hubo sangrado intraprocedimiento en 36 casos (8,6%). No hubo relación entre esta complicación y el tamaño de los pólipos ( 20 mm); OR: 0,44 (IC 0,19-1,01), como tampoco con número de pólipos resecados (1 vs. > 1) OR: 1,44; (IC 95%: 0,65-3,2). Todos los casos de sangrado fueron controlados endoscópicamente sin complicaciones adicionales. No hubo necesidad de cirugía. No hubo recurrencias locales durante el seguimiento. Conclusiones: En el presente estudio se demostró que la técnica de inyectar y cortar es práctica y efectiva, económica y fácil de ejecutar para remover los pólipos del colon. Hasta el momento es la serie más grande publicada en nuestro medio sobre el tema. Abstract in english Colonic polypectomy is the most important tool for stopping adenoma-cancer, and the inject and cut technique has demonstrated efficacy and safety in studies conducted in other countries. Since in our country there are no reported data on performance of this technique, it is necessary to describe the [...] experience of a gastroenterology unit of a university. Objectives: The objectives of this study were to describe operational characteristics of endoscopic colonic polypectomy using the inject and cut technique and to describe demographic characteristics of patients undergoing this procedure. Materials and Methods: We included all patients who underwent endoscopic colonic polypectomies in the gastroenterology unit of the Clínica Fundadores in Bogotá from January 2003 to September 2011. Data were processed using SPSS version 18 18.8 (SPSS-IBM) statistical package. Results: 420 patients underwent polypectomies which resected a total of 548 polyps. Mean patient age was 56.3 years (range 14 to 93), 201 patients were male, and 219 were female. Polyps were most commonly located in the left colon (238/64.4%). Average size was 1.6 cm. 83.8% were pedunculated, 13.3% were sessile, and 2.85% were flat. Intraoperative bleeding occurred in 36 cases (8.6%). There was no relationship between this complication and the size of polyps ( 20 mm), OR: 0.44 (CI 0.19-1.01), nor with the number of resected polyps (1Vs> 1) OR: 1.44, (95%:0.65-3 .2). All cases of bleeding were controlled endoscopically without further complications. There was no need for surgery. There were no local recurrences during follow-up. Conclusions: This study showed that the inject and cut technique is a practical, effective, economical and easy to perform technique for removal of colonic polyps. To date this is the largest series published in our country on the subject
Zhao Y.; Kishi T; Iwata N.; Ikeda M
Yueren Zhao,13 Taro Kishi,1 Nakao Iwata,1 Manabu Ikeda3,4 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, Okehazama Hospital Fujita Kokoro Care Center, Toyoake, Aichi, Japan; 3Department of Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan; 4Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan Abstract: A recent ...
Wissam El-Hage; Simon A Surguladze
Wissam El-Hage1, Simon A Surguladze21Inserm U930 ERL CNRS 3106, Université François Rabelais and Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France; 2Institute of Psychiatry, Kings College London, UKAbstract: Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or...
Gilbert, Donald L.; Batterson, J. Robert; Sethuraman, Gopalan; Sallee, Floyd R.
Objective: To compare the tic suppression, electrocardiogram (ECG) changes, weight gain, and side effect profiles of pimozide versus risperidone in children and adolescents with tic disorders. Method: This was a randomized, double-blind, crossover (evaluable patient analysis) study. Nineteen children aged 7 to 17 years with Tourette's or chronic
Full Text Available Joseph Biederman, Paul Hammerness, Robert Doyle, Gagan Joshi, Megan Aleardi, Eric MickPediatric Psychopharmacology Research Department, Massachusetts General Hospital, Boston, MA, USAObjective: Children and adolescents with bipolar disorder are also at high risk of having comorbid attention-deficit hyperactivity disorder (ADHD. The objective of this study was to estimate improvement in ADHD symptoms in children with bipolar disorder.Methods: This was an open-label, study of risperidone monotherapy for the treatment of pediatric bipolar disorder. Thirty-one children and adolescents 415 years of age (7.2 ± 2.8 years of both sexes (71%, N = 22 male with pediatric bipolar disorder (YMRS score = 32.9 ± 8.8 and ADHD (ADHD-RS score = 37.9 ± 8.9 were included in these analyses.Results: Improvement in ADHD symptoms was contingent on improvement in manic symptoms. Although both hyperactive/impulsive (?7.5 ± 5.5.6, p < 0.05 and inattentive (?6.8 ± 5.0, p < 0.05 ADHD symptoms were significantly improved with risperidone, improvement was modest, and only 29% of subjects (N = 6 showed a 30% reduction in ADHD rating scale scores and had a CGI-I ? 2.Conclusions: These results suggest that that treatment with risperidone is associated with tangible but generally modest improvement of symptoms of ADHD in children with bipolar disorder.Keywords: ADHD, bipolar disorder, children, risperidone
Guler, Gulen; Yildirim, Veli; Meryem Ozlem KUTUK; Toros,Fevziye
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with common comorbidities that include oppositional defiant disorder, conduct disorder, anxiety disorder, and affective disorders. Because of these comorbidities, drug combination treatments and drug-drug interactions are becoming increasingly more frequent. The present case report describes an acute dystonic reaction following the abrupt discontinuation of methylphenidate from a drug regimen with risperidone. Th...
P K Pardal
Full Text Available Almost all the antipsychotics can cause hyperprolactinemia-related side-effects like amenorrhea. Quetiapine has been reported to have minimal propensity to cause hyperprolactinemia. We report here two cases of risperidone-induced amenorrhea, who resumed their normal cycle on switching over the medication to quetiapine.
Svirskis, Darren; Travas-Sejdic, Jadranka; Rodgers, Anthony; Garg, Sanjay
Conducting polymers are finding applications in medicine including drug delivery systems, biosensors and templates for the regeneration of nervous pathways. We aim to develop a novel system where the drug release rate can be controlled by electrical stimulation. Polypyrrole (PPY) is being used as a drug delivery system due to its inherent electrical conductivity, ease of preparation and apparent biocompatibility. Risperidone is an atypical antipsychotic drug used in the treatment of psychosis and related disorders, including schizophrenia. PPY was synthesised using p-toluene sulfonic acid as a primary dopant, in the presence of risperidone. A validated high performance liquid chromatography (HPLC) analytical method was used to quantify risperidone release. It has been demonstrated that the release rate of risperidone can be altered through the application, or absence, of electrical stimulation. Technology such as this would find use in drug-delivering implants where the dose could be adjusted through application of external stimulus, optimising benefit to side effect ratio, while simultaneously ensuring patient adherence (which is a particular challenge in mental health conditions).
Margari, Lucia; Matera, Emilia; Petruzzelli, Maria G; Simone, Marta; Lamanna, Anna L; Pastore, Adriana; Palmieri, Vincenzo O; Margari, Francesco
The aim of this prospective observational study was to investigate the variations of serum prolactin hormone (PRL) in a sample of 34 drug-naive patients (mean age 13 years) who started risperidone therapy assuming that several factors may favor the increase in serum PRL. Serum PRL and hyperprolactinemia clinical signs were examined at baseline (T0) and after almost 3 months of treatment (T1). We considered sex, pubertal status, risperidone dosage, psychiatric diagnosis, and any personal/family history of autoimmune diseases. The mean serum PRL value increased between T0 and T1 (P=0.004). The mean serum PRL was higher in females in the pubertal/postpubertal stage and for risperidone dosage up 1âmg/day. Hyperprolactinemia was found in 20% of patients at T0 and in 38% of patients at T1 (P=0.03). The mean serum PRL increase was greater in early-onset schizophrenia spectrum psychosis patients compared with no-early-onset schizophrenia spectrum psychosis patients (P=0.04). The increase in PRL was higher in patients with a personal and a family history of autoimmune diseases. This study suggests that the increase in serum PRL in patients treated with risperidone may be linked not only to the drug and its dosage but also to several risk factors such as sex, pubertal stage, psychiatric disease, and autoimmune disorders. PMID:25514607
Full Text Available Abstract Background As schizophrenia patients are typically suspicious of, or are hostile to changes they may be reluctant to accept generic substitution, possibly affecting compliance. This may counteract drug costs savings due to less symptom control and increased hospitalization risk. Although compliance losses following generic substitution have not been quantified so far, one can estimate the possible health-economic consequences. The current study aims to do so by considering the case of risperidone in Germany. Methods An existing DES model was adapted to compare staying on branded risperidone with generic substitution. Differences include the probability of non-compliance and medication costs. Incremental probability of non-compliance after generic substitution was varied between 2.5% and 10%, while generic medication costs were assumed to be 40% lower. Effect of medication price was assessed as well as the effect of applying compliance losses to all treatment settings. The probability of staying on branded risperidone being cost-effective was calculated for various outcomes of a hypothetical study that would investigate non-compliance following generic substitution of risperidone. Results If the incremental probability of non-compliance after generic substitution is 2.5%, 5.0%, 7.5% and 10% respectively, incremental effects of staying on branded risperidone are 0.004, 0.007, 0.011 and 0.015 Quality Adjusted Life Years (QALYs. Incremental costs are 757, 343, -123 and -554 respectively. Benefits of staying on branded risperidone include improved symptom control and fewer hospitalizations. If generic substitution results in a 5.2% higher probability of non-compliance, the model predicts staying on branded risperidone to be cost-effective (NICE threshold of ?30,000 per QALY gained. Compliance losses of more than 6.9% makes branded risperidone the dominant alternative. Results are sensitive to the locations at which compliance loss is applied and the price of generic risperidone. The probability that staying on branded risperidone is cost-effective would increase with larger compliance differences and more patients included in the hypothetical study. Conclusion The model predicts that it is cost-effective to keep a patient with schizophrenia in Germany on branded risperidone instead of switching him/her to generic risperidone (assuming a 40% reduction in medication costs, if the incremental probability of becoming non-compliant after generic substitution exceeds 5.2%.
Zahra Abdollahi; Fatemeh Taghizadeh; Zeinab Hamzehgardeshi; Olia Bahramzad
Background and Purpose: Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in number of domains. In numerous studies of substance abuse treatment, self-efficacy has emerged as an important predictor of outcome, or as a mediator of treatment effects. In the event of a slip, highly self-efficacious persons are inclined ...
Jacob, SA; Ibrahim, MI Mohamed; Mohammed, F.
The present study was conducted primarily to determine the occurrence of polypharmacy in patients with schizophrenia on risperidone. The secondary aim was to ascertain the incidence of inappropriate prescribing with anticholinergics. A retrospective review of the medical records of all patients who were being followed up at the out-patient clinic of a tertiary-care hospital in Malaysia was conducted. Only patients who were being prescribed risperidone between 1 June 2008 and 31 December 2008 ...
O.I. Iribhogbe; O. Okhiai; U. Akpamu; O.O. Festus; O.B. Idonije; G.B.S. Iyalomhe
Although antipsychotic drugs are known to have an array of adverse effects, they also exhibit significant differences in causing these effects. The atherogenic effects of clozapine and risperidone have not been fully investigated among schizophrenics in Nigeria hence this research work. This study therefore investigated the extent to which monotherapy with clozapine and risperidone (atypical antipsychotic drugs) influence lipid profile in patients with schizophrenia. The study population comp...
Firouzeh Raisi; Hadi Okhovatpoor; Simin Dashti-Khavidaki; Hossein Khalili; Padideh Ghaeli
Objective: This study was designed to evaluate the effects of risperidone on fasting blood glucose (FBG) in patients with Schizophrenia . Method: Seventy five non-diabetic patients with Schizophrenia (based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) entered this cross-sectional study. Patients did not receive any medications (Including risperidone) affecting serum FBG levels for at least 2 weeks prior to the initiation of the study. Patients...
Vertical electronic transitions to singlet valence states of an antipsychotic drug, Risperidone (Risperdal), in its neutral, mono-, and diprotonated forms have been calculated within the time-dependent density functional theory using the PBE0 hybrid functional with the 6-31+G* basis set. The results of the computations show that the lowest-energy allowed ?-?* electronic excitation is affected by protonation effects, the spectral shifts of this transition being potentially useful to individuate the different forms of risperidone
Handen, Benjamin L.; Johnson, Cynthia R.; Butter, Eric M; Lecavalier, Luc; Scahill, Lawrence; AMAN, MICHAEL G.; McDougle, Christopher J.; Arnold, L Eugene; Swiezy, Naomi B.; SUKHODOLSKY, DENIS G.; Mulick, James A; White, Susan W.; Bearss, Karen; Hollway, Jill A.; Stigler, Kimberly A
A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N=49) versus risperidone plus parent training (COMB; n=75) (ages 413 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition (p=.0002) and 12 %...
Full Text Available Objective: This study was designed to evaluate the effects of risperidone on fasting blood glucose (FBG in patients with Schizophrenia . Method: Seventy five non-diabetic patients with Schizophrenia (based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria entered this cross-sectional study. Patients did not receive any medications (Including risperidone affecting serum FBG levels for at least 2 weeks prior to the initiation of the study. Patients received the mean dose of 4.5mg (range 2-12mg risperidone for 8 weeks. Pregnant women, patients with diabetes mellitus and a history of any major heart disease were excluded from this study.Additionally, none of the patients should have received electroconvulsive therapy within 6 months prior to the initiation of the antiphsychotics.FBG levels were measured at the initiation and 8 weeks after starting risperidone. Results: Fifty one patients completed the study. The mean FBG level was increased from 88.9mg/dL (baseline to 94.4 mg/dL at week 8 (P =0.003. This 8-week study showed that FBG levels may increase in schizophrenic patients receiving risperidone. Conclusion: Measuring and monitoring FBG before the initiation and during the treatment with risperidone is suggested.
Niolu, Cinzia; Bianciardi, Emanuela; Di Lorenzo, Giorgio; Marchetta, Claudia; Barone, Ylenia; Sterbini, Nicoletta; Ribolsi, Michele; Reggiardo, Giorgio; Siracusano, Alberto
Aim: This study evaluated adherence to treatment, quality of life and subjective well-being in patients with psychosis treated with long-acting injectable risperidone. Subjects enrolled were part of a larger study where patients were observed in an adherence to treatment program of the University of Rome Tor Vergata. Materials and methods: A total of 27 nonadherent patients (21 men, six women; mean age: 36.1 years; range: 2363 years) were enrolled. Maximum observational period was 30 months. Results: A total of 12 patients were under treatment for 30 months (44.44%) but only nine had a valid 30-month follow up, while the remaining three patients initially treated at our unit continued long-acting risperidone at their local centre. Reductions of monthly mean values of Scale for the Assessment of Positive Symptoms (SAPS) [repeated measures analysis of variance (rm-ANOVA): p < 0.0001] and Scale for Assessment of Negative Symptoms (SANS) (p < 0.0001), increase of monthly mean values of Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) (p < 0.0001) and Schizophrenia Quality of Life Scale (S-QoL) (p < 0.01) were observed. Significant differences with respect to SAPS baseline values from the sixth month, SANS baseline values from the seventh month, SWN baseline values from the eighth month, S-QoL baseline values from the eighteenth month were shown in post hoc tests. Reduction of SAPS mean values was associated with increase of SWN (p < 0.0001) and S-QoL (p < 0.0001) mean values as demonstrated by correlation analysis. The same inverse correlation was found between reduction of SANS mean values and increases of SWN (p < 0.0001) and S-QoL (p = 0.0001) mean values. Conclusions: Long-term treatment with long-acting risperidone may be associated with improvement to adherence to therapy and quality of life. Patients may show improvement in psychopathological symptoms, subjective well-being and quality of life. PMID:26557984
An observational and comparative study was conducted to compare the functional outcome between the patients treated with conventional antipsychotic agent haloperidol and typical antipsychotic agent, Risperidone (Risperidal). A total of 32 patients were included in the study with established schizophrenia according to (DSM iv). The data was processed on SSPE 10th version. The primary outcome measure was the improvement of negative symptoms of schizophrenia and secondary outcome measure was to observe the superiority of the atypical drug Risperid one over conventional agent haloperidol regarding side effects. Patients were assessed at baseline, 2nd and 8th week, using four tools of assessment. For treatment group receiving haloperidol mean was 47.2+-11.50 at 8th week and for Risperidone treatment group mean was 43+-14.68. The P values for all the parameters in the Clozapine group were significant as compared to haloperidol. (author)
Objective: Various studies have shown the effectiveness of risperidone and fluoxetine in the management of behavioral problems in autism. Aim: The purpose of this study was to compare these two drugs in the management of behavioral problems in autism. Materials and Methods: Forty children with autism were divided into 2 groups in a 16-week open trial that compared these two drugs. Parents rated the children using the Aberrant Behavior Checklist (ABC) and the Conners? Parent Rating Scal...
Bhargava, Kiran; Nath, Rajendra; Seth, Prahlad Kumar; Pant, Kamlesh Kumar; Dixit, Rakesh Kumar
In this work, 3D model of D2 dopamine receptor was determined by comparative homology modeling program MODELLER. The computed model's energy was minimized and validated using PROCHECK and Errat tool to obtain a stable model structure and was submitted in Protein Model Database (PMDB-ID: PM0079251). Stable model was used for molecular docking against Risperidone and their 15 derivatives using AutoDock 4.2, which resulted in energy-based descriptors such as Binding Energy, Ligand Ef...
Bishop, Jeffrey R; Pavuluri, Mani N.
Jeffrey R Bishop1,2, Mani N Pavuluri21Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Department of Psychiatry, Pediatric Mood Disorders Program and Center for Cognitive Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Risperidone is a commonly used medication for the treatment of bipolar disorder and schizophrenia in children and adolescents. It has been studied as a monotherapy treatment in ...
Mohammed, Kareem Abu Bakr; Ibrahim, Howida Kamal; Ghorab, Mahmoud Mohammed
Risperidone is a poorly water soluble atypical antipsychotic drug. This work investigated the potential of developing risperidone effervescent tablets to facilitate drug administration and mask drug taste. The solid dispersion technique was selected to improve drug solubility due to its ease of scaling up, reproducibility and affordable cost. Thirty formulas were prepared adopting a 5(1).2(1).3(1) full factorial design. Trehalose, Inulin, pregelatinized starch, carboxymethylcellulose sodium and Eudragit E100 were used as hydrophilic carriers at different ratios. Rotovap, lyophilization and the kneading-oven were applied as solvent evaporation techniques. Differential scanning calorimetry, X-ray powder diffraction, Fourier transform infrared spectroscopy and scanning electron microscopy showed that the drug was present as amorphous material entrapped within the carrier matrix. Eight tablet blends were prepared using different effervescent mixture ratios with or without binder and lubricant/glidant mixture. All of the blends had acceptable flowability, acceptable effervescence times and immediate drug release that could not be achieved by any of the control formulas. The formula of choice contained 40% effervescent mixture, 5% starch, 1% boric acid, 1% aspartame and sufficient lactose. The relative bioavailability (RB) of risperidone from this formula was 161.41% with a significantly higher extent of absorption compared to the market conventional tablets. This formula may be promising in improving patient compliance and drug efficiency. PMID:24833273
Seyyed Mohsen Foroutan
Full Text Available A simple, rapid and sensitive high-performance liquid chromatographic (HPLC method for the determination of risperidone in human plasma was developed. An HPLC system based on a Nucleosil C8 column (150×4 mm and a UV detector (?= 280 nm were used. A mixture of sodium dihydrogen phosphate buffer-acetonitrile (55:45, v/v adjusted to pH 6.0 at a flow rate of 1.5 ml min-1 was used as mobile phase. The proteins were precipitated with an acetonitrilesolution containing diltiazem as internal standard and the average recovery was 93.9±3.4%.The detection limit for risperidone in plasma was 0.5 ngml-1. The calibration curve was linear over the concentration range 2-50 ngml-1. The inter-day and intra-day assay coefficients of variation were found to be less than 5%. The present validated method was successfully used for pharmacokinetic studies of risperidone in human subjects.
Margari, Lucia; Matera, Emilia; Craig, Francesco; Petruzzelli, Maria G; Palmieri, Vincenzo O; Pastore, Adriana; Margari, Francesco
The aim of this prospective observational study was to verify the tolerability and safety profile of risperidone in a sample of antipsychotic-naive children/adolescent patients having a different psychiatric diagnosis. Twenty-two (mean age of 12Â±3.2) antipsychotic-naive patients who started therapy with risperidone were recruited. The assessment involved anthropometric data (weight, height, BMI, BMI z-score and BMI percentile), cardiovascular parameters (blood pressure and QTc interval) and blood tests (levels of glucose, triglycerides, total cholesterol, glutamic oxaloacetic and pyruvic transaminases, Î³-glutamyl transferase, prolactin, free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroglobulin, antithyroid peroxidase and antithyroglobulin). After an average follow-up of 6 months of risperidone therapy, a statistically significant increase in weight and body composition was observed. Furthermore, an increase in serum levels of prolactin was observed in 50% of patients. No other significant changes in metabolic and cardiovascular parameters were found. Although an increase in these parameters was detected, it remained in the normal range. This study suggests the use of specific protocols for monitoring children/adolescents treated with second-generation antipsychotics to manage the metabolic long-term complications and progression to more severe disease states. PMID:23689836
B.Vishnu Vardhan Reddy
Full Text Available The present study was carried out to formulate Risperidone mini tablets filled into hard gelatin capsule, as it is administered for the treatment of psychosis. The preformulation studies of Risperidone were carried out and drug polymer compatibility studies were performed by FT-IR spectra analysis. The precompression parameters revealed that all the 6 formulations had good flow Carrs index, Hausners ratio and angle of repose within the limit. Risperidone is formulated with different concentration of polymers like HPMCK100M, HPMCK15M, filler like lactose and with other excipients. A total number of 6 formulations (F1,F2,F3,F4,F5 and F6were carried and evaluated. In all the formulations thickness varies between 3.90-3.94mm and the hardness of the optimized batch was found to be 3.18kg/cm2.No variation in the hardness was found in the optimized formulation that showed powder blending was uniform. Among 6 formulations, F1, F2, F3 and F6 trials were done using K100M polymer and F4, F5 with K15M polymer using optimized quantity of lactose, best batch among those is F1 because it had 90% drug release and it could sustain its action until 20thhr, and is very economical.
Nishikawa, Tadashi; Araki, Yoichiro; Hayashi, Teruo
Hiccups or singulata are rhythmic involuntary movements of the diaphragm, caused by a variety of conditions that interfere with the functions of the nerve nuclei in the medulla and supra-spinal hiccup center. Although neurotransmitters and receptors involved in the pathophysiology of hiccups are not defined well, dopamine has been considered to play an important role. In some cases, chlorpromazine or other antipsychotics are used for the treatment of intractable hiccups but their efficacy is ...
Sacristán Jose A
Full Text Available Abstract Background In order to compare the effectiveness of different antipsychotic drugs in the treatment of schizophrenia it is very important to evaluate subjective response and compliance in patient cohorts treated according to routine clinical practice. Method Outpatients with schizophrenia entered this prospective, naturalistic study when they received a new prescription for an antipsychotic drug. Treatment assignment was based on purely clinical criteria, as the study did not include any experimental intervention. Patients treated with olanzapine, risperidone or haloperidol were included in the analysis. Subjective response was measured using the 10-item version of the Drug Attitude Inventory (DAI-10, and treatment compliance was measured using a physician-rated 4 point categorical scale. Results A total of 2128 patients initiated treatment (as monotherapy with olanzapine, 417 with risperidone, and 112 with haloperidol. Olanzapine-treated patients had significantly higher DAI-10 scores and significantly better treatment compliance compared to both risperidone- and haloperidol-treated patients. Risperidone-treated patients had a significantly higher DAI-10 score compared to haloperidol-treated patients. Conclusion Subjective response and compliance were superior in olanzapine-treated patients, compared to patients treated with risperidone and haloperidol, in routine clinical practice. Differences in subjective response were explained largely, but not completely, by differences in incidence of EPS.
A randomised, double-masked phase III/IV study of the efficacy and safety of Avastin® (Bevacizumab intravitreal injections compared to standard therapy in subjects with choroidal neovascularisation secondary to age-related macular degeneration: clinical trial design
Full Text Available Abstract Background The management of neovascular age-related macular degeneration (nAMD has been transformed by the introduction of agents delivered by intravitreal injection which block the action of vascular endothelial growth factor-A (anti-VEGF agents. One such agent in widespread use is bevacizumab which was initially developed for use in oncology. Most of the evidence supporting the use of bevacizumab for nAMD has come from interventional case series and this clinical trial was initiated because of the increasing and widespread use of this agent in the treatment of nAMD (an off-label indication despite a lack of definitive unbiased safety and efficacy data. Methods and design The Avastin® (bevacizumab for choroidal neovascularisation (ABC trial is a double-masked randomised controlled trial comparing intravitreal bevacizumab injections to standard therapy in the treatment of nAMD. Patients are randomised to intravitreal bevacizumab or standard therapy available at the time of trial initiation (verteporfin photodynamic therapy, intravitreal pegaptanib or sham treatment. Ranibizumab treatment was not included in the control arm as it had not been licensed for use at the start of recruitment for this trial. The primary outcome is the proportion of patients gaining ? 15 letters of visual acuity at 1 year and secondary outcomes include the proportion of patients with stable vision and mean visual acuity change. Discussion The ABC Trial is the first double-masked randomised control trial to investigate the efficacy and safety of intravitreal bevacizumab in the treatment of nAMD. This trial fully recruited in November 2007 and results should be available in early 2009. Important design issues for this clinical trial include (a defining the control group (b use of gain in vision as primary efficacy end-point and (c use of pro re nata treatment using intravitreal bevacizumab rather than continuous therapy. Trial registration Current controlled trials ISRCTN83325075
Full Text Available Identification and management of drug-induced movement disorders is a clinical challenge, more so when the clinical presentation is atypical. A young male with acute mania was under treatment with sodium valproate and risperidone. He developed tremors of right hand and neck. These were present at rest and exacerbated by mental activity, when under observation and during voluntarily initiated activity. There were no associated extra pyramidal symptoms or cerebellar signs. Investigations for other common causes of tremors did not reveal any evidence except for low value of serum vitamin B12 levels. The tremors persisted after the withdrawal of valproate, but resolved following the withdrawal of risperidone. It is a common dictum that drug-induced tremors are bilateral. This may not be true always as we found out in our case. These movements were probably induced by risperidone. This atypical presentation could be due to concurrent use of valproate and low serum vitamin B12 levels.
Pasternak, Björn; Svanström, Henrik; Ranthe, Mattis F; Melbye, Mads; Hviid, Anders
risperidone (n = 14,134). The primary outcome was any major cardiovascular event (composite of cardiovascular mortality, acute coronary syndrome, or ischemic stroke) within 1 year following treatment initiation. Cox regression was used to estimate hazard ratios (HRs) while on current antipsychotic monotherapy......BACKGROUND: A number of serious cardiovascular safety concerns related to the use of atypical antipsychotics, compared with no use, have emerged, but nearly all reports are from studies of older patients. We aimed to compare the risk of cardiovascular events between the three most commonly used...... in the outpatient setting, adjusting for an outcome-specific disease risk score. RESULTS: The crude rate ofany major cardiovascular event was 5.3 per 1,000 person-years among olanzapine users, 3.4 in quetiapine users, and 5.2 in risperidone users. Compared with risperidone, the risk of any major...
EnbrelÂ® ... Etanercept injection comes as a solution (liquid) in a prefilled syringe and an automatic injection device, and as ... It is usually injected once a week. When etanercept injection is used to treat chronic plaque psoriasis, it ...
Ni, Peiyan; Liang, Linhui; Wang, Yingcheng; Wei, Jinxue; Gu, Xiaochu; Zhao, liansheng; Ma, Xiaohong; Li, Tao.
Full Text Available Background and Objectives: Antipsychotics can elicit dopamine super-sensitivity by up-regulation of D2-like receptors (DRD2, DRD3, and DRD4) expression. Nevertheless, the expression profile of dopamine D2-like receptors in different brain regions and peripheral blood mononuclear cells (PBMCs), and c [...] hanges following risperidone administration were still unclear. In this study, we would investigate the expression of D2-like receptors mRNA in different brain regions and the peripheral blood mononuclear cells (PBMCs) in rats after 2, 6 weeks risperidone administration. Methods: The experimental rats were given risperidone (0.25mg/kg/day, i.p.), and the control rats were given 0.9% NaCl. The rats were sacrificed at 0 week, 2 weeks and 6 weeks after the drug administration. Expression of the dopamine D2-like receptors was quantified by Real-time PCR method. Results: Dopamine D2-like receptors expressed in all the examined regions of rat brain. Their expression significantly increased 2weeks after risperidone administration in different brain regions. However, the changed expression of DRD2 and DRD3 turned back to the basal level 6weeks later, while the increased DRD4 expression remained in left parietal cortex. Meanwhile, DRD2 and DRD3 but not DRD4 expressed in PBMCs, however, the risperidone could not affect their expression. Conclusions: The risperidone could change the dopamine D2-like receptors expression in a time-dependent manner in different brain regions, which might guide the clinical use in the near future.
Inês, Luís P. B. S.; Silva, José António P. da
Soft tissue rheumatism includes a wide spectrum of common lesions of the tendons, enthesis, tendon sheaths, bursae, ligaments and fasciae as well as nerve compression syndromes. Studies on the pathogenesis of these lesions do not support a major role for inflammation, thus questioning the rationale for glucocorticoid injections. This chapter reviews current indications for local glucocorticoid injections and available evidence on its efficacy, as well as contraindications and potential risks....
Review of the efficacy of placebo in comparative clinical trials between typical and atypical antipsychotics Revisão da eficácia do placebo nos ensaios clínicos que comparam antipsicóticos típicos e atípicos
Irismar Reis de Oliveira; Paulo Menezes Nunes; Domingos Macedo Coutinho; Eduardo Pondé de Sena
OBJECTIVE: To review the efficacy of placebo in comparison with atypical and typical antipsychotics for the treatment of schizophrenia and schizoaffective disorder and to evaluate the pertinence of using placebo in clinical trials with antipsychotics. METHOD: Trials in which the atypical antipsychotics were compared with typical antipsychotics and placebo were included. A search was conducted using the terms "amisulpride", "aripiprazole", "clozapine", "olanzapine", "quetiapine", "risperidone"...
Eficácia da aplicação da pomada EMLA® no alivio da dor desencadeada pela injeção de toxina botulínica tipo A no tratamento do blefaroespasmo essencial benigno / Efficacy of EMLA® cream application for pain relief of periocular botulinum toxin injections
Nadia Ajub, Moysés; Nilson Lopes da, Fonseca Júnior; José Ricardo Carvalho Lima, Rehder.
Full Text Available OBJETIVO: Demonstrar a eficácia da aplicação da pomada EMLA® (EMLA) no alívio da dor desencadeada pela injeção de toxina botulínica tipo A (BTX) no tratamento do blefaroespasmo essencial benigno (BEB). MÉTODOS: Estudo prospectivo, com a participação de 13 pacientes submetidos à aplicação de toxina b [...] otulínica na região periocular bilateral no tratamento de BEB. Aplicou-se a pomada EMLA na região periocular direita e placebo na esquerda antes das aplicações. Após a aplicação solicitou-se ao paciente uma nota de 0 a 10 referente à intensidade da dor. RESULTADOS: No lado em que foi aplicada a pomada EMLA, a média da intensidade da dor referida pelo paciente foi de 5,77±3,00 enquanto que no lado em que foi aplicado placebo, foi de 5,62±2,63 (p=0,92). CONCLUSÃO: Não se obteve uma redução estatisticamente significante da dor referida durante a aplicação de BTX em pacientes portadores de BEB após a aplicação da pomada EMLA. Abstract in english PURPOSE: To investigate the efficacy of EMLA® (EMLA) cream for pain relief before periocular botulinum toxin injection (BTX) on the treatment of essential benign blepharospasm (BEB). METHODS: In this prospective study, 13 patients given bilateral periocular botulinum injections for blepharospasm tre [...] atment were included. Prior to the injections, EMLA cream was applied to the right periocular side and placebo to the left side. Relative pain score from 0 to 10 was recorded after the procedure. RESULTS: The average pain score on the side where EMLA was applied was 5,77±3,00, whereas it was 5,62±2,63 on the placebo side (p=0,92). CONCLUSION: No statistically significant decrease in the pain score associated with BTX injection for BEB was noted after EMLA skin application.
Hemavathi Nagaraju Deepakumari; Hosakere Doddarevanna Revanasiddappa
The aim of study was to develop and validate two simple, sensitive, and extraction-free spectrophotometric methods for the estimation of risperidone in both pure and pharmaceutical preparations. They are based on the charge transfer complexation reactions between risperidone (RSP) as n-electron donor and p-chloranilic acid (p-CA) in method A and 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) in method B as Ï-acceptors. In method A, RSP reacts with p-CA in methanol to produce a bright pink-co...
Bo, Qi-Jing; Li, Xian-Bin; Wang, Zhi-Min; Li, An-Ning; Ma, Xin; Wang, Chuan-Yue
The risperidone maintenance treatment in schizophrenia study was designed to identify the duration of maintenance treatment required with an initial therapeutic dose in contrast to reducing the dose over time. This study investigated extrapyramidal symptoms (EPSs) in different risperidone maintenance treatment paradigms over 1 year. Clinically stabilized patients with schizophrenia (n = 374) were randomized to a no-dose-reduction group and 4-week and 26-week reduction groups, in which the dose was gradually reduced by 50% over 8 weeks and maintained. Extrapyramidal symptoms were assessed at baseline and monthly for 6 months, followed by every 2 months. The Simpson-Angus Scale of Extrapyramidal Symptoms-Chinese version assessed EPS severity. Data were analyzed by a generalized linear mixed model (GLMM). The frequency of EPS at baseline was 23.2%, 20.0%, and 21.3% in the 4-week, 26-week, and no-dose-reduction groups, respectively. Risperidone dosage, positive symptoms, and disorganized thoughts at baseline predicted development of EPS. The GLMM indicated that a significant decrease in EPS was maintained, and different trajectories occurred over time across groups. In the 235 patients who continued treatment after 1 year, the incidence of EPS decreased to 4.1%, 2.8%, and 10.0% in the 4-week, 26-week, and no-dose-reduction groups, respectively, whereas the numbers of dropouts because of intolerable EPS were not significantly different (4.8%, 6.7%, and 6.2%, respectively). These novel findings indicate EPSs were tolerable and differentially decreased depending on the dose paradigm during the 1-year treatment period. Future studies should implement a GLMM to investigate antipsychotic adverse effects during long-term treatment. PMID:26848792
Bevaart, Lisette; Aalbers, Caroline J; Vierboom, Michel P M; Broekstra, Niels; Kondova, Ivanela; Breedveld, Elia; Hauck, Bernd; Wright, J Fraser; Tak, Paul Peter; Vervoordeldonk, Margriet J
Preclinical studies to assess biodistribution, safety, and initial efficacy of ART-I02, an adeno-associated type 5 (rAAV5) vector expressing human interferon ? (hIFN-?), were performed in a total of 24 rhesus monkeys with collagen-induced arthritis. All monkeys were naïve or showed limited neutralizing antibody (Nab) titers to AAV5 at the start of the study. Animals were injected with a single intra-articular dose of ART-I02 or placebo, consisting of 3.2×10(13) vg (Dose A=maximum feasible dose), 4.58×10(12) vg (Dose B), or placebo in the first affected finger joint, the ipsilateral knee, and ankle joint at the same time point. Animals were monitored for clinical parameters and well-being with a maximum of 4 weeks, with the option that the severity of arthritis could necessitate an earlier time point of sacrifice. No adverse events were noted after injection of ART-I02. No abnormalities were observed after histological evaluation of all organs. At both dose levels, immunohistochemical staining indicated expression of hIFN-?. In animals injected with Dose A, we observed stabilization or a reduction in swelling in the finger joint in which vector was administered. The highest copy numbers of vector DNA were detected in synovial tissue of the injected joint and the draining lymph node of the injected knee. High titers of Nab to rAAV5 were observed at the end of the study. Five monkeys developed an rAAV5-specific T-cell response. Two monkeys developed Nab to hIFN-?. In conclusion, intra-articular injection of ART-I02 was well-tolerated and did not induce adverse events. After administration of Dose A of ART-I02, we observed a beneficial effect on joint swelling, substantiated by decreased histological inflammation and bone erosion scores. A GMP vector for clinical application has been manufactured and is currently being tested in GLP rodent studies, with the aim to move forward to a clinical trial. PMID:26086763
Full Text Available The objective of this study was to compare the rate and extent of absorption of a generic risperidone (Iperdal® with a reference formulation (Risperdal® when given orally. The study was an open label, randomized, two-period, two-sequence,single dose cross-over design with a 2 weeks washout period in 16 healthy Thai male volunteers. Single oral dose of two 2-mg tablets of risperidone were administered and serial blood samples were collected from the antecubital vein before and at0.17, 0.33, 0.5, 0.75, 1.0, 1.5, 2.0, 3.0, 4.0, 6.0, 8.0, 12, 24 and 48 hours post dose. Risperidone plasma concentrations were assayed using a validated High Performance Liquid Chromatographic (HPLC-UV method modified from Avenosoet al. (2000. Pharamcokinetic parameters i.e. Cmax, AUC0à48 and Tmax were analyzed by noncompartment analysis. Variations of the data were analyzed by ?Two Way Analysis of Variance? (ANOVA. Statistics were tested as stated in USP 28 guidelinefor bioequivalence study. The maximum concentration (Cmax, ng/ml of risperidone for the innovator and the generic product were 31.11±17.24 (range 5.64-56.78 and 32.58±19.77 (range 5.29-84.56 ng/ml, respectively. The area under theplasma concentration-time curve (AUC0®48 of the innovator and the generic product were 160.64±152.89 (range 18.57- 550.32 and 144.03±127.37 (range 16.27-456.0 ng.hr/ml, respectively. The time to maximum concentration (Tmax of theinnovator and the generic product were 0.97±0.41(range 0.5-2 and 1.02±0.32 (range 0.5-1.5 hr, respectively. The 90% confidence interval of the ratio of the ln-transformed of Cmax and AUC0à48 of both preparations were 89.39-112.99% and80.02-107.28% respectively which were within the acceptance range of 80.00-125.00%. Therefore, it can be concluded that both preparations used in this study are bioequivalent in terms of both the rate and extent of absorption.
Safe and Efficacious Use of Automated Bolus Advisors in Individuals Treated With Multiple Daily Insulin Injection (MDI) Therapy: Lessons Learned From the Automated Bolus Advisor Control and Usability Study (ABACUS).
Parkin, Christopher G; Barnard, Katharine; Hinnen, Deborah A
Numerous studies have shown that use of integrated automated bolus advisors (BAs) provides significant benefits to individuals using insulin pump devices, including improved glycemic control and greater treatment satisfaction. Within the past few years, BA devices have been developed specifically for individuals treated with multiple daily insulin injection (MDI) therapy; however, many clinicians who treat these individuals may be unfamiliar with insulin pump therapy and, thus, BA use. Findings from the Automated Bolus Advisor Control and Usability Study (ABACUS) revealed that BA use can be efficacious and clinically meaningful in MDI therapy, and that most patients are willing and able to use this technology appropriately when adequate clinical support is provided. The purpose of this article is to review key learnings from ABACUS and provide practical advice for initiating BA use and monitoring therapy. PMID:25795641
Manchikanti, Laxmaiah; Nampiaparampil, Devi E.; Manchikanti, Kavita N.; Falco, Frank J.E.; Singh, Vijay; Benyamin, Ramsin M.; Kaye, Alan D.; Sehgal, Nalini; Soin, Amol; Simopoulos, Thomas T.; Bakshi, Sanjay; Gharibo, Christopher G.; Gilligan, Christopher J.; Hirsch, Joshua A.
Background: The efficacy of epidural and facet joint injections has been assessed utilizing multiple solutions including saline, local anesthetic, steroids, and others. The responses to these various solutions have been variable and have not been systematically assessed with long-term follow-ups. Methods: Randomized trials utilizing a true active control design were included. The primary outcome measure was pain relief and the secondary outcome measure was functional improvement. The quality of each individual article was assessed by Cochrane review criteria, as well as the criteria developed by the American Society of Interventional Pain Physicians (ASIPP) for assessing interventional techniques. An evidence analysis was conducted based on the qualitative level of evidence (Level I to IV). Results: A total of 31 trials met the inclusion criteria. There was Level I evidence that local anesthetic with steroids was effective in managing chronic spinal pain based on multiple high-quality randomized controlled trials. The evidence also showed that local anesthetic with steroids and local anesthetic alone were equally effective except in disc herniation, where the superiority of local anesthetic with steroids was demonstrated over local anesthetic alone. Conclusion: This systematic review showed equal efficacy for local anesthetic with steroids and local anesthetic alone in multiple spinal conditions except for disc herniation where the superiority of local anesthetic with steroids was seen over local anesthetic alone. PMID:26005584
Full Text Available Background: The efficacy of epidural and facet joint injections has been assessed utilizing multiple solutions including saline, local anesthetic, steroids, and others. The responses to these various solutions have been variable and have not been systematically assessed with long-term follow-ups. Methods: Randomized trials utilizing a true active control design were included. The primary outcome measure was pain relief and the secondary outcome measure was functional improvement. The quality of each individual article was assessed by Cochrane review criteria, as well as the criteria developed by the American Society of Interventional Pain Physicians (ASIPP for assessing interventional techniques. An evidence analysis was conducted based on the qualitative level of evidence (Level I to IV. Results: A total of 31 trials met the inclusion criteria. There was Level I evidence that local anesthetic with steroids was effective in managing chronic spinal pain based on multiple high-quality randomized controlled trials. The evidence also showed that local anesthetic with steroids and local anesthetic alone were equally effective except in disc herniation, where the superiority of local anesthetic with steroids was demonstrated over local anesthetic alone. Conclusion: This systematic review showed equal efficacy for local anesthetic with steroids and local anesthetic alone in multiple spinal conditions except for disc herniation where the superiority of local anesthetic with steroids was seen over local anesthetic alone.
Wang, Sheng-Min; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A; Masand, Prakash S; Pae, Chi-Un
Improving medication adherence is critical to improving outcomes in patients with schizophrenia. A long-acting injectable (depot) antipsychotic is one of the most effective methods for improving treatment adherence and decreasing rehospitalization rates in patients with schizophrenia. Until recently, only three second-generation antipsychotics were available in a long-acting injectable formulation (risperidone, paliperidone, and olanzapine). In this respect, the emergence of long-acting aripiprazole injection (ALAI), approved by the US Food and Drug Administration for the treatment of schizophrenia in 2013, is timely. ALAI is a lyophilized powder of aripiprazole, and the aripiprazole molecule is unmodified. The initial and target dosage of ALAI is 400 mg once monthly, but it could be reduced to 300 mg if adverse reactions occur with 400 mg. When first administering ALAI, it is recommended to continue treatment with oral aripiprazole (10-20 mg/day) or another oral antipsychotic for 2 weeks in order to maintain therapeutic antipsychotic concentrations. The primary clearance route for ALAI is hepatic, ie, cytochrome P450 (CYP)2D6 and CYP3A4, so dose adjustment is required in poor CYP2D6 metabolizers. The efficacy of ALAI was demonstrated in three studies. A randomized controlled trial that formed the basis for approval of ALAI in the treatment of schizophrenia showed that ALAI significantly delayed time to impending relapse when compared with placebo (Ppsychiatric hospitalization rates were significantly lower after switching from oral antipsychotics to ALAI. Another randomized controlled trial presented in poster form suggested that ALAI 400 mg was comparable with oral aripiprazole 10-30 mg in preventing relapse. ALAI was generally well tolerated during both short-term and long-term studies. Its tolerability profile, including extrapyramidal symptoms and clinically relevant metabolic parameters, was similar to placebo. However, insomnia, headache, anxiety, akathisia, weight gain, injection site pain, and tremor need clinical attention. These studies suggest that ALAI is a viable treatment option for patients with schizophrenia, but direct head-to-head comparisons between ALAI and other long-acting injectable antipsychotics are needed to elucidate its risk-benefit profile. PMID:25210454
Eficácia do resfriamento da pele no alívio da dor desencadeada pela injeção de toxina botulínica tipo A nas distonias faciais Skin cooling efficacy on pain relief in periocular injections with botulinum toxin A in facial dystonias
Paula Barros Bandeira de Mello Monteiro
Full Text Available OBJETIVO: Avaliar a eficácia do resfriamento da pele com gelo no alívio da dor desencadeada pela injeção de toxina botulínica tipo A na região periocular em pacientes portadores de distonia facial. MÉTODOS: Neste estudo prospectivo, 13 pacientes receberam injeção de toxina botulínica tipo A em região glabelar (m. prócero e periocular (m. orbicular para tratamento de distonia facial. Antes das aplicações, um lado da região glabelar foi resfriado com gelo durante 5 minutos, enquanto no outro lado foi aplicada pomada Epitezan®, funcionando como placebo. A aplicação foi feita primeiramente no lado resfriado. Após a aplicação em cada um dos lados os pacientes foram instruídos a dar uma nota para a dor desencadeada pela injeção, em uma escala de 0 a 10 onde 0 era ausência de dor e 10 a dor mais intensa. RESULTADOS: A média das notas dadas pelos pacientes à dor desencadeada pela injeção no lado onde foi aplicado placebo foi 3,92 ± 3,28. No local onde foi aplicado gelo a média das notas foi de 2,92 ± 2,18 (p PURPOSE: To evaluate the efficacy of skin cooling with ice on pain relief in periocular injection with botulinum toxin type A in patients with facial dystonias. METHODS: In this prospective study, 13 patients received botulinum toxin type A injection in glabela (procerus m. and periocular region (orbicular m. for facial dystonias treatment. Before the injections, one side of the glabela was submitted to a 5-minute cooling period, while the opposite side had Epitezan® cream applied, as a placebo. The application was done at the cooled side first. After the application on each side the patients were instructed to rate the pain associated with the injection on a scale from 0 to 10, with 0 indicating no pain and 10 the worst pain. RESULTS: The average pain score on the side where cold was applied was 3,92 ± 3,28, while on the control side the average pain score was 2,92 ± 2,18 (p < 0,0166. CONCLUSION: In this study, skin cooling with ice cubes was efficient in pain relief in periocular botulinum toxin injections in patients with facial dystonias.
Moreton, Adam; Imran, Shermin
This case report describes the co-occurrence of a psychiatric disorder with a specific communication disorder in a teenage girl who presented to youth mental health services in crisis, posing a significant risk of harm to herself and others. Description of this case would be of interest to practitioners in youth mental health in relation to the assessment and treatment of young people with similar difficulties. We present the case of a 17-year-old girl previously admitted to an inpatient adolescent unit. Her diagnosis was reformulated 4?months into her second admission to include a specific communication disorder with both receptive and expressive difficulties, evident from her pragmatic use of language. She was started on risperidone in month eight; following this, a significant improvement was seen and the patient was discharged a month later. Prior to the start of risperidone, a referral had been made to low secure adolescent services for further assessment and advice on management, due to the patient's challenging presentation and poor engagement with treatment. PMID:26607198
Full Text Available Abstract Background Numerous structurally unrelated drugs, including antipsychotics, can prolong QT interval and trigger the acquired long QT syndrome (aLQTS. All of them are thought to act at the level of KCNH2, a subunit of the potassium channel. Although the QT-prolonging drugs are proscribed in the subjects with aLQTS, the individual response to diverse QT-prolonging drugs may vary substantially. Case presentation We report here a case of aLQTS in response to small doses of risperidone that was confirmed at three independent drug challenges in the absence of other QT-prolonging drugs. On the other hand, the patient did not respond with QT prolongation to some other antipsychotics. In particular, the administration of clozapine, known to be associated with higher QT-prolongation risk than risperidone, had no effect on QT-length. A detailed genetic analysis revealed no mutations or polymorphisms in KCNH2, KCNE1, KCNE2, SCN5A and KCNQ1 genes. Conclusions Our observation suggests that some patients may display a selective aLQTS to a single antipsychotic, without a potassium channel-related genetic substrate. Contrasting with the idea of a common target of the aLQTS-triggerring drugs, our data suggests existence of an alternative target protein, which unlike the KCNH2 would be drug-selective.
Bhargava, Kiran; Nath, Rajendra; Seth, Prahlad Kumar; Pant, Kamlesh Kumar; Dixit, Rakesh Kumar
In this work, 3D model of D2 dopamine receptor was determined by comparative homology modeling program MODELLER. The computed model's energy was minimized and validated using PROCHECK and Errat tool to obtain a stable model structure and was submitted in Protein Model Database (PMDB-ID: PM0079251). Stable model was used for molecular docking against Risperidone and their 15 derivatives using AutoDock 4.2, which resulted in energy-based descriptors such as Binding Energy, Ligand Efficiency, Inhib Constant, Intermol energy, vdW + Hbond + desolv Energy, Electrostatic Energy, Total Internal Energy and Torsional Energy. After that, we have built quantitative structure activity relationship (QSAR) model, which was trained and tested on Risperidone and their 15 derivatives having activity value pKi in µM. For QSAR modeling, Multiple Linear Regression model was engendered using energy-based descriptors yielding correlation coefficient r2 of 0.513. To assess the predictive performance of QSAR models, different cross-validation procedures were adopted. Our results suggests that ligand-receptor binding interactions for D2 employing QSAR modeling seems to be a promising approach for prediction of pKi value of novel antagonists against D2 receptor. PMID:24516319
Full Text Available Objective: Various studies have shown the effectiveness of risperidone and fluoxetine in the management of behavioral problems in autism. Aim: The purpose of this study was to compare these two drugs in the management of behavioral problems in autism. Materials and Methods: Forty children with autism were divided into 2 groups in a 16-week open trial that compared these two drugs. Parents rated the children using the Aberrant Behavior Checklist (ABC and the Conners? Parent Rating Scale - Revised (CPRS-R. The author rated the children using the Children?s Psychiatric Rating Scale and Clinical Global Impression (CGI Scale. Results: The risperidone group showed significant improvement in areas like irritability and hyperactivity, while the fluoxetine group showed significant improvement in speech deviance, social withdrawal and stereotypy. When the two drugs were compared, fluoxetine showed greater improvement in stereotypy, while both drugs showed improvement on the general autism scale; and on anger, hyperactivity and irritability scales. Conclusions : In this open trial, both drugs were well tolerated and appeared to be beneficial in the treatment of common behavioral problems in children with autism. Further controlled and double-blind studies in larger samples are warranted.
Modafinil or armodafinil (ar/mod) augmentation of antipsychotic medication in schizophrenia patients may be considered with a view to reduce negative symptoms associated with the illness or excessive daytime drowsiness due to any cause. The available data suggest that there is no role for ar/mod in reducing negative symptom burden. A recent pharmacokinetic (PK) study suggested that armodafinil (250 mg/d) reduces key PK parameters of risperidone by about 50%, and key PK parameters of 9-hydroxyrisperidone (paliperidone) by about 20%-30%, probably through induction of CYP3A4. Ar/mod augmentation is therefore best avoided in patients receiving risperidone or paliperidone (and most other atypical antipsychotic drugs, as well, because most atypical antipsychotics are metabolized by enzymes that ar/mod induce). If the ar/mod-antipsychotic drug combination is necessary, for whatever reason, then the dose of the atypical antipsychotic drug may need to be appropriately raised. If this is not done, relapse may occur; because the relapse may postdate the introduction of ar/mod by many months, the causal role of a metabolic drug interaction may not be suspected, and physicians may attribute the relapse to the natural course of the illness. Physicians need to be aware that any agent that induces the metabolism of psychotropic drugs that are used in maintenance therapy may, through lowered psychotropic drug levels, result in a delayed drug interaction that is characterized by illness relapse. PMID:26717524
Song, Jia; Xie, Jing; Li, Chenliang; Lu, Jia-Hui; Meng, Qing-Fan; Yang, Zhaogang; Lee, Robert J; Wang, Di; Teng, Le-Sheng
Microspheres have been developed as drug carriers in controlled drug delivery systems for years. In our present study, near infrared spectroscopy (NIRS) is applied to analyze the particle size and drug loading rate in risperidone poly(d,l-lactide-co-glycolide) (PLGA) microspheres. Various batches of risperidone PLGA microspheres were designed and prepared successfully. The particle size and drug-loading rate of all the samples were determined by a laser diffraction particle size analyzer and high performance liquid chromatography (HPLC) system. Monte Carlo algorithm combined with partial least squares (MCPLS) method was applied to identify the outliers and choose the numbers of calibration set. Furthermore, a series of preprocessing methods were performed to remove signal noise in NIR spectra. Moving window PLS and radical basis function neural network (RBFNN) methods were employed to establish calibration model. Our data demonstrated that PLS-developed model was only suitable for drug loading analysis in risperidone PLGA microspheres. Comparatively, RBFNN-based predictive models possess better fitting quality, predictive effect, and stability for both drug loading rate and particle size analysis. The correlation coefficients of calibration set (Rc(2)) were 0.935 and 0.880, respectively. The performance of optimum RBFNN models was confirmed by independent verification test with 15 samples. Collectively, our method is successfully performed to monitor drug-loading rate and particle size during risperidone PLGA microspheres preparation. PMID:24954726
Full Text Available Background: The aim of the present study was to evaluate the effect of risperidone in patients afflicted by autistic disorder especially with regards to its three core symptoms, including "relating to others", "communication skills", and "stereotyped behaviors" based on Childhood Autism Rating Scale (CARS. Materials and Methods: An 8-week open-label study of risperidone for treatment of autistic disorder in children 4-17 years old was designed. Risperidone dose titration was as follow: 0.02 mg/kg/day at the first week, 0.04 mg/kg/day at the second week, and 0.06 mg/kg/day at the third week and thereafter. The outcome measures were scores obtained by CARS, Aberrant Behavior Checklist (ABC, and Clinical Global Impression-Improvement (CGI-I scale. Results: Fifteen patients completed this study. After 8 weeks, CARS total score decreased significantly, (P=0.001. At the end of the study, social interactions and verbal communication skills of the patients were significantly improved (P<0.001, P=0.03, respectively. However, stereotypic behaviors did not show any significant change in this study. Increase in appetite and somnolence were the most reported side effects. Conclusion: This study suggests that risperidone may be an effective treatment for the management of core symptoms of autistic disorder.
Hasanzadeh, Elmira; Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Rezazadeh, Shams-Ali; Tabrizi, Mina; Rezaei, Farzin; Akhondzadeh, Shahin
"Ginkgo biloba" has been reported to affect the neurotransmitter system and to have antioxidant properties that could impact the pathogenesis of Autism Spectrum Disorder. Based on these studies, we decided to assess the effectiveness of "Ginkgo biloba" extract (Ginko T.D., Tolidaru, Iran) as an adjunctive agent to risperidone in the treatment of
Ghaleiha, Ali; Asadabadi, Mahtab; Mohammadi, Mohammad-Reza; Shahei, Maryam; Tabrizi, Mina; Hajiaghaee, Reza; Hassanzadeh, Elmira; Akhondzadeh, Shahin
Autism is a neurodevelopmental disorder that causes significant impairment in socialization and communication. It is also associated with ritualistic and stereotypical behaviour. Recent studies propose both hyper-and hypoglutamatergic ideologies for autism. The objective of this study was to assess the effects of memantine plus risperidone in the treatment of children with autism. Children with autism were randomly allocated to risperidone plus memantine or placebo plus risperidone for a 10-wk, double-blind, placebo-controlled study. The dose of risperidone was titrated up to 3 mg/d and memantine was titrated to 20 mg/d. Children were assessed at baseline and after 2, 4, 6, 8 and 10 wk of starting medication protocol. The primary outcome measure was the irritability subscale of Aberrant Behavior Checklist-Community (ABC-C). Difference between the two treatment arms was significant as the group that received memantine had greater reduction in ABC-C subscale scores for irritability, stereotypic behaviour and hyperactivity. Eight side-effects were observed over the trial, out of the 25 side-effects that the checklist included. The difference between the two groups in the frequency of side-effects was not significant. The present study suggests that memantine may be a potential adjunctive treatment strategy for autism and it was generally well tolerated. This trial is registered with the Iranian Clinical Trials Registry (IRCT1138901151556N10; www.irct.ir). PMID:22999292
Schotte, A; Janssen, P F; Megens, A A; Leysen, J E
Risperidone (Risperdal) is a novel antipsychotic drug, with beneficial effects on both positive and negative symptoms of schizophrenia, and with a low incidence of extrapyramidal side effects (EPS). These particular properties have been attributed to the predominant and very potent serotonin 5-HT2 receptor antagonism of the drug combined with less potent dopamine D2 antagonism. In order to provide data on the degree to which various central neurotransmitter receptors are occupied in vivo, we performed ex vivo receptor occupancy studies with risperidone in comparison with clozapine and haloperidol in rats and guinea pigs. Various types of receptors, to which the compounds were known to bind to in vitro, were investigated precisely using receptor autoradiography in sections of the same rat brain except for histamine H1 receptors that were measured in the guinea-pig cerebellum. Risperidone (2 h after s.c. treatment) occupied 5-HT2 receptors at very low doses (ED50 = 0.067 mg/kg). Nearly full occupancy (> 80%) was achieved before H1, D2, alpha 1 and alpha 2 receptors became occupied (ED50 = 0.45, 0.66, 0.75 and 3.7 mg/kg, respectively). Clozapine displayed occupancy of H1 and alpha 1 receptors at low doses (ED50 = 0.15 and 0.58 mg/kg, respectively) and of 5-HT2, 5-HT1C, D2, alpha 2, cholinergic muscarinic and 5-HT1A receptors at higher doses (ED50 = 1.3, 1.8, 9.0, 9.5, 11 and 15 mg/kg, respectively). Haloperidol occupied D2 and alpha 1 receptors at low doses (ED50 = 0.13 and 0.42 mg/kg, respectively) and 5-HT2 receptors at a higher dose (ED50 = 2.6 mg/kg). Occupancy of receptor types occurred with similar ED50-values in various brain areas, e.g. D2 receptors in striatum and mesolimbic areas. The ED50-values for the ex vivo measured occupancy of 5-HT2 and D2 receptors were in good agreement with ED50-values for functional effects putatively mediated by these central receptors. The dose-dependent occupancy of D2 receptors proceeded more gradually with risperidone (slope in the caudate-putamen: 0.85) than with clozapine (slope: 1.44) or haloperidol (slope: 1.51). It has previously been suggested that partial D2 receptor occupancy may suffice to control the positive symptoms of schizophrenia, whereas higher D2 receptor occupancy would induce extrapyramidal symptoms (EPS). The dose ratio for high (75%) vs. low (25%) D2 receptor occupancy in the caudate-putamen, was 37.3 for risperidone, 8.4 for clozapine, and 7.9 for haloperidol.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7510574
Full Text Available Although antipsychotic drugs are known to have an array of adverse effects, they also exhibit significant differences in causing these effects. The atherogenic effects of clozapine and risperidone have not been fully investigated among schizophrenics in Nigeria hence this research work. This study therefore investigated the extent to which monotherapy with clozapine and risperidone (atypical antipsychotic drugs influence lipid profile in patients with schizophrenia. The study population comprised 29 Schizophrenic patients from Psychiatric Hospital, Uselu, Benin city, Nigeria. They were placed on typical antipsychotics for six weeks: 10 patients were on risperidone (1-4 mg day-1 in divided doses and 19 patients were on clozapine (25-300 mg day-1 in divided doses. The control group comprised 30 apparently healthy volunteers. Blood samples were collected from all subjects on the first day before the commencement of treatment with antipsychotic drug and 24 h after the last administration of antipsychotics at the end of week 6 for analyses of total cholesterol (TC, triglycerides (TG, high density lipoprotein cholesterol (HDL, low density lipoprotein cholesterol (LDL and very low density Lipoprotein cholesterol (VLDL using standard methods. Comparing with the control, the basal serum TC, TG, LDL and VLDL of the clozapine treated group were not significantly different except for HDL which was significantly reduced and the atherogenic indices (TC/HDL and LDL/HDL which were significantly increased. However the risperidone treatment group showed significantly higher TC, TG, LDL and VLDL levels while HDL was significantly reduced. At the end of week 6, there was significant increase in serum TC, TG, HDL and VLDL and a significant decrease in HDL in both treatment groups compared to the control except VLDL that was not significantly different in the clozapine group. Comparing the two treatment groups, risperidone caused a more significant increase on lipid profile and atherogenic indeces than clozapine. This effect was about two times or greater with risperidone than clozapine. Conclusively, additional prospective clinical trials are required to support a specific therapeutic approach for managing dyslipidaemia that are present in clozapine and risperidone treated schizophrenic patients in an attempt to avoid its consequent adverse effects.
Full Text Available Marleen Nahuis1,2,3, Fulco van der Veen1, Jur Oosterhuis2, Ben Willem Mol1, Peter Hompes3, Madelon van Wely11Center for Reproductive Medicine, Department of Obstetrics and Gynaecology (H4-205, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; 2Department of Obstetrics and Gynaecology, Medisch Spectrum Twente, Enschede, The Netherlands; 3Department of Obstetrics and Gynaecology, Free Medical University, Amsterdam, The NetherlandsAbstract: Anovulation is a common cause of female subfertility. Treatment of anovulation is aimed at induction of ovulation. In women with clomiphene-citrate resistant WHO group II anovulation, one of the treatment options is ovulation induction with exogenous follicle-stimulating hormone (FSH or follitropin. FSH is derived from urine or is produced as recombinant FSH. Two forms of recombinant FSH are available follitropin alpha and follitropin beta. To evaluate the efficacy, safety, costs and acceptability of recombinant FSH, we performed a review to compare recombinant FSH with urinary-derived FSH products. Follitropin alpha, beta and urinary FSH products appeared to be equally effective in terms of pregnancy rates. Patient safety was also found to be comparable, as the incidence of side effects including multiple pregnancies was similar for all FSH products. In practice follitropin alpha and beta may be more convenient to use due to the ease of self-administration, but they are also more expensive than the urinary products.Keywords: follitropin apha, follitropin beta, urinary gonadotropins, polycystic ovary syndrome
Ghaleiha, Ali; Rasa, Soudeh Mohebbi; Nikoo, Mohammadali; Farokhnia, Mehdi; Mohammadi, Mohammad-Reza; Akhondzadeh, Shahin
To assess the safety and efficacy of pioglitazone added to risperidone in the treatment of irritability in autistic disorder (AD), we conducted this study. In a 10-week, randomized, double-blind, parallel-group, placebo-controlled clinical trial, 44 outpatients of both genders aged 4-12 years with a diagnosis of AD and a score of â¥12 on the Aberrant Behavior Checklist-Community (ABC-C) irritability subscale were included. Mean change of ABC-C irritability subscale score as primary outcome, change in other ABC-C subscale scores and partial and complete responses were compared between two groups. Twenty patients completed the trial in each group. Level of reduction and effect of timeÃtreatment interaction in the treatment group were significant for irritability (P=0.03), lethargy/social withdrawal (P=0.04) and hyperactivity/non-compliance (P=0.03) but not for stereotypic behavior and inappropriate speech subscales compared with the placebo group. Vomiting and headache were the most frequent reported side-effects. Results of this preliminary study indicate positive effects of pioglitazone compared with placebo in improving the behavioral symptoms of AD. PMID:26208985
Wilson, Robin P; Bhattacharyya, Sagnik
The prevalence of cannabis use in patients with psychotic mental illness is known to be high and is suspected to exacerbate symptoms and worsen prognosis. We aimed to evaluate evidence of antipsychotic efficacy in reducing the burden of psychotic symptoms and cannabis use in individuals with psychotic mental illness and co-morbid cannabis use. A systematic review was conducted of antipsychotic treatment in those with psychotic mental illness and co-morbid cannabis use. Quality of evidence for each study and outcomes were rated using the 'GRADE' approach. Twenty-two studies were identified: 13 experimental and 9 observational, including a total sample of 1543 patients, 761 of whom had a diagnosed cannabis use disorder. The most frequent antipsychotics compared were risperidone, olanzapine and clozapine with olanzapine, risperidone and haloperidol. No clear differences between antipsychotics were demonstrated. Future studies are needed to confirm whether clozapine is superior to other antipsychotics in reducing cannabis use. PMID:26510450
Eficácia do resfriamento da pele no alívio da dor desencadeada pela injeção de toxina botulínica tipo A nas distonias faciais / Skin cooling efficacy on pain relief in periocular injections with botulinum toxin A in facial dystonias
Paula Barros Bandeira de Mello, Monteiro; Nilson Lopes da, Fonseca Júnior; José Ricardo Carvalho Lima, Rehder.
Full Text Available OBJETIVO: Avaliar a eficácia do resfriamento da pele com gelo no alívio da dor desencadeada pela injeção de toxina botulínica tipo A na região periocular em pacientes portadores de distonia facial. MÉTODOS: Neste estudo prospectivo, 13 pacientes receberam injeção de toxina botulínica tipo A em regiã [...] o glabelar (m. prócero) e periocular (m. orbicular) para tratamento de distonia facial. Antes das aplicações, um lado da região glabelar foi resfriado com gelo durante 5 minutos, enquanto no outro lado foi aplicada pomada Epitezan®, funcionando como placebo. A aplicação foi feita primeiramente no lado resfriado. Após a aplicação em cada um dos lados os pacientes foram instruídos a dar uma nota para a dor desencadeada pela injeção, em uma escala de 0 a 10 onde 0 era ausência de dor e 10 a dor mais intensa. RESULTADOS: A média das notas dadas pelos pacientes à dor desencadeada pela injeção no lado onde foi aplicado placebo foi 3,92 ± 3,28. No local onde foi aplicado gelo a média das notas foi de 2,92 ± 2,18 (p Abstract in english PURPOSE: To evaluate the efficacy of skin cooling with ice on pain relief in periocular injection with botulinum toxin type A in patients with facial dystonias. METHODS: In this prospective study, 13 patients received botulinum toxin type A injection in glabela (procerus m.) and periocular region (o [...] rbicular m.) for facial dystonias treatment. Before the injections, one side of the glabela was submitted to a 5-minute cooling period, while the opposite side had Epitezan® cream applied, as a placebo. The application was done at the cooled side first. After the application on each side the patients were instructed to rate the pain associated with the injection on a scale from 0 to 10, with 0 indicating no pain and 10 the worst pain. RESULTS: The average pain score on the side where cold was applied was 3,92 ± 3,28, while on the control side the average pain score was 2,92 ± 2,18 (p
Schreiner, A; Bergmans, P; Cherubin, P; Keim, S; Llorca, P-M; Cosar, B; Petralia, A; Corrivetti, G; Hargarter, L
PALMFlexS, a prospective multicentre, open-label, 6-month, phase IIIb interventional study, explored tolerability, safety and treatment response in adults (n = 231) with non-acute but symptomatic schizophrenia switching to flexibly dosed paliperidone palmitate (PP) after unsuccessful treatment with risperidone long-acting injectable therapy (RLAT) or conventional depot antipsychotics (APs). Treatment response was measured by change in Positive and Negative Syndrome Scale (PANSS) total score from baseline (BL) to last-observation-carried-forward (LOCF) endpoint (EP). Safety and tolerability assessments included Extrapyramidal Symptom Rating Scale (ESRS) total score and treatment-emergent adverse events. Significant reductions in mean PANSS total score were observed for all groups (-7.5 to -10.6; p ? 0.01 [BL to LOCF EP]). After switching to PP, more than 50% of all patients achieved ?20% and one-third of RLAT-treated patients even achieved ?50% improvement in PANSS total score. Across groups, there were significant improvements (p medication satisfaction, and patient functioning with PP. PP was generally well tolerated. Clinically relevant benefits were observed in non-acute patients with schizophrenia switched from RLAT or conventional depot APs to PP. PMID:25999398
Full Text Available Abstract Background Distraction osteogenesis is the standard treatment for the management of lower limb length discrepancy of more than 3 cm and bone loss secondary to congenital anomalies, trauma or infection. This technique consists of an osteotomy of the bone to be lengthened, application of an external fixator, followed by gradual and controlled distraction of the bone ends. Although limb lengthening using the Ilizarov distraction osteogenesis principle yields excellent results in most cases, the technique has numerous problems and is not well tolerated by many children. The objective of the current study is to determine if Botulinum Toxin A (BTX-A, which is known to possess both analgesic and paralytic actions, can be used to alleviate post-operative pain and improve the functional outcome of children undergoing distraction osteogenesis. Methods/Design The study design consists of a multi centre, randomized, double-blinded, placebo-controlled trial. Patients between ages 5â21 years requiring limb lengthening or deformity correction using distraction will be recruited from 6 different sites (Shriners Hospital for Children in Montreal, Honolulu, Philadelphia and Portland as well as DuPont Hospital for Children in Wilmington, Delaware and Hospital for Sick Children in Toronto, Ont. Approximately 150 subjects will be recruited over 2 years and will be randomized to either receive 10 units per Kg of BTX-A or normal saline (control group intraoperatively following the surgery. Functional outcome effects will be assessed using pain scores, medication dosages, range of motion, flexibility, strength, mobility function and quality of life of the patient. IRB approval was obtained from all sites and adverse reactions will be monitored vigorously and reported to IRB, FDA and Health Canada. Discussion BTX-A injection has been widely used world wide with no major side effects reported. However, to the best of our knowledge, this is the first time BTX-A is being used under the context of limb lengthening and deformity correction. Trial Registration NCT00412035
Lessing, Charon; Ashton, Toni; Davis, Peter
This study evaluated patient health outcomes and any impact on healthcare costs consequent to the implementation of generic reference-pricing of risperidone in New Zealand using national datasets. Reference pricing risperidone reduced the price of the originator brand by 50 % as well as overall expenditure on risperidone tablets. Half of all patients made a single switch to generic risperidone, with the remainder making multiple switches between brands. 1.5 % made a switch-back to the originator brand. No difference was found in use of healthcare services between switchers and non-switchers of the originator brand or versus the comparator group. This refutes the available literature on brand-to-generic and generic-to-generic switching. PMID:25331449
A single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study: 12-month analysis
Full Text Available Rishi P Singh, Sunil K Srivastava, Justis P Ehlers, Fabiana Q Silva, Rumneek Bedi, Andrew P Schachat, Peter K Kaiser Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA Summary statement: In subjects with active exudative age-related macular degeneration, treating with a fixed intravitreal aflibercept injection dosing regimen for 12 months demonstrated improved anatomic and vision endpoints from baseline.Purpose: Switching therapies in neovascular age-related macular degeneration (AMD may offer an advantage for some patients. This study evaluates the efficacy of intravitreal aflibercept injection (IAI in subjects previously treated with ranibizumab and/or bevacizumab.Methods: Subjects (n=26 were given monthly 2 mg of IAI for 3 months, followed by 2 mg once in every 2 months for up to 12 months. The mean absolute change from baseline in central subfield thickness (CST measured by optical coherence tomography and the mean change from baseline in best-corrected visual acuity (BCVA early treatment in diabetic retinopathy study (ETDRS letter score were obtained. Additionally, the percentage of subjects who gained or lost ?15 letters of vision and the percentage of subjects who are 20/40 or better or 20/200 or worse were evaluated.Results: There was a mean decrease in CST of -50.3 µm (P<0.001 and a mean increase in ETDRS BCVA of +9.2 letters (P<0.001. Twenty-seven percent of subjects experienced a ?15-letter improvement in visual acuity, and no subject lost ?3 lines of vision from baseline. Fifty percent of subjects were 20/40 or better, and 11.5% of subjects were 20/200 or worse at month 12.Conclusion: Fixed IAI dosing regimen for 12 months demonstrated improved anatomic and vision endpoints in subjects with active exudative AMD. Keywords: aflibercept, age-related macular degeneration, bevacizumab, ranibizumab, vascular endothelial growth factors
A single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study): 12-month analysis
Singh, Rishi P; Srivastava, Sunil K; Ehlers, Justis P; Silva, Fabiana Q; Bedi, Rumneek; Schachat, Andrew P; Kaiser, Peter K
Summary statement In subjects with active exudative age-related macular degeneration, treating with a fixed intravitreal aflibercept injection dosing regimen for 12 months demonstrated improved anatomic and vision endpoints from baseline. Purpose Switching therapies in neovascular age-related macular degeneration (AMD) may offer an advantage for some patients. This study evaluates the efficacy of intravitreal aflibercept injection (IAI) in subjects previously treated with ranibizumab and/or bevacizumab. Methods Subjects (n=26) were given monthly 2 mg of IAI for 3 months, followed by 2 mg once in every 2 months for up to 12 months. The mean absolute change from baseline in central subfield thickness (CST) measured by optical coherence tomography and the mean change from baseline in best-corrected visual acuity (BCVA) early treatment in diabetic retinopathy study (ETDRS) letter score were obtained. Additionally, the percentage of subjects who gained or lost ?15 letters of vision and the percentage of subjects who are 20/40 or better or 20/200 or worse were evaluated. Results There was a mean decrease in CST of ?50.3 ?m (P<0.001) and a mean increase in ETDRS BCVA of +9.2 letters (P<0.001). Twenty-seven percent of subjects experienced a ?15-letter improvement in visual acuity, and no subject lost ?3 lines of vision from baseline. Fifty percent of subjects were 20/40 or better, and 11.5% of subjects were 20/200 or worse at month 12. Conclusion Fixed IAI dosing regimen for 12 months demonstrated improved anatomic and vision endpoints in subjects with active exudative AMD. PMID:26445522
Guler, Gulen; Yildirim, Veli; Kutuk, Meryem Ozlem; Toros, Fevziye
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with common comorbidities that include oppositional defiant disorder, conduct disorder, anxiety disorder, and affective disorders. Because of these comorbidities, drug combination treatments and drug-drug interactions are becoming increasingly more frequent. The present case report describes an acute dystonic reaction following the abrupt discontinuation of methylphenidate from a drug regimen with risperidone. The patient experienced acute dystonic reactions on three separate occasions when he forgot to take his methylphenidate medication. The present report informs clinicians about the possible side effects, such as dystonia, when psychostimulant and antipsychotic drug combinations are altered and suggests that the abrupt cessation of stimulants may lead to the development of movement disorders. Therefore, appropriate care is necessary when changing the dose of a drug or abruptly discontinuing a drug from a combination of psychostimulants and antipsychotics. PMID:25912546
characterization of how the drug distribution was influenced by the tissue morphology, and the injection parameters. For ex vivo injections in subcutaneous pig tissue the bolus was characterized for different needle lengths, injected volumes and infusion flow rates. It was shown that the drug distribution at the...... injection site was influenced by the needle length and the injected volume. Several imaging analysis tools were optimized for the characterization, and these tools were implemented also on subcutaneous injections in rats, visualized by low dose Î¼CT, and used for characterization of the morphology in mouse...
... lungs, skin, bones, joints, stomach area, blood, female reproductive organs, and urinary tract. Cefotetan injection is also ... you are using cefotetan injection.If you are diabetic, use Clinistix or TesTape (not Clinitest) to test ...
... and abdominal (stomach area), skin, blood, bone, joint, female genital tract, and urinary tract infections. Ceftazidime injection ... ceftazidime injection decreases the effectiveness of some oral contraceptives ('birth control pills). You will need to use ...
... of interest in life, and strong or inappropriate emotions). Ziprasidone is in a class of medications called ... alcoholic beverages while you are receiving ziprasidone injection. Alcohol can make the side effects from ziprasidone injection ...
... Lupron Depot-PED) is used to treat central precocious puberty (CPP; a condition causing children to enter puberty ... injection will last. When used in children with precocious puberty, leuprolide injection (Lupron Depot-PED, Lupron Depot-PED- ...
... injection is in a class of antibiotics called tetracyclines. It works by killing bacteria that cause infection. ... if you are allergic to tigecycline injection; other tetracycline antibiotics such as doxycycline (Monodox, Oracea, Vibramcyin), minocycline ( ...
Hydromorphone injection is used to relieve pain. Hydromorphone injection is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond ...
Premarin® I.V. ... The estradiol cypionate and estradiol valerate forms of estrogen injection are used to treat hot flushes (hot ... should consider a different treatment. These forms of estrogen injection are also sometimes used to treat the ...
Tacrolimus injection is used along with other medications to prevent rejection (attack of the transplanted organ by ... who have received kidney, liver, or heart transplants. Tacrolimus injection should only be used by people who ...
Ipilimumab injection is used to treat melanoma (a type of skin cancer) that cannot be treated with ... has spread to other parts of the body. Ipilimumab injection is in a class of medications called ...
A validated analytical method by high-performance liquid chromatography (HPLC) was applicable to study of 1 mg/mL Risperidone oral solution stability. The above method was linear, accurate, specific and exact. A stability study of the 1 mg/mL Risperidone oral solution was developed determining its expiry date. The shelf life study was conducted for 24 months at room temperature; whereas the accelerated stability study was conducted with product under influence of humidity and temperature; analysis was made during 3 months. Formula fulfilled the quality specifications described in Pharmacopeia. The results of stability according to shelf life after 24 months showed that the product maintains the parameters determining its quality during this time and in accelerated studies there was not significant degradation (p> 0.05) in the product. Under mentioned conditions expiry date was of 2 years
Nurmi, E L; Spilman, S L; Whelan, F.; Scahill, L L; Aman, M G; McDougle, C. J.; Arnold, L. E.; Handen, B; Johnson, C; Sukhodolsky, D G; Posey, D.J.; Lecavalier, L; Stigler, K A; Ritz, L; Tierney, E.
Second-generation antipsychotic exposure, in both children and adults, carries significant risk for excessive weight gain that varies widely across individuals. We queried common variation in key energy balance genes (FTO, MC4R, LEP, CNR1, FAAH) for their association with weight gain during the initial 8 weeks in the two NIMH Research Units on Pediatric Psychopharmacology Autism Network trials (N=225) of risperidone for treatment of irritability in children/adolescents aged 417 years with au...
Radovan P?ikryl; Hana P?ikrylová Ku?erová; Michaela Vrzalová; Eva ?eková
Approximately 80% of patients with the first-episode schizophrenia reach symptomatic remission after antipsychotic therapy. However, within two years most of them relapse, mainly due to low levels of insight into the illness and nonadherence to their oral medication. Therefore, although the formal data available is limited, many experts recommend prescribing long-acting injectable second-generation antipsychotics (mostly risperidone or alternatively paliperidone) in the early stages of schizo...
Structures and IR and Raman spectra of Risperidone in its neutral, mono- and di-protonated forms were calculated in gas phase by DFT-B3LYP/6-31G* level. Mono-protonation occurs at the nitrogen atom of the piperidine ring, while nitrogen atom of the pyrimidine ring is the preferred site for the second protonation. The lowest-energy structure of the mono-protonated Risperidone is characterized by formation of a strong seven-membered O(pyrimidine ring)⋯ +H-N(piperidine ring) intramolecular hydrogen-bonded cycle. In the high-energy spectral region (3500-2500 cm -1), the bands of the N-H + stretches and the changes in wavenumbers and IR intensities of the C-H stretches near to the piperidine nitrogen atom (Bohlmann effect) are potentially useful to discriminate conformations and protonation states. Di-protonated structures can be identified by the presence of an isolated absorption peak located in the low-energy IR region (660-690 cm -1), attributed to the out-of-plane N-H +(pyrimidine ring) bending deformation. The most intense Raman band of neutral Risperidone placed at ca. 1500 cm -1, assigned to C dbnd C(pyrimidine ring) stretch + C dbnd N(pyrimidine ring) stretch, can be a useful vibrational marker to distinguish the neutral from the protonated forms.
Handen, Benjamin L; Johnson, Cynthia R; Butter, Eric M; Lecavalier, Luc; Scahill, Lawrence; Aman, Michael G; McDougle, Christopher J; Arnold, L Eugene; Swiezy, Naomi B; Sukhodolsky, Denis G; Mulick, James A; White, Susan W; Bearss, Karen; Hollway, Jill A; Stigler, Kimberly A; Dziura, James; Yu, Sunkyung; Sacco, Kelley; Vitiello, Benedetto
A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N=49) versus risperidone plus parent training (COMB; n=75) (ages 4-13 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition (p=.0002) and 12 % increase in compliance to parental requests (p=.004) for the two treatment conditions combined. Parents displayed 64 % greater use of positive reinforcement (p=.001) and fewer repeated requests for compliance (p<.0001). In the analysis of covariance (ANCOVA), COMB parents used significantly more positive reinforcement (p=.01) and fewer restrictive statements (p<.05) than MED parents. The SOAP is sensitive to change in child and parent behavior as a function of risperidone alone and in combination with PMT and can serve as a valuable complement to parent and clinician-based measures. PMID:23730123
A Phase IIb, Multicenter, Open-Label, Safety, and Efficacy Study of High-Dose, Propylene Glycol-Free Melphalan Hydrochloride for Injection (EVOMELA) for Myeloablative Conditioning in Multiple Myeloma Patients Undergoing Autologous Transplantation.
Hari, Parameswaran; Aljitawi, Omar S; Arce-Lara, Carlos; Nath, Rajneesh; Callander, Natalie; Bhat, Gajanan; Allen, Lee F; Stockerl-Goldstein, Keith
Autologous stem cell transplantation (ASCT) after high-dose melphalan conditioning is considered a standard of care procedure for patients with multiple myeloma (MM). Current formulations of melphalan (eg, Alkeran for Injection [melphalan hydrochloride]; GlaxoSmithKline, Research Triangle Park, NC, USA) have marginal solubility and limited chemical stability upon reconstitution. Alkeran requires the use of propylene glycol as a co-solvent, which itself has been reported to cause such complications as metabolic/renal dysfunction and arrhythmias. EVOMELA (propylene glycol-free melphalan HCl; Spectrum Pharmaceuticals, Inc., Irvine, CA, USA) is a new i.v. melphalan formulation that incorporates Captisol (Ligand Pharmaceuticals, Inc., La Jolla, CA, USA), a specially modified cyclodextrin that improves the solubility and stability of melphalan and eliminates the need for propylene glycol. This new formulation has been shown to be bioequivalent to Alkeran. EVOMELA (200 mg/m(2)) was administered as 2 doses of 100 mg/m(2) each in a phase IIb, open-label, multicenter study to confirm its safety and efficacy as a high-dose conditioning regimen for patients with MM undergoing ASCT. At 5 centers, 61 patients (26 women) with a median age of 62 years (range, 32-73) were enrolled. All patients achieved myeloablation with a median time of 5 days post-ASCT, and all successfully achieved neutrophil and platelet engraftment with median times of 12 days post-ASCT and 13 days post-ASCT, respectively; treatment-related mortality on day 100 was 0%. Overall response rate (according to independent, blinded review) was high (100%), with an overall complete response rate of 21% (13% stringent complete response; 8% complete response) and overall partial response rate of 79% (61% very good partial response; 18% partial response). The incidence of grade 3 mucositis and stomatitis was low (10% and 5%, respectively) with no grade 4 mucositis or stomatitis reported (graded according to National Cancer Institute Common Terminology Criteria for Adverse Events). Based on investigators' assessment of mucositis using the World Health Organization (WHO) oral toxicity scale, 75% of patients had a shift in mucositis score from WHO grade 0 at baseline to a higher grade on study, of which 13% of patients reported WHO grade 3 as the worst post-treatment mucositis over the course of the study; there were no reports of WHO grade 4 mucositis during the study. This study confirms the efficacy and acceptable safety profile of EVOMELA, a new propylene glycol-free melphalan formulation, as a high-dose conditioning regimen for ASCT in patients with MM. PMID:26327631
Berry Sally A
Full Text Available Abstract Background In clinical practice, physicians often need to change the antipsychotic medications they give to patients because of an inadequate response or the presence of unacceptable or unsafe side effects. However, there is a lack of consensus in the field as to the optimal switching strategy for antipsychotics, especially with regards to the speed at which the dose of the previous antipsychotic should be reduced. This paper assesses the short-term results of strategies for the discontinuation of olanzapine when initiating risperidone. Methods In a 6-week, randomized, open-label, rater-blinded study, patients with schizophrenia or schizoaffective disorder, on a stable drug dose for more than 30 days at entry, who were intolerant of or exhibiting a suboptimal symptom response to more than 30 days of olanzapine treatment, were randomly assigned to the following switch strategies (common risperidone initiation scheme; varying olanzapine discontinuation: (i abrupt strategy, where olanzapine was discontinued at risperidone initiation; (ii gradual 1 strategy, where olanzapine was given at 50% entry dose for 1 week after risperidone initiation and then discontinued; or (iii gradual 2 strategy, where olanzapine was given at 100% entry dose for 1 week, then at 50% in the second week, and then discontinued. Results The study enrolled 123 patients on stable doses of olanzapine. Their mean age was 40.3 years and mean (± standard deviation (SD baseline Positive and Negative Syndrome Scale (PANSS total score of 75.6 ± 11.5. All-cause treatment discontinuation was lowest (12% in the group with the slowest olanzapine dose reduction (gradual 2 and occurred at half the discontinuation rate in the other two groups (25% in abrupt and 28% in gradual 1. The relative risk of early discontinuation was 0.77 (confidence interval 0.610.99 for the slowest dose reduction compared with the other two strategies. After the medication was changed, improvements at endpoint were seen in PANSS total score (-7.3; p p p = 0.171 and anxiety/depression (-1.4; p = 0.0005 subscale scores. Severity of movement disorders and weight changes were minimal. Conclusion When switching patients from olanzapine to risperidone, a gradual reduction in the dose of olanzapine over 2 weeks was associated with higher rates of retention compared with abrupt or less gradual discontinuation. Switching via any strategy was associated with significant improvements in positive and anxiety symptoms and was generally well tolerated. Trial registration ClinicalTrials.gov NCT00378183
CHANG, YA-JEN; HSU, WEI-HSIN; CHANG, CHIH-HSIEN; LAN, KENG-LI; TING, GANN; LEE, TE-WEI
Rhenium-188 (188Re) displays abundant intermediate energy ? emission and possesses a physical half-life of 16.9 h. Sorafenib is an orally available multikinase inhibitor that targets Raf kinases and vascular endothelial growth factor receptors (VEGFRs). Sorafenib has demonstrated preclinical and clinical activity against several types of tumors, such as renal cell and colorectal carcinoma. In this study, we investigated the efficacy of radiotherapeutics of 188Re-liposomes combined with sorafenib in a C26-luc metastatic colorectal liver tumour mouse model. Liver metastases were established by intrasplenic injection of C26-luc murine colon cancer cells. Based on the results of the toxicity assessment, an administration dose of 80% the maximum tolerated dose was selected. 188Re-liposomes were administered on day 1, when metastases of several hundred micrometers in diameter were observed. In the combination therapy group, 10 mg/kg sorafenib (co-developed and co-marketed by Bayer and Onyx Pharmaceuticals as Nexavar) was administered every other day for 1 week and the survival of mice was assessed. The tumor growth was more significantly inhibited in the 188Re-liposome plus sorafenib group compared with the 188Re-liposome alone, sorafenib alone and untreated normal saline groups (P=0.0000). Furthermore, 188Re-liposomes combined with sorafenib achieved higher survival rates compared with the 188Re-liposome alone, sorafenib alone and untreated normal saline groups (P=0.0000). These results support the use of combined radio-chemotherapy with 188Re-liposomes plus sorafenib as a viable treatment option in the adjuvant setting for liver metastases of colorectal cancer. PMID:24772304
Chang, Ya-Jen; Hsu, Wei-Hsin; Chang, Chih-Hsien; Lan, Keng-Li; Ting, Gann; Lee, Te-Wei
Rhenium-188 ((188)Re) displays abundant intermediate energy ? emission and possesses a physical half-life of 16.9 h. Sorafenib is an orally available multikinase inhibitor that targets Raf kinases and vascular endothelial growth factor receptors (VEGFRs). Sorafenib has demonstrated preclinical and clinical activity against several types of tumors, such as renal cell and colorectal carcinoma. In this study, we investigated the efficacy of radiotherapeutics of (188)Re-liposomes combined with sorafenib in a C26-luc metastatic colorectal liver tumour mouse model. Liver metastases were established by intrasplenic injection of C26-luc murine colon cancer cells. Based on the results of the toxicity assessment, an administration dose of 80% the maximum tolerated dose was selected. (188)Re-liposomes were administered on day 1, when metastases of several hundred micrometers in diameter were observed. In the combination therapy group, 10 mg/kg sorafenib (co-developed and co-marketed by Bayer and Onyx Pharmaceuticals as Nexavar) was administered every other day for 1 week and the survival of mice was assessed. The tumor growth was more significantly inhibited in the (188)Re-liposome plus sorafenib group compared with the (188)Re-liposome alone, sorafenib alone and untreated normal saline groups (P=0.0000). Furthermore, (188)Re-liposomes combined with sorafenib achieved higher survival rates compared with the (188)Re-liposome alone, sorafenib alone and untreated normal saline groups (P=0.0000). These results support the use of combined radio-chemotherapy with (188)Re-liposomes plus sorafenib as a viable treatment option in the adjuvant setting for liver metastases of colorectal cancer. PMID:24772304
Khodaie-Ardakani, Mohammad-Reza; Seddighi, Sahar; Modabbernia, Amirhossein; Rezaei, Farzin; Salehi, Bahman; Ashrafi, Mandana; Shams-Alizadeh, Narges; Mohammad-Karimi, Maryam; Esfandiari, Gholam-Reza; Hajiaghaee, Reza; Akhondzadeh, Shahin
Some 5-HT3 antagonists such as ondansetron have shown beneficial effects on negative symptoms of patients with schizophrenia. We aimed to evaluate the efficacy of granisetron (another 5-HT3 antagonist) add-on therapy in the treatment of negative symptoms of patients with stable schizophrenia. In a randomized, double-blind, and placebo-controlled study, forty stable patients with schizophrenia (DSM-IV-TR), were randomized to either granisetron (1 mg twice daily) or placebo (twice daily) in addition to risperidone up to 6 mg/day for eight weeks. The patients were assessed using positive and negative syndrome scale (PANSS) and extrapyramidal symptom rating scale (ESRS) at baseline, week 4 and 8. Hamilton depression rating scale (HDRS) was used to assess depression at baseline and week 8. Thirty-eight patients completed the trial. Granisetron group showed a significantly greater improvement on negative subscale than the placebo group at endpoint [t(38) = 6.046, mean difference (±95% CI) = 3.2(1.8-3.7), P < 0.001]. The same effect was observed for total score [t(38) = 4.168, mean difference (95% CI) = 3.2(1.6-4.7), P < 0.001]. However the placebo and granisetron groups did not differ in their reduction of positive and general psychopathology symptoms scores. HDRS scores and its changes did not differ between the two groups. The ESRS score at week 4 was significantly lower in the granisetron than the placebo group while the two groups showed similar ESRS score at week 8. Frequency of other side effects was similar between the two groups. In summary, granisetron add-on can safely and effectively reduce the primary negative symptoms of patients with schizophrenia. PMID:23375406
Panda, Apoorva; Meena, Jairam; Katara, Rajesh; Majumdar, Dipak K
In the current study, polylactide-co-glycolide (PLGA) nanoparticles entrapping both clozapine (CLZ) and risperidone (RIS) were formulated by spray-drying using Buchi Nano Spray Dryer B-90 (Flawil, Switzerland). Parameters such as inlet temperature, spray mesh diameter, sample flow rate, spray rate and applied pressure were optimized to produce nanoparticles having desired release profile using both low- and high-molecular weight PLGA polymer. Smallest size nanoparticle of size around 248?nm could be prepared using a 4.0 ?m mesh diameter with low-molecular weight polymer. The load of CLZ and RIS was 126.3 and 58.2??g/mg of polymer particles, respectively. Entrapment efficiency of drugs in PLGA nanoparticles was 94.74% for CLZ and 93.12% for RIS. Both the drugs released continuously from the nanoparticle formulations. PLGA nanoparticles formulated using low-molecular weight polymer released around 80% of the entrapped drug over 10 days of time. Nature of drug inside polymer particles was amorphous, and there was no chemical interaction of CLZ and RIS with polymer. Polymeric nanoparticles were found to be non-toxic in nature using PC12 cell line. This nanospray drying process proved to be suitable for developing polymeric nanoformulation delivering dual drugs for the treatment of Schizophrenia. PMID:25403112
Bartmann, W; Bracco, C; Drosdal, L; Gianfelice, E; Goddard, B; Kain, V; Papaphilippou, Y; Vanbavinckhove, G
This note summarizes the results obtained at injection during the 2nd MD block and the floating MD block in July. Highlights are presented for injection in the LHC with the Q20 SPS optics, influence of the supercycle and injection with 25 ns bunch spacing. Beams were successfully injected into the LHC using the Q20 optics [1, 3]. Small corrections were needed to steer the beam in the transfer lines. Dispersion measurements were conducted for both beams. The horizontal normalized dispersion in TI2 was a factor 2 smaller for Q20 with respect to Q26, for TI8 on the other hand the opposite was observed. The results for injection loss dependency on super cycle composition show only a small increase in losses for beam 2. The losses observed must therefore mainly come from other sources such as shot-by-shot stability or quality of scraping. For the injection with 25 ns bunch spacing bunches were injected for both beams. For B1 up to the maximum of 288 bunches. For B2 on the other only up to 144 bunches were injected...
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer's website to obtain the Medication Guide. ... about the risks of receiving romiplostim injection.Romiplostim injection may cause ... program online [at http://www.fda.gov/Safety/MedWatch] or by phone [ ...
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer's website to obtain the Medication Guide. ... or giving ciprofloxacin injection to your child.Ciprofloxacin injection may cause ... program online [at http://www.fda.gov/Safety/MedWatch] or by phone [ ...
... the instructions, or visit the manufacturer's website at http://www.evzio.com/pdfs/NDA%20205787%20Approval%2003apr14-2%20PPI%20and%20IFU.pdf to get the instructions. In case of emergency, even a person who has not been trained to inject naloxone should still try to inject the medication. ...
This review focuses on the comparative safety and efficacy profile of nine atypical antipsychotic drugs (amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone and zotepine), which may ultimately affect the therapeutic options available for patients with schizophrenia. These antipsychotic compounds differ markedly in their potential to impact a number of quality-of-life measures. Furthermore, their differential effects on anxiety disorders, treatment-resistant depressive illness, cognitive functions and manic disorders may influence the selection of atypical antipsychotics for conditions associated with schizophrenia. The possible relevance of these parameters in evaluating the risk/benefit equation and probable involvement of varying receptor mechanisms is also discussed. PMID:17659473
Amodeo, Dionisio A; Jones, Joshua H; Sweeney, John A; Ragozzino, Michael E
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interactions with restricted interests and repetitive behaviors (RRBs). RRBs can severely limit daily living and be particularly stressful to family members. To date, there are limited options for treating this feature in ASD. Risperidone, an atypical antipsychotic, is approved to treat irritability in ASD, but less is known about whether it is effective in treating "higher order" RRBs, for example cognitive inflexibility. Risperidone also has multiple receptor targets in which only a subset may be procognitive and others induce cognitive impairment. 5HT2A receptor blockade represents one promising and more targeted approach, as various preclinical studies have shown that 5HT2A receptor antagonists improve cognition. The present study investigated whether risperidone and/or M100907, a 5HT2A receptor antagonist, improved probabilistic reversal learning performance in the BTBR T + tf/J (BTBR) mouse model of autism. The effects of these treatments were also investigated in C57BL/6J (B6) mice as a comparison strain. Using a spatial reversal learning test with 80/20 probabilistic feedback, similar to one in which ASD individuals exhibit impairments, both risperidone (0.125 mg) and M100907 (0.01 and 0.1 mg) improved reversal learning in BTBR mice. Risperidone (0.125 mg) impaired reversal learning in B6 mice. Improvement in probabilistic reversal learning performance resulted from treatments enhancing the maintenance of the newly correct choice pattern. Because risperidone can lead to unwanted side effects, treatment with a specific 5HT2A receptor antagonist may improve cognitive flexibility in individuals with ASD while also minimizing unwanted side effects. PMID:24894823
Kalra, Sanjay; Balhara, Yatan Pal Singh; Baruah, Manash P.; Chadha, Manoj; Chandalia, Hemraj B.; Chowdhury, Subhankar; Kumar, K.M. Prasanna; Modi, Sonal; Pitale, Shailesh; Shukla, Rishi; Sahay, Rakesh; Sundaram, Annamalai; Unnikrishnan, Ambika G; Wangnoo, Subhash K.
Advances in the treatment of diabetes have led to an increase in the number of injectable therapies, such as human insulin, insulin analogues, and glucagon-like peptide-1 analogues. The efficacy of injection therapy in diabetes depends on correct injection technique, among many other factors. Good injection technique is vital in achieving glycemic control and thus preventing complications of diabetes. From the patients and health-care providers perspective, it is essential to have guideline...
... infections; and urinary tract, abdominal (stomach area), female reproductive organs, blood, bone, joint, and skin infections. Cefoxitin ... you are taking cefoxitin injection.If you are diabetic and test your urine for glucose, use Clinistix ...
... spinal cord infections; and abdominal (stomach area), female reproductive organs, skin, blood, bone, joint, and urinary tract ... you are taking cefotaxime injection.If you are diabetic and test your urine for sugar, use Clinistix ...
... of interest in life, and strong or inappropriate emotions). Aripiprazole injection (Abilify) is used to treat episodes ... this medication affects you.you should know that alcohol can add to the drowsiness caused by this ...
... of interest in life, and strong or inappropriate emotions). Haloperidol injection is also used to control motor ... this medication affects you.you should know that alcohol can add to the drowsiness caused by this ...
... of interest in life, and strong or inappropriate emotions). Olanzapine injection is used to treat episodes of ... this medication affects you.you should know that alcohol can add to the drowsiness caused by this ...
Golimumab injection is used alone or with other medications to relieve the symptoms of certain autoimmune disorders ( ... did not help or could not be tolerated. Golimumab is in a class of medications called tumor ...
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using adalimumab injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using albiglutide injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of receiving omalizumab injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using mipomersen injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using tocilizumab injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.Talk to your doctor about the risk of receiving metoclopramide injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using dulaglutide injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using exenatide injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of receiving eculizumab injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using rituximab injection.
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.Talk to your doctor about the risks of using telavancin injection.
Clindamycin injection is used to treat certain types of bacterial infections, including infections of the lungs, skin, ... bones, joints, female reproductive organs, and internal organs. Clindamycin is in a class of medications called lincomycin ...
... with surgery. Gemcitabine is also used to treat cancer of the pancreas that has spread to other parts of the ... 4 weeks. When gemcitabine is used to treat cancer of pancreas it may be injected once every week. The ...
... doctor.if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving belatacept injection.plan to avoid unnecessary or prolonged exposure to sunlight, tanning beds, and ...
... certain infections caused by bacteria including pneumonia, and skin, urinary tract, and kidney infections. Cefepime injection is used in combination with metronidazole (Flagyl) to treat abdominal (stomach area) infections. Cefepime ...
... stiffening and jerking of the arms and legs aggression seizures uncontrollable rapid eye movements hives rash itching difficulty breathing or swallowing Midazolam injection may cause other side effects. Call your doctor if you ...
... transmitted disease); and skin, blood, bone, joint, and urinary tract infections. Cefuroxime injection may also be used before, during, ... this medication.tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. ...
... treat prostate cancer (cancer of a male reproductive organ) that has already been treated with other medications. Cabazitaxel injection is in a class of medications called microtubule inhibitors. It works by slowing or stopping the growth of cancer cells.
... selective serotonin receptor agonists. It works by narrowing blood vessels in the brain, stopping pain signals from ... a pre-filled auto-injection device and in vials to be used with disposable syringes. If you ...
... How to give intravitreal injections. 2013. http://www.aao.org/publications/eyenet/201304/upload/April-2013-Ophthalmic- ... American Academy of Ophthalmology; 2014. Available at: www.aao.org/ppp. Accessed August 29, 2013. Mitchell P, ...
... have been exposed to anthrax germs in the air. Levofloxacin injection is in a class of antibiotics ... treat endocarditis (infection of the heart lining and valves), tuberculosis (TB), and plague (a serious infection that ...
... injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid ... as possible: tenderness warmth irritation drainage redness swelling pain ¶ These branded products are no longer on the ...
Deanna L. Kelly; Wehring, Heidi J.; Linthicum, Jared; Feldman, Stephanie; Robert P. McMahon; Love, Raymond C.; Wagner, Tara; Shim, Joo Cheol; Fowler, David R.
Clozapine is a superior agent for treatment-refractory patients with schizophrenia, but is underutilized in the US, likely due to the risk of side effects. This study examined all available autopsy data on cardiac disease and risk factors in people with schizophrenia in a sample of deceased persons with severe mental illness who had received clozapine (N = 62) or risperidone (N = 42). The mean body mass index (BMI) at the time of death was 31.4 ± 8.8 kg/m2 and 27.1 ± 8.2 kg/m2 in the clozapin...
Faye, Abhijeet Dhawalram; Gawande, Sushil; Tadke, Rahul; Kirpekar, Vivek C; Bhave, Sudhir H
Calcification of basal ganglia or Fahr's syndrome is a rare disease characterized by bilateral and symmetrical intracranial deposition of calcium mainly in cerebral basal ganglia. Motor and neuropsychiatric symptoms are prominent features. We report a case presented with a few motor symptoms, features of delirium and prominent psychiatric symptoms (disorganized behavior) predominantly evident after the improvement in delirium. Radiological findings were suggestive of bilateral basal ganglia calcification. Parathyroid hormone levels were low with no significant findings in other investigations and negative family history. Patient showed significant improvement in behavioral disturbances with risperidone, low dose of lorazepam, oxcarbazepine, and memantine. PMID:24891710
Terry, Alvin V.; Gearhart, Debra A.; Warner, Samantha E.; Zhang, Guodong; Bartlett, Michael G.; Middlemore, Mary-Louise; Beck, Wayne D.; Mahadik, Sahebarao P.; Waller, Jennifer L
First and second generation antipsychotics (FGAs and SGAs) ameliorate psychotic symptoms of schizophrenia, however, their chronic effects on information processing and memory function (i.e., key determinants of long term functional outcome) are largely unknown. In this rodent study the effects of different time periods (ranging from two weeks to six months) of oral treatment with the FGA, haloperidol (2.0 mg/kg/day), or the SGA, risperidone (2.5 mg/kg/day) on a water maze repeated acquisition...
Full Text Available Inappropriate hypersexual behaviors have been frequently reported in subjects with autism, however, literature on management of such behaviors in this group is very limited. In this paper, we describe an adolescent with autistic disorder and mental retardation who developed severe inappropriate sexual behaviors and has been treated successfully with risperidone-paroxetine combination. As presence of hypersexual behaviors in individuals with autism is a distressing factor for their family and social environment, appropriate management seems to be essential. (Archives of Neuropsychiatry 2012; 49: 311-313
Manna, Sugata; Bhandoola, Avinash
Intrathymic injection is used in several T cell-associated immunological studies to deliver cells or other substances directly into the thymus. Here, we describe the intrathymic injection procedure involving surgical incision of the mouse with or without a thoracotomy. Though this procedure can result in poor recovery, postsurgical complications, and distress to the animal, it is actually a simple procedure that can be carried out relatively easily and quickly with experience. PMID:26294410
Full Text Available Sheng-Min Wang,1 Changsu Han,2 Soo-Jung Lee,5 Ashwin A Patkar,3 Prakash S Masand,4 Chi-Un Pae3,5 1International Health Care Center, Seoul St Marys Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea; 2Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea; 3Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 4Global Medical Education, New York, NY, USA; 5Department of Psychiatry, Bucheon St Marys Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea Abstract: Improving medication adherence is critical to improving outcomes in patients with schizophrenia. A long-acting injectable (depot antipsychotic is one of the most effective methods for improving treatment adherence and decreasing rehospitalization rates in patients with schizophrenia. Until recently, only three second-generation antipsychotics were available in a long-acting injectable formulation (risperidone, paliperidone, and olanzapine. In this respect, the emergence of long-acting aripiprazole injection (ALAI, approved by the US Food and Drug Administration for the treatment of schizophrenia in 2013, is timely. ALAI is a lyophilized powder of aripiprazole, and the aripiprazole molecule is unmodified. The initial and target dosage of ALAI is 400 mg once monthly, but it could be reduced to 300 mg if adverse reactions occur with 400 mg. When first administering ALAI, it is recommended to continue treatment with oral aripiprazole (1020 mg/day or another oral antipsychotic for 2 weeks in order to maintain therapeutic antipsychotic concentrations. The primary clearance route for ALAI is hepatic, ie, cytochrome P450 (CYP2D6 and CYP3A4, so dose adjustment is required in poor CYP2D6 metabolizers. The efficacy of ALAI was demonstrated in three studies. A randomized controlled trial that formed the basis for approval of ALAI in the treatment of schizophrenia showed that ALAI significantly delayed time to impending relapse when compared with placebo (P<0.0001, log-rank test. An open-label, mirror study demonstrated that total psychiatric hospitalization rates were significantly lower after switching from oral antipsychotics to ALAI. Another randomized controlled trial presented in poster form suggested that ALAI 400 mg was comparable with oral aripiprazole 1030 mg in preventing relapse. ALAI was generally well tolerated during both short-term and long-term studies. Its tolerability profile, including extrapyramidal symptoms and clinically relevant metabolic parameters, was similar to placebo. However, insomnia, headache, anxiety, akathisia, weight gain, injection site pain, and tremor need clinical attention. These studies suggest that ALAI is a viable treatment option for patients with schizophrenia, but direct head-to-head comparisons between ALAI and other long-acting injectable antipsychotics are needed to elucidate its riskbenefit profile. Keywords: aripiprazole, schizophrenia, depot, long-acting injectable, relapse, treatment
Robinson, Delbert G; Gallego, Juan A; John, Majnu; Petrides, Georgios; Hassoun, Youssef; Zhang, Jian-Ping; Lopez, Leonardo; Braga, Raphael J; Sevy, Serge M; Addington, Jean; Kellner, Charles H; Tohen, Mauricio; Naraine, Melissa; Bennett, Natasha; Greenberg, Jessica; Lencz, Todd; Correll, Christoph U; Kane, John M; Malhotra, Anil K
Research findings are particularly important for medication choice for first-episode patients as individual prior medication response to guide treatment decisions is unavailable. We describe the first large-scale double-masked randomized comparison with first-episode patients of aripiprazole and risperidone, 2 commonly used first-episode treatment agents. One hundred ninety-eight participants aged 15-40 years with schizophrenia, schizophreniform disorder, schizoaffective disorder or psychotic disorder Not Otherwise Specified, and who had been treated in their lifetime with antipsychotics for 2 weeks or less were randomly assigned to double-masked aripiprazole (5-30mg/d) or risperidone (1-6mg/d) and followed for 12 weeks. Positive symptom response rates did not differ (62.8% vs 56.8%) nor did time to response. Aripiprazole-treated participants had better negative symptom outcomes but experienced more akathisia. Body mass index change did not differ between treatments but advantages were found for aripiprazole treatment for total and low-density lipoprotein cholesterol, fasting glucose, and prolactin levels. Post hoc analyses suggested advantages for aripiprazole on depressed mood. Overall, if the potential for akathisia is a concern, low-dose risperidone as used in this trial maybe a preferred choice over aripiprazole. Otherwise, aripiprazole would be the preferred choice over risperidone in most situations based upon metabolic outcome advantages and some symptom advantages within the context of similar positive symptom response between medications. PMID:26338693
McKibben, Claire E; Jenkins, Trisha A; Adams, Hayley N; Harte, Michael K; Reynolds, Gavin P
Sub-chronic administration of phencyclidine to the rat induces enduring cognitive and pathophysiological changes that resemble some features of schizophrenia. The present study aimed to determine if concurrent administration of the atypical antipsychotic, risperidone, could attenuate the effect of phencyclidine on object recognition memory and parvalbumin-containing neurons in the prefrontal cortex. Rats were administered phencyclidine at a dose of 2mg/kg i.p. bi-daily for 1 week, or vehicle. Half of the phencyclidine group was concurrently treated with risperidone (0.5mg/kg i.p.) twice daily for 10 days, beginning 3 days before the start of phencyclidine administration. Novel object recognition memory and subsequent brain analysis were assessed 6 weeks post-phencyclidine treatment. Phencyclidine produced a deficit in object recognition memory as measured by the discrimination ratio. In addition, 6 weeks post-phencyclidine, analysis of brains showed a reduction in expression of parvalbumin-immunoreactive neurons in the prefrontal cortex, with specific deficits observed in the prelimbic region, but not infralimbic or cingulate cortices. Concurrent administration of risperidone showed no protective effects against these deficits. These results show the importance of the sub-chronic phencyclidine rat in modelling cognitive and prefrontal pathophysiology observed in schizophrenia, but suggest that concurrent risperidone is not neuroprotective in this model. PMID:19914297
Long-term, naturalistic treatment with olanzapine, risperidone, quetiapine, or haloperidol monotherapy: 24-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study.
Lee, Phil; Eung Kim, Chul; Yoon Kim, Chang; Lin, Wei-Wen; Habil, Hussain; Dyachkova, Yulia; Mcbride, Margaret; Dossenbach, Martin
Objective. To compare the effectiveness of olanzapine, risperidone, quetiapine, or haloperidol monotherapy in patients with schizophrenia who were treated in routine clinical practice settings for a period of 2 years. The incidence and persistence of adverse events encountered during long-term therapy are also reported. Method. Outpatients with schizophrenia who entered this 3-year, prospective, observational study were classified according to their initially prescribed antipsychotic monotherapy: olanzapine (n=3222), risperidone (n=1116), quetiapine (n=189), or haloperidol (n=256). Patients were included in the analysis for as long as this treatment was maintained. Results. Over 2 years, olanzapine recipients had significantly (P?0.001) greater reduction in overall CGI-S score (and the negative, depressive, and cognitive symptoms domains), lower incidence of sexual and motor dysfunction, and greater odds of response compared to risperidone or haloperidol-treated patients. However, olanzapine patients gained more weight than patients in other treatment groups. The incidence of motor dysfunction was significantly (P?0.001) greater in haloperidol-treated patients, relative to the atypical treatment groups. Conclusion. The results of this observational study indicate that, in these patients with schizophrenia, long-term monotherapy with olanzapine may offer benefits over risperidone and haloperidol, but the potential for weight gain should be considered in the clinical management of these patients. PMID:24931661
Leuprorelin is indicated for the palliative treatment of advanced prostate cancer (APC) and is available as 1, 3, 4 and 6-monthly injections. There are advantages of longer leuprorelin injection intervals in the treatment of APC. Across all injection intervals, efficacy is similar and the majority of patients achieve testosterone suppression and normalisation of prostate-specific antigent. Treatment is well tolerated. Six-monthly leuprorelin injections are less costly to the healthcare system than the shorter interval injections. PMID:26209999
... injection is also sometimes used to treat Behcet's syndrome (ulcers in the mouth and on the genitals and inflammation of various ... runny nose back pain white patches in the mouth vaginal itching, burning, and pain, or other signs of a yeast ...
... Liraglutide injection also slows the emptying of the stomach and may decrease appetite and cause weight loss. ... heat. Store unused liraglutide pens in the refrigerator (36Â°F to 46Â°F [2Â°C to 8Â° ...
... Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website http://www.vivitrol.com to obtain the Medication Guide. ... or throat hoarseness difficulty swallowing chest pain Naltrexone injection may ... program online [at http://www.fda.gov/Safety/MedWatch] or by phone [ ...
... visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide. ... flu-like symptoms pale skin fast heartbeat Ketorolac injection may cause other ... program online [at http://www.fda.gov/Safety/MedWatch] or by phone [ ...
... Medication Guide) when you begin treatment with ustekinumab injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or ...
(toe' sih too moe' mab)Tositumomab injection may cause serious or life-threatening allergic reactions. Tell your doctor if you are allergic to medications made from murine (mouse) proteins, or if you are not sure if a medication you are allergic to is made ...
... test before each treatment. You must have a negative pregnancy test before the start of each treatment.tell your doctor if you are breastfeeding. Do not breastfeed while you are using mitoxantrone injection.if you are having surgery, including dental surgery, tell the doctor or dentist ...
... injected into a large muscle (such as your buttock or hip), under your skin, or into a vein.You will probably receive nalbuphine every 3 to 6 hours as needed for pain. Your doctor may also order other pain medications ...
El-Habeeb, Abeer A.; Al-Saif, Foziah A.; Refat, Moamen S.
The focus of present investigation was to assess the utility of non-expensive techniques in the evaluation of risperidone (Ris) in solid and solution states with different traditional ?-acceptors and subsequent incorporation of the analytical determination into pharmaceutical formulation for a faster release of risperidone. Charge-transfer complexes (CTC) of risperidone with picric acid (PA), 2,3-dichloro-5,6-dicyano-p-benzoquinon (DDQ), tetracyanoquinodimethane (TCNQ), tetracyano ethylene (TCNE), tetrabromo-p-quinon (BL) and tetrachloro-p-quinon (CL) have been studied spectrophotometrically in absolute methanol at room temperature. The stoichiometries of the complexes were found to be 1:1 ratio by the photometric molar ratio between risperidone and the ?-acceptors. The equilibrium constants, molar extinction coefficient (?CT) and spectroscopic-physical parameters (standard free energy (?Go), oscillator strength (f), transition dipole moment (?), resonance energy (RN) and ionization potential (ID)) of the complexes were determined upon the modified Benesi-Hildebrand equation. Risperidone in pure form was applied in this study. The results indicate that the formation constants for the complexes depend on the nature of electron acceptors and donor, and also the spectral studies of the complexes were determined by (infrared, Raman, and 1H NMR) spectra and X-ray powder diffraction (XRD). The most stable mono-protonated form of Ris is characterized by the formation of +Nsbnd H (pyrimidine ring) intramolecular hydrogen bonded. In the high-wavenumber spectral region 3400 cm-1, the bands of the +Nsbnd H stretching vibrations and of the pyrimidine nitrogen atom could be potentially useful to discriminate the investigated forms of Ris. The infrared spectra of both Ris complexes are confirming the participation of +Nsbnd H pyrimidine ring in the donor-acceptor interaction.
Full Text Available Background: The effectiveness of various atypical antipsychotics in the treatment of acute mania is reported repeatedly, but those for typical antipsychotics are restricted to haloperidol and chlorpromazine. As there is a comparative importance of side effects for typical and atypical antipsychotics, we decided to compare the therapeutic effect of thiothixene and risperidone as a combination with lithium for the treatment of patients with bipolar disorder. Materials and Methods: In 8 week double-blind clinical trial, 84 patients with a diagnosis of bipolar disorder were randomized for treatment with lithium plus thiothixene (N=42 or lithium plus risperidone (N=42. Manic, positive-negative symptoms, anxiety and depression were measured bi-weekly with Young Mania Rating, positive and negative symptom scale (PANSS and Hamilton rating scale score. Fasting blood sugar, weight, general side effects and extrapyramidal symptoms were also evaluated. The measures analyzed using SPSS-17 software. To compare demographic characteristics t-test, ?2 test and fixed effects method were used. A fixed effects method was applied to omit missing data effects. Results: There was no significant difference between the thiothixene and risperidone groups in Young mania rating scale and other outcome measures during the 8 week trial. There was no significant difference in weight, blood sugar and clinical global impression (CGI between groups. Conclusion: Thiothixene is as effective as risperidone in the improvement of manic and psychotic symptoms. There was no significant difference with risperidone in developing extrapyramidal symptoms, so it can be used as an appropriate combination with lithium for the treatment of bipolar patients in psychotic manic episode.
Full Text Available Advances in the treatment of diabetes have led to an increase in the number of injectable therapies, such as human insulin, insulin analogues, and glucagon-like peptide-1 analogues. The efficacy of injection therapy in diabetes depends on correct injection technique, among many other factors. Good injection technique is vital in achieving glycemic control and thus preventing complications of diabetes. From the patients? and health-care providers? perspective, it is essential to have guidelines to understand injections and injection techniques. The abridged version of the First Indian Insulin Injection technique guidelines developed by the Forum for Injection Technique (FIT India presented here acknowledge good insulin injection techniques and provide evidence-based recommendations to assist diabetes care providers in improving their clinical practice.
Bellino, Silvio; Bozzatello, Paola; Rinaldi, Camilla; Bogetto, Filippo
Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD). Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects. The aim of this study is to evaluate efficacy and safety of paliperidone ER in BPD patients. 18 outpatients with a DSM-IV-TR diagnosis of BPD were treated for 12 weeks with paliperidone ER (3-6?mg/day). They were assessed at baseline, week 4, and week 12, using the CGI-Severity item, the BPRS, the HDRS, the HARS, the SOFAS, the BPD Severity Index (BPDSI), and the Barratt Impulsiveness Scale (BIS-11). Adverse events were evaluated with the DOTES. Paliperidone ER was shown to be effective and well tolerated in reducing severity of global symptomatology and specific BPD symptoms, such as impulsive dyscontrol, anger, and cognitive-perceptual disturbances. Results need to be replicated in controlled trials. PMID:21826264
Studies have commenced on an injector for LEP, the CERN 100 GeV e+-e- storage ring design. The minimum energy for injection is 20 GeV, and a synchrotron injector is chosen in preference to a linac for cost reasons and to obtain faster ring filling. Factors involved in the design of the injector synchrotron are discussed and 2 alternative schemes are outlined for the filling of the 32 e+ and 32 e- LEP bunches
As second-generation antipsychotic long-acting injections (SGA-LAIs) are rapidly replacing depot first-generation antipsychotics as first-line agents in treating schizophrenia spectrum disorders, a systematic assessment of their adverse effects is timely. English-language, peer-reviewed articles reporting original data on the safety and tolerability of SGA-LAIs were identified electronically by searching the MEDLINE, EMBASE, PsycINFO, and DARE databases and the Cochrane Library (January 2001-April 2013). In addition to second-generation (atypical) antipsychotics and long-acting injection (depot) antipsychotics, a separate search was performed for each available drug: aripiprazole LAI, olanzapine pamoate, paliperidone palmitate, and risperidone LAI. Articles were excluded if they were review articles, post hoc analyses, analyses of subsets of patients enrolled in previous trials, single case reports, case series studies, small naturalistic studies (involving less than 50 patients), studies providing no safety data, and studies lasting less than 8 weeks. Of 181 articles identified from the search, 140 were excluded; thus, 41 articles met the inclusion criteria. Predictably, the reviewed information revealed that SGA-LAIs have safety profiles consistent with their oral parent formulations. However, they seem to also show unforeseen and worrisome safety signals. Indeed, the routine use of olanzapine-LAI in clinical practice could be limited not only by the well-known risk of postinjection syndrome, whose clinical management remains a matter of concern, but also by the risk of worsening of psychosis. The reviewed information seems to suggest that worsening of psychotic symptoms and depression could also be associated with both risperidone-LAI and paliperidone palmitate. The leading cause of death among patients enrolled in risperidone-LAI studies was suicide. Given the exponential growth in the clinical use of SGA-LAIs, further studies must be urgently performed in order to confirm or exclude the potential safety signals associated with such drugs. PMID:23776129
Caridad Margarita García Peña
Full Text Available Se desarrolló el estudio de estabilidad de las tabletas de risperidona 3 mg y se determinó su fecha de vencimiento. Este estudio se realizó por los métodos de vida de estante y de estabilidad acelerada mediante cromatografía líquida de alta eficiencia, validados en el Centro de Investigación y Desarrollo de Medicamentos. El estudio de vida de estante se desarrolló por un periodo de 24 meses a temperatura ambiente; mientras que el estudio de estabilidad acelerada se efectuó sometiendo el producto a la influencia de la luz, la humedad y la temperatura; se realizó el análisis durante 3 meses, para los 2 primeros y durante 6 meses para el estudio de la temperatura. La formulación de risperidona tabletas 3 mg cumplió con las especificaciones de calidad descritas en la Farmacopea. Los resultados del estudio de estabilidad por vida de estante después de transcurridos los 24 meses indican que el producto mantiene los parámetros que determinan su calidad durante ese tiempo, y en los estudios acelerados no se observó degradación del producto. Se estableció 2 años como fecha de vencimiento en las condiciones señaladas.Stability study was conducted of 3 mg Risperidone tablets determining its caducity date and using the shelf life methods and of accelerated stability by high-performance liquid chromatography validated in Drug Development and Research Center. The shelf life study was developed during 24 months at room temperature; whereas the accelerated stability study was performed subjecting the product to light, humidity and temperature influence. The 3 mg Risperidone tablets formula fulfilled the quality specifications described in Pharmacopeia. Results from shelf life study after 24 months show that the product maintains the parameters determining its quality during that time and in accelerated studies product degradation was noted. Under conditions signaled 2 years was established as the expiry date.
Caridad Margarita, García Peña; Antonio, Iraizoz Barrios; Vivian, Martínez Espinosa.
Full Text Available Se desarrolló el estudio de estabilidad de las tabletas de risperidona 3 mg y se determinó su fecha de vencimiento. Este estudio se realizó por los métodos de vida de estante y de estabilidad acelerada mediante cromatografía líquida de alta eficiencia, validados en el Centro de Investigación y Desar [...] rollo de Medicamentos. El estudio de vida de estante se desarrolló por un periodo de 24 meses a temperatura ambiente; mientras que el estudio de estabilidad acelerada se efectuó sometiendo el producto a la influencia de la luz, la humedad y la temperatura; se realizó el análisis durante 3 meses, para los 2 primeros y durante 6 meses para el estudio de la temperatura. La formulación de risperidona tabletas 3 mg cumplió con las especificaciones de calidad descritas en la Farmacopea. Los resultados del estudio de estabilidad por vida de estante después de transcurridos los 24 meses indican que el producto mantiene los parámetros que determinan su calidad durante ese tiempo, y en los estudios acelerados no se observó degradación del producto. Se estableció 2 años como fecha de vencimiento en las condiciones señaladas. Abstract in english Stability study was conducted of 3 mg Risperidone tablets determining its caducity date and using the shelf life methods and of accelerated stability by high-performance liquid chromatography validated in Drug Development and Research Center. The shelf life study was developed during 24 months at ro [...] om temperature; whereas the accelerated stability study was performed subjecting the product to light, humidity and temperature influence. The 3 mg Risperidone tablets formula fulfilled the quality specifications described in Pharmacopeia. Results from shelf life study after 24 months show that the product maintains the parameters determining its quality during that time and in accelerated studies product degradation was noted. Under conditions signaled 2 years was established as the expiry date.
Lorenzo G. Mantovani
Full Text Available Objective: to estimate the costs and effects of long-acting risperidone (LAR in the treatment of schizophrenic patients in Italy, as compared to conventional and oral atypical antipsychotics. Methods: a discrete event model was used. The model simulates patients. history for every single therapeutic alternative and selects incident events, on the basis of pre-defined probability distribution-powered, randomized repetitions. The model operates on two types of parameters: patient characteristics and time-dependent variables. Patient characteristics (age, sex, illness profile and severity, probability of incurring in an adverse event and potential dangerousness remain fixed during the 5 simulated years. Time-dependent variables are subject to changes and include outpatient visits, severity of psychotic episodes, symptom-scores, compliance, incidence of adverse effects, site of treatment and dangerousness. Three treatments have been selected: scenario 1 begins with LAR, switches to olanzapine and then to clozapine; scenario 2 starts with olanzapine, switches to oral risperidone and ends with clozapine. Direct medical costs have been computed on the basis of psychiatric visits, drug costs and costs of the institution in which the patient is treated (hospital, rehabilitation clinic, etc. Outcome measures were number of psychotic episodes in 5 years, total time spent during these episodes and cumulative score of positive and negative symptoms at 5 years. Information on alternatives, transition probabilities, model structure and health resources utilization were derived from the literature and from a panel of experts. Results: it has been estimated that LAR is economically dominant (more effective at lower cost respect to oral atypical antipsychotics, being able to prevent 0.87 psychotic episodes per patient, with a net cost saving of 4,773 euro per patient. Sub-group analysis indicate that LAR is always more effective than the considered alternatives and, in general, also less costly than oral atypical antipsychotics. Sensitivity analyses confirmed the robustness of the model to several variations of key parameters. Conclusions: LAR therapy dominates oral atypical antipsychotics.
Fragoso, Viviane Muniz da Silva; Hoppe, Luanda Yanaan; AraÃºjo-Jorge, TÃ¢nia Cremonini de; Azevedo, Marcos JosÃ© de; Campos, JerÃ´nimo Diego de Souza; Cortez, CÃ©lia Martins; Oliveira, Gabriel Melo de
Aggression is defined as the act in which an individual intentionally harms or injures another of their own species. Antipsychotics are a form of treatment used in psychiatric routine. They have been used for decades in treatment of patients with aggressive behavior. Haloperidol and risperidone promote the control of psychiatric symptoms, through their respective mechanisms of action. Experimental models are obtained by behavioral, genetic, and pharmacological manipulations, and use a reduced number of animals. In this context, we applied the model of spontaneous aggression (MSA), originating the presence of highly aggressive mice (AgR) when reassembled in adulthood. We administered haloperidol and risperidone in escalating doses, for ten consecutive days. Using positive and negative control groups, we evaluated the effectiveness of these drugs and the reversal of the aggressive behavior, performing the tail suspension test (TST) and open field test (OFT) on 10th day of treatment and 10 days after its discontinuation. The results showed that both antipsychotic drugs were effective in AgR and reversed the aggressive phenotype, reducing the number of attacks by AgR and the extent of lesions in the subordinate mice (AgD) exposed to the pattern of aggressive behavior (PAB) of the aggressors. This conclusion is based on the reduction in the animals' motor and exploratory activity, and on the reversal of patterns of aggressive behavior. The association between the MSA and experiments with other therapeutic protocols and different antipsychotics can be an important methodology in the study of aggressive behavior in psychiatric patients. PMID:26698401
Bobes, J; Garc A-Portilla, M P; Rejas, J; Hern Ndez, G; Garcia-Garcia, M; Rico-Villademoros, F; Porras, A
Atypical antipsychotics seem to differ mainly in their tolerability profile. The aim of this cross-sectional study, the Estudio de Investigaci n de Resultados en Esquizofrenia (Outcomes Research Study in Schizophrenia; EIRE study), was to assess in a clinical setting the frequency of several side-effects related to haloperidol, risperidone, olanzapine, and quetiapine. This article addresses sexual dysfunction and other reproductive side-effects (gynecomastia, menorrhage, amenorrhea, and galactorrhea). We recruited outpatients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria and who had received a single antipsychotic (risperidone, olanzapine, quetiapine, or haloperidol) for at least 4 weeks. During a single visit, we collected data, including demographic and clinical characteristics, current antipsychotic and concomitant treatment, and adverse effects listed in a modified version of the UKU Scale. We used a Chi-squared test to determine pairs comparisons of the frequency of adverse reactions between treatments. To estimate risk of a given adverse reaction with a given treatment, we used a logistic regression method. We assessed 636 evaluable patients out of 669 recruited. Frequency of sexual dysfunction was high with haloperidol (38.1%) and also with olanzapine (35.3%), quetiapine (18.2%), and risperidone (43.2%). We found the frequency of other reproductive side-effects to be relatively low with all four drugs: haloperidol (6.9%), olanzapine (6.4%), quetiapine (2.7%), and risperidone (11.7%). Sexual dysfunction appeared to be dose-related with haloperidol, risperidone, and olanzapine. Risperidone and olanzapine showed a higher risk of sexual dysfunction and other reproductive sideeffects than haloperidol. Quetiapine showed a lower risk of sexual dysfunction during short-term treatment ( 12 weeks) are lacking. Our results suggest that none of the atypical antipsychotics that we studied significantly improved sexual dysfunction and other reproductive side-effects of the conventional antipsychotic, haloperidol, in stabilized patients during long-term treatment. Quetiapine appears to improve this profile during short-term treatment; however, longterm data, with larger samples, are required with this latter drug. PMID:12623765
Bennett, J R J; Gray, D A; Harold, M R; Maidment, J R; Rees, G H; Weldon, A G
Studies have commenced of an injector for LEP, the CERN 100 GeV e/sup +/-e/sup -/ storage ring design. The minimum energy for injection is 20 GeV, and a synchrotron injector is chosen in preference to a linac for cost reasons and to obtain faster ring filling. Factors involved in the design of the injector synchrotron are discussed and 2 alternative schemes are outlined for the filling of the 32 e/sup +/ and 32 d/sup -/ LEP bunches. (4 refs.).
Chang, Ya-Jen; Hsu, Wei-Hsin; Chang, Chih-Hsien; Lan, Keng-Li; Ting, Gann; Lee, Te-Wei
Rhenium-188 (188Re) displays abundant intermediate energy ? emission and possesses a physical half-life of 16.9 h. Sorafenib is an orally available multikinase inhibitor that targets Raf kinases and vascular endothelial growth factor receptors (VEGFRs). Sorafenib has demonstrated preclinical and clinical activity against several types of tumors, such as renal cell and colorectal carcinoma. In this study, we investigated the efficacy of radiotherapeutics of 188Re-liposomes combined with sorafe...
Cortisone shot - hip; Hip injection; Intra-articular steroid injections - hip ... can see where to place the medicine. The steroid medicine is slowly injected into the joint. After the injection, you will remain on the table for another ...
Avaliação em camundongo da eficácia do antiveneno administrado no local da inoculação intramuscular do veneno de Crotalus durissus terrificus Evaluation in mice, of the antivenom efficacy injected at the same place of the intramuscular inoculation of the Crotalus durissus terrificus venom
Lindioneza Adriano Ribeiro
Full Text Available A eficácia do antiveneno crotálico por via intramuscular (im no local da inoculação, também im, do veneno de Crotalus durissus terrificus foi avaliada em camundongos. Em três experimentos inocularam-se duas DLSO do veneno por via im e administrou-se o antiveneno de três formas: metade da DE50 por via intraperitoneal (ip e metade por via im, no mesmo local, imediatamente após (1º e 30' após (2º a inoculação do veneno; quatro quintos de DE50 por via ip e um quinto por via im, no mesmo local e 30' após a inoculação do veneno (3º. O antiveneno ofereceu, por via ip, maior proteção aos camundongos (menor taxa de óbito em 48 horas do que quando foi administrado, em parte, por via im, no local da inoculação do veneno (pThe efficacy of the Crotalus durissus terrificus antivenom administration by intramuscular (im injection at the same place of the im inoculation, of the C. d. terrificus venom was evaluated in mice. In three experiments two DL50 of the venom were inoculated and the antivenom was administered in three differents ways: half of the ED50 by intraperitoneal (ip administration and half by injection, at the same place, immediatelly after the venom inoculation and thirty minutes after the im venom inoculation; four fifth of ED50 by ip administration and one fifth by injection, at the same place and thirty minutes after the venom inoculation. The antivenom that was administred by intraperitoneal route provided a higher protection to mice (a lower death rate in a 48 hours period than when it was administred in parts, by intramuscular injection, at the same place of the venom inoculation (p<0,05. Therefore, it is concluded that this should not be used in human beings bitten by snakes.
Mao Lian; Dirani Riad D; Kozma Chris M; DeSouza Cherilyn; Crivera Concetta; Macfadden Wayne
Abstract Background Schizophrenia is a chronic mental health disorder associated with increased hospital admissions and excessive utilization of outpatient services and long-term care. This analysis examined health care resource utilization from a 24-month observational study of patients with schizophrenia initiated on risperidone long-acting therapy (RLAT). Methods Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation (SOURCE) was a 24-month observational study designed to exami...
Nierenberg, AA; Ostacher, MJ; Calabrese, JR; Ketter, TA; Marangell, LB; Miklowitz, DJ; Miyahara, S.; Bauer, MS; Thase, ME; Wisniewski, SR; Sachs, GS
OBJECTIVE: Clinicians have few evidence-based options for the management of treatment-resistant bipolar depression. This study represents the first randomized trial of competing options for treatment-resistant bipolar depression and assesses the effectiveness and safety of antidepressant augmentation with lamotrigine, inositol, and risperidone. METHOD: Participants (N=66) were patients with bipolar I or bipolar II disorder enrolled in the NIMH Systematic Treatment Enhancement Program for Bipo...
Crespo-Facorro, Benedicto; Pérez-Iglesias, Rocío; Mata, Ignacio; Caseiro, Olalla; Martínez-Garcia, Obdulia; Pardo, Gema; Ramirez-Bonilla, Mariluz; Pelayo-Terán, Jose Maria; Vázquez-Barquero, José L
The effectiveness of antipsychotics in preventing relapses and attaining symptomatic remission is a relevant topic of psychopharmacological research. The purpose of the present study was to compare the relapse and symptomatic remission rates during the first year of treatment between low doses of haloperidol and SGAs (olanzapine and risperidone) in drug-naïve first-episode non-affective psychosis individuals. This is a prospective, randomized, open-label study conducted from February 2001 to February 2006. Data for the present investigation were obtained from a large epidemiologic and 3-year longitudinal intervention program of first-episode psychosis (DSM-IV criteria) conducted at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy four patients were randomly assigned to haloperidol (N = 56), olanzapine (N = 55), or risperidone (N = 63) and followed up for 1 year. Primary effectiveness measures were the time up to relapse and rates of relapse and symptomatic remission. There were no significant differences in the relapse rate between treatments (11.1% haloperidol; 18.5% olanzapine, and 13.8% risperidone) (?(2) = 1.230; p = 0.541) or in the time up to relapse (Log Rank ?(2) = 0.308; p = 0.857). The rates of relapse for adherent (11.2%) and non-adherent (26.9%) patients were significantly different (?(2) = 4.215; df = 1; p = 0.040). The remission rate did not differ significantly between treatment groups (?(2) = 2.760; p = 0.252) and adherence to medication did not seem to significantly influence remission rates. We conclude that haloperidol, olanzapine and risperidone show a similar effectiveness in relapse prevention or in remission attainment during the first year of treatment. PMID:21106207
Erba?ci, A B; Herken, H; Köylüoglu, O; Yilmaz, N; Tarakçioglu, M
Activation of the inflammatory response system and varied levels of cytokines in acute schizophrenia have been suggested by recent studies. Psychopharmacologic agents can differentially effect cytokine production, which suggests that therapeutic function of neuroleptics may involve immunomodulation. The present study was carried out to examine: (i) serum concentrations of interleukin (IL)-1beta, soluble interleukin-2 receptor (sIL-2R), IL-6, IL-8 and tumour necrosis factor (TNF)-alpha in schizophrenic patients; (ii) their relation with psychopathological assessment; and (iii) the relation of the initial cytokine levels with responsiveness to risperidone therapy. Thirty-four drug-free schizophrenic patients with acute exacerbation and 23 age- and gender-matched healthy controls were recruited for this study. Psychopathological assessments at admission and throughout risperidone treatment for 60 days were recorded. Serum cytokine concentrations were determined with chemilumunescence assays. According to our results, serum IL-1beta, sIL-2R, IL-6, IL-8 and TNF-alpha concentrations adjusted for age, gender, body mass index and smoking were no different in patients with schizophrenia and controls and among subtypes of schizophrenia. However, the initial TNF-alpha concentrations had a significant effect on Brief Psychiatric Rating Scale and Scale Assessment of Positive Symptoms scores. The initial cytokine concentrations of the patients responsive to risperidone were not significantly different from those of non-responsive patients. The present study demonstrates that plasma levels of IL-1beta, sIL-2R, IL-6, IL-8 and TNF-alpha adjusted for confounding factors are not altered in drug-free schizophrenic patients at acute exacerbation. We suggest that, if cytokine production is altered in schizophrenia, these alterations may not be detectable in systemic circulation. According to our results, the therapeutic effect of risperidone is not related to basal levels of the aforementioned cytokines. However, serum TNF-alpha may contribute to symptomatology in schizophrenia PMID:11545247
Estudio de biodisponibilidad comparativa de dos formulaciones de risperidona existentes en el mercado chileno A comparative bioavailability study of two formulations of risperidone available in the Chilean market
Leonardo E Gaete
Full Text Available Background: Bioavailability of a particular drug can vary according to the formulation used. Therefore, studies of comparative bioavailability of different formulations of a same drug are worthwhile. Aim: To compare the bioavailability of two risperidone formulations available in the Chilean market. Material and methods: The bioavailability of a local risperidone formulation (SpironÂ® was compared with the original formulation of the drug (RisperdalÂ® in 12 healthy volunteers, aged 19Â±1 years. A single dose of 3 mg was given orally, using a randomized double blind protocol in two periods. Fifteen blood samples were obtained at regular intervals, until 24 h after drug administration. Risperidone plasma levels were measured by high pressure liquid chromatography. Pharmacokinetic parameters were calculated using a computer program that is independent of compartmental analysis. Results: The area under the curve of plasma concentration versus time, from 0 to infinite (ABC0-â and from 0 to 24 h (ABC0-24, early exposure (ABC from 0 to maximal time and maximal plasma concentrations were significantly lower for SpironÂ®. Half life time and time to achieve the maximal concentration were similar for the two formulations. Conclusions: According to bioequivalence tests suggested by the Food and Drug Administration (FDA of the United States (90% confidence interval for the difference of log transformed mean pharmacokinetic parameters, the formulations RisperdalÂ® and SpironÂ®, cannot be considered interchangeable (Rev MÃ©d Chile 2003; 131: 527-34.
Estudio de biodisponibilidad comparativa de dos formulaciones de risperidona existentes en el mercado chileno / A comparative bioavailability study of two formulations of risperidone available in the Chilean market
Leonardo E, Gaete; Jaime, Solís G; Pablo, Venegas F; Mitzy J, Carrillo C; Oscar, Schatloff B; Iván, Saavedra S.
Full Text Available [...] Abstract in english Background: Bioavailability of a particular drug can vary according to the formulation used. Therefore, studies of comparative bioavailability of different formulations of a same drug are worthwhile. Aim: To compare the bioavailability of two risperidone formulations available in the Chilean market. [...] Material and methods: The bioavailability of a local risperidone formulation (Spiron®) was compared with the original formulation of the drug (Risperdal®) in 12 healthy volunteers, aged 19±1 years. A single dose of 3 mg was given orally, using a randomized double blind protocol in two periods. Fifteen blood samples were obtained at regular intervals, until 24 h after drug administration. Risperidone plasma levels were measured by high pressure liquid chromatography. Pharmacokinetic parameters were calculated using a computer program that is independent of compartmental analysis. Results: The area under the curve of plasma concentration versus time, from 0 to infinite (ABC0-?) and from 0 to 24 h (ABC0-24), early exposure (ABC from 0 to maximal time) and maximal plasma concentrations were significantly lower for Spiron®. Half life time and time to achieve the maximal concentration were similar for the two formulations. Conclusions: According to bioequivalence tests suggested by the Food and Drug Administration (FDA) of the United States (90% confidence interval for the difference of log transformed mean pharmacokinetic parameters), the formulations Risperdal® and Spiron®, cannot be considered interchangeable (Rev Méd Chile 2003; 131: 527-34).
Combined administration in a single injection of a feline multivalent modified live vaccine against FHV, FCV, and FPLV together with a recombinant FeLV vaccine is both safe and efficacious for all four major feline viral pathogens.
Kanellos, Theo; Sutton, David J; Salisbury, Claire F; Chalmers, William Stuart K
Nobivac Tricat, a lyophilised trivalent modified live attenuated vaccine is routinely used to protect cats against three commonly diagnosed feline viral pathogens namely herpesvirus, calicivirus and panleukopenia virus. The recognition of feline leukaemia virus (FeLV) as an important viral pathogen has prompted the development of an efficacious liquid recombinant subunit FeLV vaccine (p45 envelope protein). Lyophilised Tricat vaccine was dissolved in the liquid FeLV vaccine and no detectable deleterious effect on the titre of any of the live virus components was observed after 2h incubation. In vivo studies where the vaccines were mixed in the same syringe prior to inoculation showed no alteration to the safety profile assessed by repeat and overdose studies. Serological comparisons of the modified live viral antibody titres showed no evidence of reduced responses following administration of the mixed products. Challenge studies using pathogenic herpesvirus and FeLV revealed no difference in the degree of clinical protection. This paper shows that neither safety nor efficacy is adversely affected as a result of mixing the two vaccines. PMID:18448375
For over 40 years, antipsychotic drugs have been used as long-term maintenance treatment to control symptoms and reduce relapse rates in patients with schizophrenia. 'First-generation' oral agents such as haloperidol and chlorpromazine are associated with high levels of unwanted neurological effects and poor rates of patient adherence.1,2 Long-acting ('depot') injections of antipsychotics were developed to try to improve adherence. 'Second-generation' antipsychotic agents (also known as atypical antipsychotics) were introduced into clinical practice over 16 years ago. Although these agents have a lower propensity to cause extrapyramidal side effects, they are associated with a range of other unwanted effects (e.g. weight gain and its sequelae).1,3,4 Initially, second-generation agents were only available as orally administered medicines. Three long-acting injectable formulations of second-generation antipsychotics are now available in the UK: olanzapine embonate injection (ZypAdhera), paliperidone injection (Xeplion) and risperidone injection (Risperdal Consta). In this article we review the evidence for these agents and discuss the practical implications of their use. PMID:22966099
Krishnamurthy, Sairam; Garabadu, Debapriya; Reddy, Nagannathahalli Ranga; Joy, Keerikkattil P
The present investigation evaluates the anti-stress activity of risperidone (RIS) in the cold restraint stress (CRS) model and related stress pathways. Rats were pretreated with RIS (0.1 and 1.0 mg/kg) for 21 days before subjecting to CRS. Ultra low dose of RIS (ULD; 0.1 mg/kg) in contrast to higher dose (1.0 mg/kg) significantly reduced stress in terms of ulcer index. ULD also reversed stress-induced increase in plasma corticosterone and norepinephrine levels used as markers for the function of hypothalamo-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) respectively. ULD caused dose and brain region (hippocampus, prefrontal cortex and striatum) specific changes to stress-induced perturbations of serotonin, dopamine and its metabolites indicating modulation of brain monoaminergic system (BMS). ULD did not show any extrapyramidal side effects. Thus, the anti-stress effect ULD is probably mediated through the HPA axis, SNS and BMS. The study indicates a potential use of ULD in stress disorders. PMID:21660590
Zoccali, Rocco A; Bruno, Antonio; Muscatello, Maria Rosaria Anna
Sertindole is an atypical antipsychotic reintroduced into the European market in 2005 after a reevaluation of its risks and benefits, under the agreement that close electrocardiographic screening would be conducted. It has a high affinity for dopamine D2, serotonin 5-HT2A and 5-HT2C, and ?1 adrenergic receptors. Moreover, sertindole shows modest affinity for H1-histaminergic and muscarinic receptors. The pharmacological properties, clinical efficacy, safety, and tolerability of sertindole are covered in this article based on a literature review from 1990 to 2014. Given current available findings, sertindole is at least effective as haloperidol, risperidone, and olanzapine on schizophrenia symptoms. Regarding its efficacy on cognitive symptoms, sertindole effect is supported by both preclinical and clinical studies versus haloperidol and olanzapine; however, its role on cognition needs further clarification. Concerning safety and tolerability issues, sertindole is characterized by a low potential to cause sedation and extrapyramidal symptoms, and by an acceptable metabolic profile; nevertheless, cardiac safety remains a major concern, and the electrocardiographic monitoring should be carried out during treatment to substantially reduce cardiovascular risk. In conclusion, although it has an equivalent profile compared to other antipsychotic drugs, sertindole actually remains a second-line choice for schizophrenic patients intolerant to at least one other antipsychotic agent. PMID:25830594
Injection laryngoplasty is one of the treatment options for voice problems. In the recent years, more safe and more biocompatible injection materials are available on the market. Long and short term injection materials are discussed in this review.
Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to ... early in the treatment of certain serious infections. Penicillin G procaine injection is in a class of ...
Gräs, Søren; Klarskov, Niels; Lose, Gunnar
PURPOSE: Intraurethral injection of in vitro expanded autologous skeletal muscle derived cells is a new regenerative therapy for stress urinary incontinence. We examined the efficacy and safety of a simpler alternative strategy using freshly harvested, minced autologous skeletal muscle tissue with...... its inherent content of regenerative cells. MATERIALS AND METHODS: A total of 20 and 15 women with uncomplicated and complicated stress urinary incontinence, respectively, received intraurethral injections of minced autologous skeletal muscle tissue and were followed for 1 year. Efficacy was assessed...... events were noted. CONCLUSIONS: Intraurethral injection of minced autologous muscle tissue is a simple surgical procedure that appears safe and moderately effective in women with uncomplicated stress urinary incontinence. It compares well to a more complicated regenerative strategy using in vitro...
Price, M C; Hoffman, D W
This laboratory developed a simple and efficient solid-phase extraction method that is combined with high-performance liquid chromatography for rapid and precise therapeutic monitoring of risperidone (Risperdal) in blood concentrations. The solid-phase extraction uses a mixed bed column. Sensitivity of the chromatographic method is 0.5 ng/ml (180 pmol/ml) of drug in serum, and separations can be performed in a 15-minute chromatographic run. Advantages of this approach include enhanced speed, sensitivity, and efficiency. A high level of sensitivity may be achieved because of the absence of interference from other drugs, metabolites, or serum components. PMID:9200776
Sipuleucel-T injection is used to treat certain types of advanced prostate cancer. Sipuleucel-T injection is in a class of medications called ... Sipuleucel-T injection comes as a suspension (liquid) to be injected over about 60 minutes into a vein by ...
Nurmi, E L; Spilman, S L; Whelan, F; Scahill, L L; Aman, M G; McDougle, C J; Arnold, L E; Handen, B; Johnson, C; Sukhodolsky, D G; Posey, D J; Lecavalier, L; Stigler, K A; Ritz, L; Tierney, E; Vitiello, B; McCracken, J T
Second-generation antipsychotic exposure, in both children and adults, carries significant risk for excessive weight gain that varies widely across individuals. We queried common variation in key energy balance genes (FTO, MC4R, LEP, CNR1, FAAH) for their association with weight gain during the initial 8 weeks in the two NIMH Research Units on Pediatric Psychopharmacology Autism Network trials (N=225) of risperidone for treatment of irritability in children/adolescents aged 4-17 years with autism spectrum disorders. Variants in the cannabinoid receptor (CNR)-1 promoter (P=1.0 × 10(-6)), CNR1 (P=9.6 × 10(-5)) and the leptin (LEP) promoter (P=1.4 × 10(-4)) conferred robust-independent risks for weight gain. A model combining these three variants was highly significant (P=1.3 × 10(-9)) with a 0.85 effect size between lowest and highest risk groups. All results survived correction for multiple testing and were not dependent on dose, plasma level or ethnicity. We found no evidence for association with a reported functional variant in the endocannabinoid metabolic enzyme, fatty acid amide hydrolase, whereas body mass index-associated single-nucleotide polymorphisms in FTO and MC4R showed only trend associations. These data suggest a substantial genetic contribution of common variants in energy balance regulatory genes to individual antipsychotic-associated weight gain in children and adolescents, which supersedes findings from prior adult studies. The effects are robust enough to be detected after only 8 weeks and are more prominent in this largely treatment naive population. This study highlights compelling directions for further exploration of the pharmacogenetic basis of this concerning multifactorial adverse event. PMID:23799528
S. Nasreen, M. R. Khan, S. Peerzada and S. A. Andrabia
A study of comparative efficacy of six different commercial anthelmintic formulations against natural helminth infestations in sheep was conducted. Pre and post-treatment EPG (eggs per gram) values were recorded and efficacies compared. Results showed that a combination of Ivermectin and Clorsulon in injectable form gave the overall highest curative rate against the parasites studied.
San, Luis; Arranz, Belen; Perez, Victor; Safont, Gemma; Corripio, Iluminada; Ramirez, Nicolas; Dueñas, Rosa; Alvarez, Enric
The aim of this study was to compare the 12-month effectiveness of several second-generation antipsychotic drugs, with that of haloperidol in never-treated patients with first-episode psychosis. In total, 114 patients without life time exposure to any psychotropic medication were randomized to haloperidol, olanzapine, risperidone, quetiapine or ziprasidone. Primary outcome was time to all-cause discontinuation. Secondary outcomes included discontinuation rates and symptom change as measured by the Positive and Negative Syndrome Scale (PANSS). The overall discontinuation rate 64%. At 12 months, the proportion of patients discontinuing treatment was 40.0% for olanzapine, 56.5% for quetiapine, 64.0% for risperidone, 80.0% for ziprasidone and 85.7% for haloperidol. Mean time to antipsychotic discontinuation was higher in patients randomized to second-generation antipsychotics than in those taking haloperidol. Significantly lower discontinuation was noted in patients on olanzapine than on haloperidol, or ziprasidone. Our results suggest that olanzapine might lead to longer treatment continuation in treatment naïve FEP patients than haloperidol and, possibly ziprasidone. Global psychopathology was significantly less reduced by haloperidol than with each individual SGA in this earliest phase of treatment. PMID:22954905
Su, Zheng-Xing; Shi, Ya-Nan; Teng, Le-Sheng; Li, Xiang; Wang, Le-xi; Meng, Qing-Fan; Teng, Li-Rong; Li, You-Xin
The preparation and investigation of sustained-release risperidone-encapsulated microspheres using erodible poly(D, L-lactide-co-glycolide) (PLGA) of lower molecular weight were performed and compared to that of commercial Risperdal Consta for the treatment of schizophrenia. The research included screening and optimizing of suitable commercial polymers of lower molecular weight PLGA50/50 or the blends of these PLGA polymers to prepare microspheres with zero-order release kinetics properties. Solvent evaporation method was applied here while studies of the risperidone loaded microsphere were carried out on its drug encapsulation capacity, morphology, particle size, as well as in vitro release profiles. Results showed that microspheres prepared using 50504A PLGA or blends of 5050-type PLGAs exerted spherical and smooth morphology, with a higher encapsulation efficiency and nearly zero-order release kinetics. These optimized microspheres showed great potential for a better depot preparation than the marketed Risperdal Consta, which could further improve the patient compliance. PMID:20370594
Alvaro, Cavieres F.
Full Text Available La hiperprolactinemia y las disfunciones sexuales son complicaciones frecuentes, pero poco estudiadas del tratamiento con risperidona. Objetivos: Determinar la prevalencia de hiperprolactinemia y disfunciones sexuales en un grupo de personas jóvenes con esquizofrenia, tratadas con risperidona. Métod [...] os: Un total de 40 pacientes (19 mujeres, edad promedio: 27 años) completaron el Cuestionario de Funcionamiento Sexual del Hospital General de Massachussets y el Cuestionario sobre Calidad de Vida: Satisfacción y Placer. Todos los pacientes fueron evaluados con las escalas PANSS y UKU y se determinó su nivel plasmático de prolactina. Resultados: El 90% de los pacientes presenta hiperprolactinemia, con valores significativamente más altos para las mujeres. El 62,5% de los pacientes, informó padecer alguna disfunción sexual, sin diferencias con la contraparte no afectada, en cuanto a género, edad ni tiempo de tratamiento. Aunque no se encontró relación con la prolactinemia, ni con la dosis de risperidona, quienes reportaron alguna disfunción sexual obtuvieron mayores puntajes de efectos adversos psíquicos y neurológicos en la escala UKU. Las disfunciones sexuales se asociaron con los síntomas negativos y generales de la PANSS y con menores puntajes en las subescalas de salud física y ánimo del Cuestionario sobre Calidad de Vida: Satisfacción y Placer. Conclusiones: Los resultados confirman la elevada frecuencia de disfunciones sexuales e hiperprolactinemia en las personas enfermas de esquizofrenia. Nuevos estudios se requieren para clarificar, en la práctica clínica habitual, la asociación entre disfunción sexual y el empleo de la risperidona, y su impacto en la calidad de vida de los pacientes. Abstract in english Hyperprolactinemia and Sexual dysfunction arefrequent, yetseldom studied, complications of the use of risperidone Objectives: To determine the prevalence and clinical correlates of sexual dysfunctions and hyperprolactinemia in a sample of youngpeople with schizophrenia treated with risperidone Metho [...] ds: 40 outpatients (19females; mean age: 27years) with schizophrenia treated with risperidone, participated in the study Sexual dysfunction and quality oflife were assessed with the Massachusetts General Hospital Sexual Functioning Questionnaire (MGH-SFQ) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), respectively Allpatients were evaluated with the Positive and Negative Syndrome Scale and the UKU side effect rating scale. Blood samples were analyzed for prolactine. Results: Hyperprolactinemia was found in 90% ofpatients, with levéis significantly higher in women. Sexual dysfunctions occurred in 25 (62.5%) patients. Patients with and without sexual dysfunction, did not significantly differ in gender, age or years of treatment. Although no association was found with prolactinemia or the dose of risperidone, patients with sexual dysfunction reported more psychic and neurologic side effects, and had higher scores in the negative symptoms and general psychopatology subscales ofthe PANSS and lower scores in the physical health and mood items of the Q-LES-Q. Conclusions: Results confirm the high prevalence of hyperprolactinemia and sexual dysfunctions in people with schizophrenia. Further study is warranted in order to clarify the association between sexual dysfunction and risperidone treatment in clinical practice and its impact in the quality oflife ofthe patients.
Calcitonin salmon injection is used to treat osteoporosis in postmenopausal women. Osteoporosis is a disease that causes bones to weaken and break more easily. Calcitonin salmon injection is also used to treat Paget's disease ...
Intracytoplasmic sperm injection, or ICSI, is a form of in vitro fertilization in which fertilization occurs outside of the ... laboratory dish. Within a few hours, a single sperm is injected through a fine needle into the ...
Sodium ferric gluconate injection is used to treat iron-deficiency anemia (a lower than normal number of ... are also receiving the medication epoetin (Epogen, Procrit). Sodium ferric gluconate injection is in a class of ...
Iron dextran injection is used to treat iron-deficiency anemia (a lower than normal number of red blood ... be treated with iron supplements taken by mouth. Iron dextran injection is in a class of medications called ...
... any other iron injection such as ferumoxytol (Feraheme), iron dextran (Dexferrum, Infed, Proferdex), or sodium ferric gluconate (Ferrlecit); any other medications; or any of the ingredients in iron sucrose injection. Ask your pharmacist for a list ...
Aminocaproic acid injection is used to control bleeding that occurs when blood clots are broken down too quickly. This ... the baby is ready to be born). Aminocaproic acid injection is also used to control bleeding in ...
Deoxycholic acid injection is used to improve the appearance and profile of moderate to severe submental fat ('double chin'; fatty tissue located under the chin). Deoxycholic acid injection is in a class of medications called ...
Background information is provided on the geothermal brine injection problem and each of the project tasks is outlined in detail. These tasks are: evaluation of methods of monitoring the movement of injected fluid, preparation for an eventual field experiment, and a review of groundwater regulations and injection programs. (MHR)
Srivastava P; Bajaj A
Background: Warts are caused by various strains of Human Papilloma Virus. They involve the epithelium of the skin and mucus membrane. Various treatment options are available, but extensive and recalcitrant warts not only cause distress to the patient cosmetically and psychologically but also pose a therapeutic challenge to the treating dermatologist. Aim: To evaluate the efficacy of autowart injection as a treatment option for extensive and recalcitrant warts. Materials and Methods: Autowart ...
Rauch, Anna-Sophia; Fleischhacker, W Wolfgang
Antipsychotics are the mainstay of the long-term treatment of patients with schizophrenia. In this context, the evidence also supports the effectiveness of long-acting injections (LAIs) or depots of antipsychotics regarding their relapse-preventing properties. When a LAI formulation of risperidone was launched as the first second-generation depot, there was a renaissance of interest in these formulations. In the meantime, olanzapine, paliperidone, and aripiprazole have been approved by regulatory authorities as LAIs in various countries. All studies using the new-generation depots have shown a clear advantage over placebo regarding relapse prevention and symptom reduction. Safety profiles of the long-acting compounds are comparable to their oral formulations with the exception of olanzapine pamoate injections, which can sometimes lead to a post-injection delirium. Despite the fact that many treatment guidelines recommend LAI antipsychotics as an important treatment option for the long-term management of schizophrenia, they are still most frequently used in chronically ill patients with considerable compliance problems. It is imperative to overcome this indication bias in order to be able to utilize all available treatment options in the long-term management of schizophrenia. There is little evidence on comparisons between LAIs and their oral mother compounds, and even less concerning effectiveness comparisons between different depots. The purpose of this manuscript is to review the recent clinical evidence on new-generation depot antipsychotics. PMID:23780619
Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R
This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks. PMID:24694328
Full Text Available Onabotulinumtoxin A (BoNTA has been reported to be effective in the therapy for migraines. Acupuncture has been used worldwide for the treatment of migraine attacks. Injection of a small amount of drug at acupuncture points is an innovation as compared to traditional acupuncture. The purpose of this study was to evaluate and compare the effectiveness of fixed (muscle-site and acupoint-site injections of BoNTA for migraine therapy in a randomized, double-blinded, placebo-controlled clinical trial extending over four months. Subjects with both episodic and chronic migraines respectively received a placebo (n = 19 or BoNTA (2.5 U each site, 25 U per subject injection at fixed-sites (n = 41 including occipitofrontalis, corrugator supercilii, temporalis and trapeziue, or at acupoint-sites (n = 42 including Yintang (EX-HN3, Taiyang (EX-HN5, Baihui (GV20, Shuaigu (GB8, Fengchi (GB20 and Tianzhu (BL10. The variations between baseline and BoNTA post-injection for four months were calculated monthly as outcome measures. BoNTA injections at fixed-sites and acupoint-sites significantly reduced the migraine attack frequency, intensity, duration and associated symptoms for four months compared with placebo (p < 0.01. The efficacy of BoNTA for migraines in the acupoint-site group (93% improvement was more significant than that in the fixed-site group (85% improvement (p < 0.01. BoNTA administration for migraines is effective, and at acupoint-sites shows more efficacy than at fixed-sites. Further blinded studies are necessary to establish the efficacy of a low dose toxin (25 U introduced with this methodology in chronic and episodic migraines.
This paper presents ten turn horizontal injection in CRYRING. Computer simulations and the design of the injection section will be presented. The efficiency calculations are made with a Monte-Carlo method where the injected ions are Gaussian distributed. The injection efficiency will be about 85%. The losses depend mainly on the large dispersion, 1.6 m. In order not to exceed the space charge limit the vertical emittance might have to be enlarged. The closed orbit will be shifted locally at the injection section with electrostatic kickers
Avaliação da eficácia do antiveneno botrópico administrado no local da inoculação intramuscular do veneno de Bothrops jararaca: estudo experimental em camundongos Assessment of the efficacy of antivenom injection at the site of the intramuscular inoculation of Bothrops jararaca venom in mice
Carla Lilian Agostini Utescher
Full Text Available Foi determinada, em camundongos de 18 a 20 g, a dose efetiva 50% do antiveneno botrópico, por via intraperitoneal (ip, imediatamente (DE50 Oh e 30 minutos (DE50 30' após a inoculação de 2 DL50 do veneno de B. jararaca, por via intramuscular (im. A DE50 30' foi três vezes maior do que a DE50 Oh. A eficácia do antiveneno administrado no local da inoculação do veneno foi avaliada inoculando-se duas DL50 do veneno, por via im, e administrando-se a DE50 do antiveneno imediatamente (DE50 Oh e 30 minutos após (DE50 30', de duas formas a saber: totalmente por via ip (1ª e metade por via ip e metade por via im (2ª, no mesmo local da inoculação do veneno. O antiveneno ofereceu, por via ip, maior proteção aos camundongos (menor taxa de óbito em 48 horas do que quando metade do mesmo foi administrado, por via im, no local da inoculação do veneno. Conclui-se que, neste modelo experimental, quando se inicia o tratamento tardiamente há necessidade de maior dose de antiveneno botrópico e que não há benefício em administrá-lo no local da picada.The 50% effective intraperitoneal (ip dose of Bothrops jararaca antivenom (ED50 was assessed in mice immediately (ED50 Oh and thirty minutes (ED50 30' after the intramuscular (im injection of two 50% lethal dose (LD50 of Bothrops jararaca venom. The efficacy of the antivenom injected at the venom inoculation site was assessed by the inoculation of two LD50 of the venom by im route, followed immediately (ED50 Oh and 30 minutes later (ED50 30' by administration of the ED50 of the antivenom either entirely by the ip route or 50 percent ip plus 50 percent im, at the same inoculation site. It was shown that the ED50 30' was 3 times greater, than the ED50 Oh and that the antivenom was more protective to mice (lower death rate in 48 hours when given entirely ip. It was concluded that, in this experimental model, a higher dose of bothropic antivenom is needed when the treatment is started lately, and that there is no benefit in its administration at the venom inoculation site.
Doshi, Jalpa A; Pettit, Amy R; Stoddard, Jeffrey J; Zummo, Jacqueline; Marcus, Steven C
Pharmacological treatment is central to effective management of schizophrenia. Prescribing clinicians have an increasing array of options from which to choose, and oral antipsychotic polypharmacy is common in routine clinical practice. Practice guidelines recommend long-acting injectable (LAI) formulations, typically viewed as monotherapeutic alternatives, for patients with established nonadherence. Yet there are limited data on the prevalence and nature of concurrent oral antipsychotic prescriptions in patients receiving LAIs. Our observational, claims-based study examined the frequency and duration of concurrent oral prescriptions in 340 Medicaid patients receiving LAI therapy. Specifically, we examined patients with a recent history of nonadherence and hospitalization for schizophrenia and included both first-generation antipsychotic depot medications (fluphenazine decanoate, haloperidol decanoate) and more recently available second-generation injectables (LAI risperidone, paliperidone palmitate). Of all patients initiated on LAIs, 75.9% had a concurrent oral antipsychotic prescription in the 6 months post-hospital discharge. Patients receiving concurrent prescriptions were frequently prescribed an oral formulation of their LAI agent, but many first-generation LAI users received a concurrent second-generation oral medication. The lowest rate of concurrent prescribing (58.8%) was found with paliperidone palmitate, whereas the highest rate was with LAI risperidone (88.9%). Overlap in oral and LAI prescriptions typically occurred for a substantial period of time (ie, >30 days) and for a notable percentage of the days covered by LAIs (often 50% or more). Our findings highlight the need to further examine such prescribing patterns, to probe the reasons for them, and to clarify the optimal roles of different antipsychotic treatments in clinical practice. PMID:26075492
Sung, Mi Sook [The Catholic University of Korea, Pucheon (Korea, Republic of)
Low back pain combined with radicular pain remains as one of the most challenging musculoskeletal problems for its therapeutic management. This malady results from nerve root impingement and/or inflammation that causes neurologic symptoms in the distribution of the affected nerve root(s) Conservative treatment, percutaneous spine interventions and surgery have all been used as treatment; and the particular treatment that's chosen depends on the severity of the clinical and neurologic presentation. In 1930, Evans reported that sciatica could treated by epidural injection. The use of epidural corticosteroid injections for the treatment of axial and radicular back pain was first reported in 1953. Epidural steroid injections are currently used by many medical professionals for the treatment of lumbosacral radiculopathy. Performing 'blind' epidural steroid injection lacks target specificity that often results in incorrect delivery of medication to the lesion. Imaging-guided steroid injections are now becoming more popular despite the controversy regarding their efficacy. Many reports, including a few randomized controlled trials, have documented the clinical utility of epidural steroid injections.
Low back pain combined with radicular pain remains as one of the most challenging musculoskeletal problems for its therapeutic management. This malady results from nerve root impingement and/or inflammation that causes neurologic symptoms in the distribution of the affected nerve root(s) Conservative treatment, percutaneous spine interventions and surgery have all been used as treatment; and the particular treatment that's chosen depends on the severity of the clinical and neurologic presentation. In 1930, Evans reported that sciatica could treated by epidural injection. The use of epidural corticosteroid injections for the treatment of axial and radicular back pain was first reported in 1953. Epidural steroid injections are currently used by many medical professionals for the treatment of lumbosacral radiculopathy. Performing 'blind' epidural steroid injection lacks target specificity that often results in incorrect delivery of medication to the lesion. Imaging-guided steroid injections are now becoming more popular despite the controversy regarding their efficacy. Many reports, including a few randomized controlled trials, have documented the clinical utility of epidural steroid injections
In a method of injecting pellets at a high speed by supplying a high temperature/high pressure gas present in a reservoir tank to the back of the pellet in an injection pipe to cause shock waves, the gas is supplied from a plurality of reservoir tanks into one injection pipe by way of injection valves simultaneously or at different timings. When a pellet of a high strength is injected, each of the injection valves are opened simultaneously to supply high temperature/high pressure gas at the same time to cause great shock waves, and pellets are injected at a great acceleration. Higher temperature/higher pressure gas can be generated without using a large-scaled high temperature/high pressure gas generation facility. When pellets of low strength are injected, each of the injection valves is succeedingly opened at a predetermined timing to successively supply on every short period of time. Then, relatively small shock waves are generated one by one to inject pellets at substantially constant acceleration. As a result, pellets can be accelerated to high speed while keeping the integrity. (N.H.)
Melissa Guarieiro Ramos
Full Text Available OBJETIVO: O emprego de antipsicóticos atípicos (AA no tratamento de sintomas psicológicos e comportamentais das demências (SPCD tem sido alvo de discussão em relação à eficácia e à segurança. O objetivo deste artigo é propiciar atualização sobre o tema. MÉTODOS: Revisão da literatura publicada nos últimos dez anos com ênfase em metanálises e ensaios clínicos randomizados (ECR controlados com placebo. RESULTADOS: Três metanálises e nove ensaios clínicos foram analisados. Há evidências de eficácia clínica para risperidona (1mg/dia, olanzapina (5 a 10mg/dia e aripiprazol (2 a 15mg/dia no tratamento de agressividade e/ou SPCD em geral, e para risperidona (1mg/dia no tratamento de sintomas psicóticos associados à demência. Os eventos adversos comuns com o uso de AA foram sonolência, sintomas extrapiramidais (SEP, incontinência ou infecção do trato urinário e alterações de marcha. O tratamento com AA associou-se a maior risco de eventos cerebrovasculares e de mortalidade em idosos com demência. CONCLUSÃO: Baixas dosagens de risperidona, olanzapina e aripiprazol são eficazes na redução de agressividade e/ou SPCD globais; risperidona é eficaz na redução de sintomas psicóticos associados à demência. Em virtude de esses tratamentos associarem-se a pequeno aumento no risco de eventos cerebrovasculares e mortalidade, seu uso deve ser reservado para sintomatologia moderada/grave.OBJECTIVE: Concerns have been raised about efficacy and adverse events of atypical antipsychotics in the treatment of behavioural and psychological symptoms of dementia (BPSD. This paper is an update on current evidence of this theme. METHODS: Review of published meta-analysis and randomized placebo-controlled trials (RCTs in the last ten years. RESULTS: Three meta-analysis and nine RCTs were evaluated. Evidence suggests that risperidone (1mg/day, olanzapine (5 to 10mg/day, and aripiprazole (2 to 15mg/day are effective in treating aggression and/or BPSD overall; risperidone (1mg/day reduces psychosis. Adverse events were mainly somnolence, extrapyramidal symptoms, urinary tract infection or incontinence, and abnormal gait with drug treatment. Atypical antipsychotics were associated with increased risk for cerebrovascular adverse events and mortality in elderly patients with dementia. CONCLUSION: Low doses of risperidone, olanzapine, and aripiprazole are effective in treating aggression and/or BPSD overall, and risperidone reduces psychosis associated with dementia. In view of the increased risk of cerebrovascular adverse events and mortality, the use of atypical antipsychotics in individuals with dementia should be reserved for patients with moderate/severe behavioural symptoms.
Melissa Guarieiro, Ramos; Fábio Lopes, Rocha.
Full Text Available OBJETIVO: O emprego de antipsicóticos atípicos (AA) no tratamento de sintomas psicológicos e comportamentais das demências (SPCD) tem sido alvo de discussão em relação à eficácia e à segurança. O objetivo deste artigo é propiciar atualização sobre o tema. MÉTODOS: Revisão da literatura publicada nos [...] últimos dez anos com ênfase em metanálises e ensaios clínicos randomizados (ECR) controlados com placebo. RESULTADOS: Três metanálises e nove ensaios clínicos foram analisados. Há evidências de eficácia clínica para risperidona (1mg/dia), olanzapina (5 a 10mg/dia) e aripiprazol (2 a 15mg/dia) no tratamento de agressividade e/ou SPCD em geral, e para risperidona (1mg/dia) no tratamento de sintomas psicóticos associados à demência. Os eventos adversos comuns com o uso de AA foram sonolência, sintomas extrapiramidais (SEP), incontinência ou infecção do trato urinário e alterações de marcha. O tratamento com AA associou-se a maior risco de eventos cerebrovasculares e de mortalidade em idosos com demência. CONCLUSÃO: Baixas dosagens de risperidona, olanzapina e aripiprazol são eficazes na redução de agressividade e/ou SPCD globais; risperidona é eficaz na redução de sintomas psicóticos associados à demência. Em virtude de esses tratamentos associarem-se a pequeno aumento no risco de eventos cerebrovasculares e mortalidade, seu uso deve ser reservado para sintomatologia moderada/grave. Abstract in english OBJECTIVE: Concerns have been raised about efficacy and adverse events of atypical antipsychotics in the treatment of behavioural and psychological symptoms of dementia (BPSD). This paper is an update on current evidence of this theme. METHODS: Review of published meta-analysis and randomized placeb [...] o-controlled trials (RCTs) in the last ten years. RESULTS: Three meta-analysis and nine RCTs were evaluated. Evidence suggests that risperidone (1mg/day), olanzapine (5 to 10mg/day), and aripiprazole (2 to 15mg/day) are effective in treating aggression and/or BPSD overall; risperidone (1mg/day) reduces psychosis. Adverse events were mainly somnolence, extrapyramidal symptoms, urinary tract infection or incontinence, and abnormal gait with drug treatment. Atypical antipsychotics were associated with increased risk for cerebrovascular adverse events and mortality in elderly patients with dementia. CONCLUSION: Low doses of risperidone, olanzapine, and aripiprazole are effective in treating aggression and/or BPSD overall, and risperidone reduces psychosis associated with dementia. In view of the increased risk of cerebrovascular adverse events and mortality, the use of atypical antipsychotics in individuals with dementia should be reserved for patients with moderate/severe behavioural symptoms.
ESI; Spinal injection for back pain; Back pain injection; Steroid injection - epidural; Steroid injection - back ... procedure does not cure the cause of your back pain. You will need to continue back exercises and ...
Full Text Available Sleep disturbances including nightmares are often reported as hallmark of posttraumatic stress disorder (PTSD. The literature related to the pharmacological treatment of PTSD-related nightmares is sparse and inconclusive. After reviewing the literature it was obvious that currently a limited data on studies supporting the use of antipsychotic medications for the treatment of PTSD are published. Moreover, even more limited scientific evidence is now available to formulate evidence-based guidelines for the treatment of PTSD-related nightmares which are often reported as the most intrusive and disruptive symptom. Objective for this study is to review comprehensively the current research literature which reflects use of antipsychotic medication risperidone for the treatment of PTSD-related nightmares of different etiology.
Sørensen, Mette Møller; Lundby, L; Buntzen, S; Laurberg, S
INTRODUCTION: The aim of this study was to evaluate the functional efficacy of intersphincteric injected silicone biomaterial (PTQ) in patients with faecal incontinence. METHOD: Prospective study of 33 consecutively included patients (male-female ratio: 9:24); median age 53 years (range: 21-75 years) with faecal incontinence of varied aetiology. The PTQ was injected under general anaesthesia with antibiotic cover. All patients had anorectal manometry, endoanal ultrasonography and responded to fa...
... ISD repair; Injectable bulking agents for stress urinary incontinence ... JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...
Injection laryngoplasty; Botox-larynx: spasmodic dysphonia-BTX; Essential voice tremor (EVT)-btx; Glottic insufficiency; Percutaneous electromyography-guided botulinum toxin treatment; Percutaneous ...
Based on interviews with experts in the petroleum and natural gas exploration industry and results of a workshop insight is given into the attitudes, opinions and perceptions on the possibility to store wastes from the exploration activities in the deep underground, e.g. by means of injection. In a separate report a comparison is made on injection and other waste processing options
In a solid hydrogen pellet injection device, a thermal insulation space of low thermal conductivity is disposed between a portion for receiving heat from an acceleration gas and a cryogenic temperature portion, to prevent the heat of the acceleration gas that intrudes to an inner pipe from intruding to an outer pipe and the cryogenic temperature portion. Further, also in a pellet injection pipe, heat received by a punched pipe is prevented from introducing to the pellet injection pipe and the cryogenic temperature portion by disposing a thermal insulation gap between the punched pipe and the injection pipe. With such a constitution, intrusion of the heat of the acceleration gas to a solid hydrogen generation portion can be suppressed to prevent melting of solid hydrogen during pellet injection, thereby enabling to conduct repeating pellet injection for several hundreds to thousand times required for a practical reactor. Further, since the total amount of gas released necessary for the injection can be increased, injection at a higher speed can be attained. In addition, since small pellets can be supplied to the reactor at a high frequency, plasma density can be controlled stably. (N.H.)
M. Dehghani, M.D.
Full Text Available Background and purpose: Tennis elbow is a common complaint. Several treatment strategies, such as corticosteroid injections and physical terapy and braces have been described with no predictable efficacy. The purpose of this study was to evaluate prospectively the result of refractory lateral epicondylitis with autologus blood injections.Materials and Methods: Twenty two patients with lateral epicondylitis were injected with 2 mL of autologous blood under the extensor carpi radialis brevis. All patients had failed the two previous non surgical treatments including all or combination of physical therapy, splintinge, non steroidal anti-inflammatory medication and prior steroid injection. The patients were evaluated with patient-rated Tennis Elbow Evaluation (PRTEE.Results: The average fallow-up period was 7.3 months (range, 4-10mo. After autologus blood injection, the average pain score decreased from 43.7 to 9.1 (P-value < 0.001. The average functional score decreased from 42.4 to 10.1 (P-value <0.001.Conclusion: On the basis of this study, this minimally invasive treatment advocates refractory Tennis elbow.
Nada M. Al Thani
Full Text Available In this paper we generalize the notion of pure injectivity of modules by introducing what we call a pure Baer injective module. Some properties and some characterization of such modules are established. We also introduce two notions closely related to pure Baer injectivity; namely, the notions of a Ã¢ÂÂ-pure Baer injective module and that of SSBI-ring. A ring R is an SSBI-ring if and only if every smisimple R-module is pure Baer injective. To investigate such algebraic structures we had to define what we call p-essential extension modules, pure relative complement submodules, left pure hereditary rings and some other related notions. The basic properties of these concepts and their interrelationships are explored, and are further related to the notions of pure split modules.
Brooks Peter; Connelly Luke B; Bisset Leanne; Coombes Brooke K; Vicenzino Bill
Abstract Background Corticosteroid injection and physiotherapy are two commonly prescribed interventions for management of lateral epicondylalgia. Corticosteroid injections are the most clinically efficacious in the short term but are associated with high recurrence rates and delayed recovery, while physiotherapy is similar to injections at 6 weeks but with significantly lower recurrence rates. Whilst practitioners frequently recommend combining physiotherapy and injection to overcome harmful...
Chou, Yuan Hwa; Chu, Po-Chung; Wu, Szu-Wei; Lee, Jen-Chin; Lee, Yi-Hsuan; Sun, I-Wen; Chang, Chen-Lin; Huang, Chien-Liang; Liu, I-Chao; Tsai, Chia-Fen; Yen, Yung-Chieh
Bipolar disorder (BD) is a major psychiatric disorder that is easily misdiagnosed. Patient adherence to a treatment regimen is of utmost importance for successful outcomes in BD. Several trials of antipsychotics suggested that depot antipsychotics, including long-acting first- and second-generation agents, are effective in preventing non-adherence, partial adherence, and in reducing relapse in BD. Various long-acting injectable (LAI) antipsychotics are available, including fluphenazine decanoate, haloperidol decanoate, olanzapine pamoate, risperidone microspheres, paliperidone palmitate, and aripiprazole monohydrate. Due to the increasing number of BD patients receiving LAI antipsychotics, treatment guidelines have been developed. However, the clinical applicability of LAI antipsychotics remains a global cause for concern, particularly in Asian countries. Expert physicians from Taiwan participated in a consensus meeting, which was held to review key areas based on both current literature and clinical practice. The purpose of this meeting was to generate a practical and implementable set of recommendations for LAI antipsychotic use to treat BD; target patient groups, dosage, administration, and adverse effects were considered. Experts recommended using LAI antipsychotics in patients with schizophrenia, rapid cycling BD, BD I, and bipolar-type schizoaffective disorder. LAI antipsychotic use was recommended in BD patients with the following characteristics: multiple episodes and low adherence; seldom yet serious episodes; low adherence potential per a physicians clinical judgment; preference for injectable agents over oral agents; and multiple oral agent users still experiencing residual symptoms. PMID:26243837
Hansen, Elo Harald
, where the system is stationary while the solution moves through a set of conduits in which all required manipulations are performed. Emphasis is placed on flow injection analysis (FIA) and its further developments, that is, sequential injection analysis (SIA) and the Lab-on-Valve (LOV) approach. Since...... FIA is based on the creation of a concentration gradient of the injected sample solution and on reproducible and precise timing of all events, it allows exploitation of a transient read-out. This in turn implies that not only does FIA allow the augmentation of existing analytical techniques, but it...
Testing and monitoring of emulsified zero-valent ironTM (EZVI) injections was conducted at Cape Canaveral Air Force Stations Launch Complex 34, FL, in 2002 to 2005 to evaluate the technologys efficacy in enhancing in situ dehalogenation of dense nonaqueous-phase liquid (DNAPL) ...
SÃ¸rensen, Mette MÃ¸ller; Lundby, L; Buntzen, S; Laurberg, S
INTRODUCTION: The aim of this study was to evaluate the functional efficacy of intersphincteric injected silicone biomaterial (PTQ) in patients with faecal incontinence. METHOD: Prospective study of 33 consecutively included patients (male-female ratio: 9:24); median age 53 years (range: 21...
Ali Osman Saatci; Aylin Yaman; Melih Parlak; Oya Donmez
In this brief report, we share our observations on a splitted Dexamethasone implant (Ozurdex) which we discovered a week after the injection. It is likely that implant splitting neither changes the efficacy of the implant nor creates a mishap for the patient.
... by bacteria, including infections of the skin, female reproductive organs, and abdomen (area between the chest and ... using ampicillin and sulbactam injection. If you are diabetic, use Clinistix or TesTape (not Clinitest) to test ...
To give an insulin injection, you need to fill the right syringe with the right amount of medicine, decide where to give the ... of each medicine to give. The type of insulin should match the type of syringe: U-100 ...
Kim, Dae-Hyeong; Lee, Youngsik
The delivery of flexible electronic scaffolds to precise locations in biological tissues or cavities is achieved by injecting them via a syringe needle with a diameter much smaller than the size of the scaffold.
... drug will be either injected into a large muscle (such as your buttock or hip) or added ... lung or thyroid disease, heart disease, seizures, prostatic hypertrophy, or urinary problems.tell your doctor if you ...
... drug will be either injected into a large muscle (such as your buttock or hip) or added ... alcoholism, lung or thyroid disease, heart disease, prostatic hypertrophy, or lung or urinary problems.tell your doctor ...
Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik
We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used in an injection moulding process, to fabricate the antireflective surfaces. The cycle-time was 35 s. The injection moulded structures had a height of 125 nm, and the visible spectrum reflectance of injection moulded black polypropylene surfaces was reduced from 4.5±0.5% to 2.5±0.5%. The gradient of the refractive index of the nanostructured surfaces was estimated from atomic force micrographs and the theoretical reflectance was calculated using the transfer matrix method and effective medium theory. The measured reflectance shows good agreement with the theory of graded index antireflective nanostructures. © 2014 Elsevier B.V. All rights reserved.
Rapolu Bharath Kumar and Zuheb Ur Rahman
Full Text Available Needle-free injection systems are novel ways to introduce various medicines into patients without piercing the skin with a conventional needle. Needle-free technology offers the very obvious benefit of reducing patient concern about the use of needle. Needle free injection gives very effective injections for a wide range of drugs and bioequivalent to syringe and needle, results in less pain, and is strongly preferred by patients. Additional benefits include very fast injection compared with conventional needles and no needle disposal issues. Not only it can benefit the pharmaceutical industry in increasing product sales, it has the added potential to increase compliance with dosage regimens and improved outcomes. Today, they are a steadily developing technology that promises to make the administration of medicine more efficient and less painful.
... injected into a large muscle (such as your buttock or hip); added to an intravenous fluid that ... as possible: tenderness warmth irritation drainage redness swelling pain ¶ These branded products are no longer on the ...
... injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid ... as possible: tenderness warmth irritation drainage redness swelling pain ¶ These branded products are no longer on the ...
... injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid ... as possible: tenderness warmth irritation drainage redness swelling pain ¶ These branded products are no longer on the ...
Yellowlees, Ann; Perry, Richard H J
Animal models are used to predict the effect of an intervention in humans. An example is the prediction of the efficacy of a vaccine when it is considered unethical or infeasible to challenge humans with the target disease to assess the effect of the vaccine on the disease in humans directly. In such cases, data from animal studies are used to develop models relating antibody level to protection probability in the animal, and then data from a study or studies in human subjects vaccinated with the proposed vaccine regimen are used in combination with the relevant animal models to predict protection in humans, and hence estimate vaccine efficacy. We explain the statistical techniques required to provide an estimate of vaccine efficacy and its precision. We present simulated examples showing that precise estimation of the relationship between antibody levels and protection in animals, at levels likely to be induced in humans by the vaccine regimen, is key to precise estimation of the vaccine efficacy. Because the confidence interval for the estimate of vaccine efficacy cannot be expressed in analytical form, but must be estimated from resampling, or bootstrapping, it is not possible to design studies with required power analytically. Therefore we propose that a simulation-based design of experiments approach using preliminary data is used to maximise the power of further studies and thus minimise the human and animal experimentation required. PMID:25818749
Bracco, C; Barnes, M J; Carlier, E; Drosdal, L N; Goddard, B; Kain, V; Meddahi, M; Mertens, V; Uythoven, J
Performance and failures of the LHC injection and ex- traction systems are presented. In particular, a comparison with the 2010 run, lessons learnt during operation with high intensity beams and foreseen upgrades are described. UFOs, vacuum and impedance problems related to the injection and extraction equipment are analysed together with possible improvements and solutions. New implemented features, diagnostics, critical issues of XPOC and IQC applications are addressed.
Injection facility Nuclotron is intended to inject into Nuclotron the beams of light and heavy ions with charge to mass ratio q/A?1/3 at the energy 5 MeV/nucleon and the protons at the energy 20 MeV. The basic upgrade directions of laser ion source of light elements and the source of heavy elements KRION, production of new source of polarized particles SPI, preaccelerator's reconstruction plans are described
SÃ¸rensen, H.; Andersen, P.; Andersen, S. A.; Andersen, Verner; Nielsen, Arne Nordskov; Sass, Bjarne Ove; Weisberg, Knud-Vilhelm
A pellet injection system made for the TFR tokamak at Fontenay-aux-Roses, Paris is described. 0.12-mg pellets are injected with velocities of around 600-700 m/s through a 5-m long guide tube. Some details of a new light gas gun are given; with this gun, hydrogen pellets are accelerated to...... size by means of a microwave cavity is outlined....
Jose Maria ALONSO; Antonio GUZMAN; Marta BELTRAN; Rodolfo BORDON
The increase in the number of databases accessed only by some applications has made code injection attacks an important threat to almost any current system. If one of these applications accepts inputs from a client and executes these inputs without first validating them, the attackers are free to execute their own queries and therefore, to extract, modify or delete the content of the database associated to the application. In this paper a deep analysis of the LDAP injection techniques is pres...
Aline Costa, Barcelos; Andreia Mota, Trein; Gustavo Santos, Sousa; Luciano, Fleury Neto; Leonardo, Baldaçara.
Full Text Available Antipsicóticos atípicos têm sua ação em doses que podem produzir efeitos colaterais importantes. A risperidona é o antipsicótico atípico de nova geração mais utilizado na atualidade e seu uso está associado a tratamento de esquizofrenia, transtornos psicóticos, episódio [...] s de mania e nos distúrbios de comportamento, entre outros. Os efeitos adversos mais importantes estão relacionados ao sistema nervoso central e autônomo, sistema endócrino e sistema cardiovascular. Neste último, pode haver efeitos inotrópicos negativos e alterações no eletrocardiograma, como prolongamento do intervalo QT, podendo causar taquicardia e arritmias. Relatamos um caso de um homem de 48 anos com história de delírio persecutório após ser ameaçado no trabalho, que estava sendo tratado com risperidona e paroxetina. Por não haver melhora, suas doses foram aumentadas e o paciente apresentou alargamento do intervalo QTc, com diminuição da amplitude da onda T e aumento da onda U, e hipocalemia. Além disso, o paciente era hipertenso e estava em uso de hidroclorotiazida. A risperidona tem o potencial de bloquear o componente rápido do canal cardíaco de potássio e isso prolonga o processo de repolarização dos ventrículos, podendo causar torsade de pointes, morte súbita e arritmias. Já a hidroclorotiazida causa hipocalemia, provocando alterações na contração e relaxamento do miocárdio. Houve interação medicamentosa grave entre duas drogas com potencial arritmogênico, o que levou às alterações no eletrocardiograma e produziu sintomas danosos ao paciente. A troca do antipsicótico atípico para um típico e da hidroclorotiazida por um diurético que não causa hipocalemia trouxe melhoras ao paciente. Abstract in english Atypical antipsychotics have their actions in doses that can cause important side effects. The risperidone is the new generation atypical antipsychotic most widely used these days and it is related to the treatment of schizophrenia, psychotic disorders, manic episodes a [...] nd behavioral disorder, among others. The most significant side effects are associated with the central and autonomic nervous system, endocrine system and cardiovascular system. Considering the latter, negative inotropic effects and changes on eletrocardiograma can occur, with QT-interval prolongation, which can cause tachycardia and arrhythmias. We reported a case of a 48 years old man with history of persecutory delusion after being threatened at work, treated with risperidone and paroxetine. Since there was no improvement, the doses were increased and the patient showed QTc-interval prolongation, with a T-wave amplitude decrease and an increase on the U-wave, in addition to hypokalemia. Besides, the patient was hypertensive and was using hydrochlorothiazide. Risperidone has the potential to block the fast component of the cardiac potassium channel and it extends the repolarization process of the ventricles, which can lead to torsade de pointes, sudden cardiac death and arrhythmias. Also hydrochlorothiazide can cause hypokalemia, with disturbances on the myocardium depolarization and repolarization. There was a serious drug interaction with two potentially arrhythmogenic drugs, which led to the alterations on the electrocardiogram and generated hurtful symptoms to the patient. The shift of the atypical antipsychotic to one typical and of the hydrochlorothiazide to a diuretic that does not cause hypokalemia brought improvements to the patient.
Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO study
Full Text Available Abstract Background With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. Methods W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162 and vice versa (n=136. Clinical status was assessed at the visit when the first switch was made (i.e. before switching and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization. Results 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019. Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26, extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89 and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13. No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013. Conclusion Our study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.
Stanley, W. D.; Lawrence, R., W.
New technique for controlling noise injection in Dicke feedback noise-injection microwave radiometer utilizes digital counter in which noise injection is kept on during countdown interval. Digital portion of loop replaces analog filters used in previous systems.
A vast majority of the medium and high speed Diesel engines are equipped with multi-hole injection nozzles nowadays. Inaccuracies in workmanship and changing hydraulic conditions in the nozzles result in differences in injection rates between individual injection nozzle holes. The new deformational measuring method described in the paper allows injection rate measurement in each injection nozzle hole. The differences in injection rates lead to uneven thermal loads of Diesel engine combustion ...
Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.
Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100??m. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.
PORTA, M; Gamba, M.; Bertacchi, G; Vaj, P
OBJECTIVESTo investigate the safety and efficacy of ultrasound guided botulinum toxin type A (BTX-A) injections into salivary glands for the treatment of sialorrhoea in patients with neurological disorders.?METHODSThe parotid and submandibular glands of 10 patients were injected with BTX-A using ultrasound guidance. Before injection, the baseline rate of salivation was assessed using a visual analogue scale. Postinjection, assessments were repeated at regular intervals ...
Deniz, Orhan; AygÃ¼l, Recep; Kotan, Dilcan; Ãzdemir, GÃ¶khan; OdabaÅ, Faruk Ãmer; Kaya, M. Dursun; Ulvi, HÄ±zÄ±r
The aim of this study was to evaluate the efficacy of steroid injection for the treatment of the carpal tunnel syndrome (CTS), with F-wave parameters and sympathetic skin response (SSR). Seventeen hands of 10 women patients were treated with local steroid injection with 2-month follow-up. All patients underwent single injection into the carpal tunnel. Response to injection was measured nerve conduction studies (NCSs), median nerve F waves, and SSR before and after treatment. To determine the ...
Full Text Available Abstract Background Schizophrenia is a chronic mental health disorder associated with increased hospital admissions and excessive utilization of outpatient services and long-term care. This analysis examined health care resource utilization from a 24-month observational study of patients with schizophrenia initiated on risperidone long-acting therapy (RLAT. Methods Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation (SOURCE was a 24-month observational study designed to examine real-world treatment outcomes by prospectively following patients with schizophrenia initiated on RLAT. At baseline visit, prior hospitalization and ER visit dates were obtained for the previous 12 months and subsequent hospitalization visit dates were obtained at 3-month visits, if available. The health care resource utilization outcomes measures observed in this analysis were hospitalizations for any reason, psychiatric-related hospitalizations, and emergency room (ER visits. Incidence density analysis was used to assess pre-event and postevent rates per person-year (PY. Results The primary medical resource utilization analysis included 435 patients who had a baseline visit, ?1 postbaseline visits after RLAT initiation, and valid hospitalization dates. The number of hospitalizations and ER visits per PY declined significantly (p p Conclusion The results suggest that treatment with RLAT may result in decreased hospitalizations for patients with schizophrenia. Trial Registration ClinicalTrials.gov: NCT00246194
Li, Zongchang; Hu, Maolin; Zong, Xiaofen; He, Ying; Wang, Dong; Dai, Lulin; Dong, Min; Zhou, Jun; Cao, Hongbao; Lv, Luxian; Chen, Xiaogang; Tang, Jinsong
Accumulating evidence indicates a putative association of telomere length and mitochondrial function with antipsychotics response in schizophrenia (SCZ). However, pharmacological findings were limited and no previous work has assessed this in a prospective longitudinal study. This study assessed telomere length and mitochondrial DNA copy number in first-episode antipsychotic-naïve SCZ patients with 8-week risperidone treatment to evaluate the association between these biomarkers and clinical treatment response. We recruited 137 first-episode antipsychotic-naive SCZ patients (and 144 controls) at baseline and 89 patients completed the 8-week follow-up. Patients, completed follow-up, were divided into Responders (N?=?46) and Non-Responders (N?=?43) according to the percentage of symptoms improvement. Linear regression analyses show that SCZ patients had significantly lower mtDNA copy number (??=??0.108, p?=?0.002), and no alteration of telomere length when compared with healthy controls. In addition, compared with Non-Responders, Responders had significantly lower mtDNA copy number (??=??0.178, p?=?0.001), and longer telomere length (??=?0.111, p?=?0.071) before the 8-week treatment. After treatment, Responders persisted lower mtDNA copy number comparing with No-Responders (partial ?2?=?0.125, p?=?0.001). These findings suggest that telomere length and mtDNA copy number may hold the potential to serve as predictors of antipsychotic response of SCZ patients. PMID:26680692
David E. Rapp
Full Text Available Despite the favorable outcomes seen using botulinum toxin (BTX for voiding dysfunction using BTX, a standardized technique and protocol for toxin injection is not defined. We reviewed the current literature on intravesical BTX injection for DO (detrusor overactivity. Specific attention was placed on defining optimal injection protocol, including dose, volume, and injection sites. In addition, we sought to describe a standard technique to BTX injection.
Rapp, David E.; Alvaro Lucioni; Bales, Gregory T.
Despite the favorable outcomes seen using botulinum toxin (BTX) for voiding dysfunction using BTX, a standardized technique and protocol for toxin injection is not defined. We reviewed the current literature on intravesical BTX injection for DO (detrusor overactivity). Specific attention was placed on defining optimal injection protocol, including dose, volume, and injection sites. In addition, we sought to describe a standard technique to BTX injection.
During the last 10 to 15 years, significant progress has been made worldwide in the area of pellet injection technology. This specialized field of research originated as a possible solution to the problem of depositing atoms of fuel deep within magnetically confined, hot plasmas for refueling of fusion power reactors. Using pellet injection systems, frozen macroscopic (millimeter-size) pellets composed of the isotopes of hydrogen are formed, accelerated, and transported to the plasma for fueling. The process and benefits of plasma fueling by this approach have been demonstrated conclusively on a number of toroidal magnetic confinement configurations; consequently, pellet injection is the leading technology for deep fueling of magnetically confined plasmas for controlled thermonuclear fusion research. Hydrogen pellet injection devices operate at very low temperatures (congruent 10 K) at which solid hydrogen ice can be formed and sustained. Most injectors use conventional pneumatic (light gas gun) or centrifuge (mechanical) acceleration concepts to inject hydrogen or deuterium pellets at speeds of congruent 1--2 km/s. Pellet injectors that can operate at quasi-steady state (pellet delivery rates of 1--40 Hz) have been developed for long-pulse fueling. The design and operation of injectors with the heaviest hydrogen isotope, tritium, offer some special problems because of tritium's radioactivity. To address these problems, a proof-of-principle experiment was carried out in which tritium pellets were formed and accelerated to speeds of 1.4 km/s. Tritium pellet injection is scheduled on major fusion research devices within the next few years. Several advanced accelerator concepts are under development to increase the pellet velocity. One of these is the two-stage light gas gun, for which speeds of slightly over 4 km/s have already been reported in laboratory experiments with deuterium ice
Luo, Jing-Wen; Zhang, Ting; Zhang, Quan; Cao, Xi; Zeng, Xin; Fu, Yao; Zhang, Zhi-Rong; Gong, Tao
Systemically administered anticancer treatments were greatly limited by extensive side effects mainly due to nonspecific distributions in vivo, and multidrug resistance in various tumors. A phospholipids-based in situ-forming gel platform has been developed for the concurrent delivery of doxorubicin (DOX) and bromotetrandrin (W198). Phospholipid gel containing DOX and W198 remained in a solution (sol) state before injection and underwent rapid gelation after injection in vivo. The release of DOX and W198 from phospholipid gel (PG) was sustained in vitro for over 20 days (d). DOX and W198 from PG achieved prolonged release for over two weeks in rats via subcutaneous injection. Compared with repeated injections of free drug, eliminated cardiac toxicity and less bone marrow inhibition were observed for DOX and W198-loaded PG (DOX/W198-PG) in normal rats via subcutaneous injection. Also, a single intratumoral injection of DOX/W198-PG in the resistant MCF-7/Adr xenograft-bearing mice showed much better antitumor efficacy compared to other treatment groups. In sum, DOX/W198-PG was well demonstrated to achieve sustained drug release both in vitro and in vivo with eliminated toxicity and improved antitumor efficacy by reversing the multidrug resistance in breast cancers. PMID:26628333
Sorenson, Spencer C.; Glensvig, Michael; Abata, Duane L.
A series of preliminary investigations has been performed in order to investigate the behavior of DME in a diesel injection environment. These studies have in-cluded visual observations of the spray penetration and angles for high pressure injection into Nitrogen using conventional jerk pump...... same system. As a first attempt to simulate combustion of DME in Diesel engines, the results of the spray studies have been incorporated into a simplified spray combustion model. A turbulent jet structure was adjusted to fit the penetration rates of the observed sprays. The observed spray widths agreed...
In 1980, China initiated a program to study the feasibility on the disposal of liquid radioactive wastes in the deep shale formation using hydrofracture process. From then on, studies on siting, geologic and hydrogeologic investigations, site characterization, cementitious slurry formulation as well as the underground injection test with radioactive tracers, have been completed. This paper summarizes the results obtained in the underground injection test and the further developments for this program. The main purposes of this test were to characterize the fracture induced hydraulically in the Silurian shale in the southwest of China, and to demonstrate the workability of the simulated slurry formula
Sandeep, Valasingam; Kumar, Manikya; Jyostna, P; Duggi, Vijay
Effective pain control during local anesthetic injection is the cornerstone of behavior guidance in pediatric dentistry. The aim of this study was to evaluate the practical efficacy of a 2-stage injection technique in reducing injection pain in children. This was a split-mouth, randomized controlled crossover trial. One hundred cooperative children aged 7 to 13 years in need of bilateral local anesthetic injections (inferior alveolar nerve block, posterior superior alveolar nerve block, or maxillary and mandibular buccal infiltrations) for restorative, endodontic, and extraction treatments were recruited for the study. Children were randomly allocated to receive either the 2-stage injection technique or conventional technique at the first appointment. The other technique was used at the successive visit after 1 week. Subjective and objective evaluation of pain was done using the Wong-Baker FACES Pain Rating Scale (FPS) and Sound Eye Motor (SEM) scale, respectively. The comparison of pain scores was done by Wilcoxon sign-rank test. Both FPS and SEM scores were significantly lower when the 2-stage injection technique of local anesthetic nerve block/infiltration was used compared with the conventional technique. The 2-stage injection technique is a simple and effective means of reducing injection pain in children. PMID:26866405
The 5-cell, lumped-delay-line structure of the first-generation SPS injection kickers. For a more detailed description see 7502072X. See also 7502073X and Annual Report 1975, p.162. To the left: Roland Tröhler; to the right: Giacomo Busetta.
One of the first-generation SPS injection kicker magnets. Lifting the tank-lid reveals the inner structure. For a more detailed description see 7502072X. See also 7502074X and Annual Report 1975, p.162. To the left: Roland Tröhler; to the right: Giacomo Busetta.
Existing analytic design equations for magnetron injection guns (MIG's) are approximated to obtain a set of scaling laws. The constraints are chosen to examine the maximum peak power capabilities of MIG's. The scaling laws are compared with exact solutions of the design equations and are supported by MIG simulations
... abnormal eyelid movements) in adults who have used onabotulinumtoxinA (Botox). IncobotulinumtoxinA injection is in a class of medications ... if you are allergic to incobotulinumtoxinA, abobotulinumtoxinA (Dysport), onabotulinumtoxinA (Botox), rimabotulinumtoxinB (Myobloc), any other medications, or any ...
Cheng, Jacqueline T; Perkins, Stephen W; Hamilton, Mark M
Soft tissue augmentation of facial rhytids, scars, and deformities is a frequently performed office procedure. This article reviews the available biologic (collagen, Dermalogen, Autologen, Isolagen, autologous fat, Fibrel, hyaluronic acid derivatives, particulate fascia lata, micronized Alloderm) and alloplastic (silicone, Bioplastique, and Artecoll) soft tissue injectable fillers. PMID:11781208
A compressor introduces air as a starting material and sends it to a dust removing device, a dehumidifying device and an adsorption/separation system disposed downstream. The facility of the present invention is disposed in the vicinity of an injection point and installed in a turbine building of a BWR type reactor having a pipeline of a feedwater system to be injected. The adsorbing/separation system comprises an adsorbing vessel and an automatic valve, and the adsorbing vessel is filled with an adsorbent for selectively adsorbing nitrogen. Zeolite is used as the adsorbent. Nitrogen in the air passing through the adsorbing vessel is adsorbed and removed under a pressurized condition, and a highly concentrated oxygen gas is formed. The direction of the steam of the adsorbed nitrogen is changed by an opening/closing switching operation of an automatic valve and released to the atmosphere (the pressure is released). Generated oxygen gas is stored under pressure in a tank, and injected to the pipeline of the feedwater system by an oxygen injection conduit by way of a flow rate control valve. In the adsorbing vessel, steps of adsorption, separation and storage under pressure are repeated successively. (I.N.)
The present invention provides a thermonuclear device in which thermal loads on a shielding member disposed to a drift tube are reduced, and the beam injection efficiency into plasmas can be improved. Namely, factors which give influence on the beam injection efficiency are analyzed and evaluated. The focus of the neutron particles is determined to an optimum position between the center of the plasmas and the drift tube based on the result. Then, the thermal loads on the shielding member of the drift tube are reduced, and the neutron beam injection efficiency is improved. Further, the cross section of the drift tube is determined corresponding to the shape of the distribution of the neutron beams. Then, the cross sectional area of the drift tube can be minimized. In addition, the shielding member is adapted to have a shape slanted relative to the beams based on the distribution of the neutron beams. Then, thermal loads injected to the shielding member can be reduced. (I.S.)
Harmer, CJ; Cowen, PJ; Goodwin, GM
Current antidepressant agents are similar in efficacy to the original drugs discovered in the 1950s. The development of new treatments for depression is, however, limited by the absence of validated human biomarker models to predict efficacy, clinical profile and dosing. Such models need to meet key criteria for biomarkers including sensitivity, specificity and relevance to depression. Here we review studies exploring whether early changes in emotional processing with antidepressant drug admi...
Garibaldi, Angelo; GULLINO, Maria Lodovica; GILARDI, Giovanna; RICAUDA AIMONINO, Davide
The efficacy of three steam application techniques (steam injection, iron pan and sheet steaming) was evaluated against five soilborne pathogens under controlled laboratory conditions. Injection and pan steam systems proved to be efficient and feasible alternatives to traditional sheet steaming for suppressing Fusarium oxysporum f. sp. basilici at 60% moisture field capacity in sandy-loam soil. Injecting steam was the best technique to suppress F. oxysporum f. sp. b...
Full Text Available Objective: Myofascial pain syndrome is a disorder characterized by hypersensitive sites called trigger points at one or more muscles and/or connective tissue, leading to pain, muscle spasm, sensitivity, rigor, weakness. The aim of this study was to explore the efficacy of lidocain and steroid in myofascial pain syndrome. Material and Methods: One hundred and sixty-four patients with myofascial pain syndrome were recruited into the study. Patients received lidocaine 2% (5ml+NaCl 0.9% (5ml onto the trigger points at first day. Lidocaine 2% (5ml+triamsinolone 40mg (1ml+NaCl 0.9% (4ml were injected to the patients at fourth and eighth day. Pain was evaluated with visual analogue score (VAS, palpable muscle spasm scoring (PMSS and number of trigger point at baseline, first and second month. Results: Pain control values with treatment were statistically better compared with pretreatment values. VAS scores, PMSS and number of trigger points significantly reduced 1 and 2 months after lidocaine and triamsinolone injection at the trigger point (p<0.01. Conclusion: The local anesthetic and steroid injection at the trigger point seems to be beneficial in myofascial pain syndrome. In conclusion, this therapy may be a alternative to other methods in the management of myofascial pain syndrome.
Chang, Jim J. (Dublin, CA)
A new injection-controlled laser resonator incorporates self-filtering and self-imaging characteristics with an efficient injection scheme. A low-divergence laser signal is injected into the resonator, which enables the injection signal to be converted to the desired resonator modes before the main laser pulse starts. This injection technique and resonator design enable the laser cavity to improve the quality of the injection signal through self-filtering before the main laser pulse starts. The self-imaging property of the present resonator reduces the cavity induced diffraction effects and, in turn, improves the laser beam quality.
Rehospitalization rates of patients with schizophrenia discharged on haloperidol, risperidone or clozapine / Taxas de re-hospitalização de pacientes após alta hospitalar em uso de haloperidol, risperidona ou clozapina
Ana Paula Werneck de, Castro; Helio, Elkis.
Full Text Available OBJETIVO: O propósito desse estudo foi observar as taxas de re-hospitalização de pacientes com esquizofrenia que receberam alta do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo em uso de haloperidol, risperidona ou clozapina. MÉTODO: Este foi [...] um estudo naturalístico conduzido de forma a observar as taxas de re-hospitalizações dos pacientes que receberam alta em uso de haloperidol (n = 43), risperidona (n = 22) ou clozapina (n = 31). O tempo de re-hospitalização foi analisado de acordo com a fórmula produto-limite (Kaplan-Meier) por três anos. Fatores de risco associados à internação foram examinados. RESULTADOS: Aos 36 meses, permaneceram em seguimento extra-hospitalar 74% dos pacientes em uso de haloperidol, 59% em uso de risperidona e 84% em uso de clozapina. O grupo tratado com haloperidol apresentou predomínio do gênero feminino, idade de início mais tardia e menor tempo de doença que os demais grupos, enquanto o oposto ocorreu em relação ao grupo com clozapina. CONCLUSÕES: Pacientes em uso de clozapina apresentaram taxas de re-hospitalização menores que aqueles em uso de haloperidol e risperidona. No entanto, variáveis tais como distribuição de gênero e idade de início da doença podem representar limitações importantes que devem ser levadas em consideração na interpretação dos resultados. Abstract in english OBJECTIVE:The purpose of this study was to evaluate the rehospitalization rates of patients discharged from the Institute of Psychiatry of the Hospital das Clínicas of the Universidade de São Paulo Medical School while being treated with haloperidol, risperidone or clozapine. METHOD: This is a natur [...] alistic study designed to monitor rehospitalization rates for patients discharged on haloperidol (n = 43), risperidone (n = 22) or clozapine (n = 31). Time to readmission over the course of three years was measured by the product-limit (Kaplan-Meier) method. Risk factors associated with rehospitalizations were examined. RESULTS: At 36 months, remained in the community 74% of the haloperidol-treated patients, 59% of the risperidone-treated patients and 84% of the clozapine-treated patients. The haloperidol group showed a higher proportion of women, a late age of onset and shorter length of illness than the other groups, whereas the opposite was observed in the clozapine group. CONCLUSIONS: This study suggests that the rehospitalization rates of patients taking clozapine are lower than the rate for patients treated with haloperidol and risperidone. However confounding variables such as gender distribution and age of onset represent limitations that should be taken into account for the interpretation of the results.
SØrensen, H.; Andersen, P.
A pellet injection system made for the TFR tokamak at Fontenay-aux-Roses, Paris is described. 0.12-mg pellets are injected with velocities of around 600-700 m/s through a 5-m long guide tube. Some details of a new light gas gun are given; with this gun, hydrogen pellets are accelerated to velocities above 1400 m/s, deuterium pellets to velocities above 1300 m/s and neon pellets to velocities above 500 m/s. Finally, a new acceleration method where a pellet should be accelerated by means of a magnetically stabilised electrical discharge is discussed, and a set up for measuring of the pellet size by means of a microwave cavity is outlined.
A discussion is given of the work done at Riso National Laboratory on the design and construction of deuterium pellet injectors. A pellet injection system made for the TFR tokamak at Fontenay-aux-Roses, Paris is described. 0.12-mg pellets are injected with velocities of around 600-700 m/s through a 5-m long guide tube. Next some of the details of a new light gas gun are given; with this gun, hydrogen pellets are accelerated to velocities above 1400 m/s, deuterium pellets to velocities above 1300 m/s and neon pellets to velocities above 550 m/s. Finally, a new acceleration method where a pellet should be accelerated by means of a magnetically stabilised electrical discharge is discussed, and a set up for measuring of the pellet size by means of a microwave cavity is outlined
One of the first-generation SPS injection kicker magnets, view of the complete tank. First proton beam from the PS was injected into the SPS in 1976, at a beam momentum of 10 GeV/c. These kickers served until the end of 1979 and were replaced at the beginning of 1980 by stronger ones, in preparation for the SPS as a proton-antiproton collider. For this, transfer momentum from the PS to the SPS was raised to 26 GeV/c, so as to avoid acceleration of the dense p and pbar bunches through SPS transition energy. Bearded Roland Tröhler is at the left, Giacomo Busetta smiles at the right. See also 7502073X, 7502074X and Annual Report 1975, 162.
The semiconductor injection laser includes a thin inner GaAs p-n junction layer between two outer GaAlAs layers which are backed by further thin outer GaAlAs layers with a heavier doping of AlAs. This reduces optical losses. Optical energy is further confined within the inner layers and the lasing threshold reduced by added outer GaAs layers of low electrical and thermal resistivity
To the left is the PS ring, viewed against the direction of the protons. At the left, the injection line (also viewed upstream), coming from the 50 MeV linac 1 (behind the wall) and going towards the 800 MeV Booster. The drum-like device is a "debuncher" (a 200 MHz cavity), which reduces the momentum spread of the proton bunches. See also 7802261.
It is shown that when a spin-polarized current is injected into a superconductor from a ferromagnet in ferromagnet/superconductor (FM/SC) and FM/SC/FM tunnel junctions, the spin and charge degrees of freedom of electrons are carried by quasi-particles and Cooper pairs in SC, respectively. The spin accumulation competes with the superconductivity and the spin current gives rise to the transverse charge current in SC. (author)
Hanquinet, S. [Department of Radiology, Hopital Universitaire Cantonal de Pediatrie, Geneve (Switzerland)]|[Children`s University Hospital Reine Fabiola, Brussels (Belgium); Christophe, C. [Children`s University Hospital Reine Fabiola, Brussels (Belgium); Greef, D. de [Nycomed SA/NV, Brussels (Belgium); Gordon, P. [Nycomed Imaging AS, Oslo (Norway); Perlmutter, N. [Children`s University Hospital Reine Fabiola, Brussels (Belgium)
The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82 %). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children. (orig.). With 3 figs., 1 tab.
The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82 %). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children. (orig.). With 3 figs., 1 tab
In a hydrogen pellet injection device, a nozzle block having a hydrogen gas supply channel is disposed at the inner side of a main cryogenic housing, and an electric resistor is attached to the block. Further, a nozzle block and a hydrogen gas introduction pipe are attached by way of a thermal insulating spacer. Electric current is supplied to the resistor to positively heat the nozzle block and melt remaining solid hydrogen in the hydrogen gas supply channel. Further, the effect of temperature elevation due to the resistor is prevented from reaching the side of the hydrogen gas introduction pipe by the thermal insulation spacer. That is, the temperature of the nozzle block is directly and positively elevated, to melt the solid hydrogen rapidly. Preparation operation from the injection of the hydrogen pellet to the next injection can be completed in a shorter period of time compared with a conventional case thereby enabling to make the test more efficient. Further, only the temperature of the nozzle block is elevated with no effect of temperature elevation due to the resistor to other components by the thermal insulation flange. (N.H.)
Moore, T. E.; Chandler, M. O.; Buzulukova, N.; Collinson, G. A.; Kepko, E. L.; Garcia-Sage, K. S.; Henderson, M. G.; Sitnov, M. I.
As the Polar spacecraft apogee precessed through the magnetic equator in 2001, Polar encountered numerous substorm events in the region between geosynchronous orbit and 10 RE geocentric distance; most of them in the plasma sheet boundary layers. Of these, a small number was recorded near the neutral sheet in the evening sector. Polar/Thermal Ion Dynamics Experiment provides a unique perspective on the lowest-energy ion plasma, showing that these events exhibited a damped wavelike character, initiated by a burst of radially outward flow transverse to the local magnetic field at approximately 80 km/s. They then exhibit strongly damped cycles of inward/outward flow with a period of several minutes. After one or two cycles, they culminated in a hot plasma electron and ion injection, quite similar to those observed at geosynchronous orbit. Cold plasmaspheric plasmas comprise the outward flow cycles, while the inward flow cycles contain counterstreaming field-parallel polar wind-like flows. The observed wavelike structure, preceding the arrival of an earthward moving substorm injection front, suggests an outward displacement driven by the inward motion at local times closer to midnight, that is, a "snowplow" effect. The damped in/out flows are consistent with interchange oscillations driven by the arrival at the observed local time by an injection originating at greater radius and local time.
Full Text Available Abstract Whilst unsupervised injectable methadone and diamorphine treatment has been part of the British treatment system for decades, the numbers receiving injectable opioid treatment (IOT has been steadily diminishing in recent years. In contrast, there has been a recent expansion of supervised injectable diamorphine programs under trial conditions in a number of European and North American cities, although the evidence regarding the safety, efficacy and cost effectiveness of this treatment approach remains equivocal. Recent British clinical guidance indicates that IOT should be a second-line treatment for those patients in high-quality oral methadone treatment who continue to regularly inject heroin, and that treatment be initiated in newly-developed supervised injecting clinics. The Randomised Injectable Opioid Treatment Trial (RIOTT is a multisite, prospective open-label randomised controlled trial (RCT examining the role of treatment with injected opioids (methadone and heroin for the management of heroin dependence in patients not responding to conventional substitution treatment. Specifically, the study examines whether efforts should be made to optimise methadone treatment for such patients (e.g. regular attendance, supervised dosing, high oral doses, access to psychosocial services, or whether such patients should be treated with injected methadone or heroin. Eligible patients (in oral substitution treatment and injecting illicit heroin on a regular basis are randomised to one of three conditions: (1 optimized oral methadone treatment (Control group; (2 injected methadone treatment; or (3 injected heroin treatment (with access to oral methadone doses. Subjects are followed up for 6-months, with between-group comparisons on an intention-to-treat basis across a range of outcome measures. The primary outcome is the proportion of patients who discontinue regular illicit heroin use (operationalised as providing >50% urine drug screens negative for markers of illicit heroin in months 4 to 6. Secondary outcomes include measures of other drug use, injecting practices, health and psychosocial functioning, criminal activity, patient satisfaction and incremental cost effectiveness. The study aims to recruit 150 subjects, with 50 patients per group, and is to be conducted in supervised injecting clinics across England.
Full Text Available BACKGROUND: Several clinical trials demonstrated that atypical antipsychotics are more effective but also more expensive (as drug cost compared with the typical neuroleptics by treating psychotic disorders. The present study aimed to evaluate this result using an observational approach which better reflects the real clinical practice. OBJECTIVE: To evaluate clinical effectiveness (including work and social functioning and overall direct costs in a group of patients affected by psychotic disorders (schizophrenia and bipolar and treated with typical and atypical (olanzapine and risperidone antipsychotics. METHODS: With a multicentre observational design - two years long - 89 patients (in charge by Psychiatric Centers of Regione Campania - Italy were assessed using CGI (Clinical Global Impression and GAF (Global Assessment of Functioning scales. Moreover economic data were collected with reference to pharmacological and non-pharmacological (hospitalization, medical/nurse visits, etc. resources consumption. The pharmacoeconomic analysis were conducted choosing the perspective of the local Psychiatric Services for costs attribution. RESULTS: Considering the treatment outcomes, the use of the atypical drugs provided better performances with reference to the patients quality of life. The results in terms of work and social functioning indicated an advantage in the olanzapine group of patients. Overall direct costs of treatment (drugs and healthcare resources didnt generate significant differences among the groups of therapy despite the pharmacological cost evidentiated an economic advantage (p<0,05 in the typical group due to the cheaper cost of these drugs. The use of olanzapine was associated to a lower number of hospitalizations and showed a general reduction (- 16% of total treatment costs between 1st and 2nd year of observation. CONCLUSIONS: The lack of side effects, the improvement in work and social functioning, associated to a more efficient use of total healthcare resources seems to be at the basis of the better pharmacoeconomic profile for olanzapine compared with the other antipsychotic therapies.
We describe a case report and technique for using a portable ultrasound scanner and a curvilinear transducer (4-5MHz) (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A.) to guide sacroiliac joint (SIJ) injection. A 42-year-old male presented with chronic lower back pain centered on his left SIJ. His pain averaged 7 out of 10 (numerical rating scale). For the ultrasound-guided SIJ injection the patient was placed in the prone position. The ultrasound transducer was oriented in a transverse orientation at the level of the sacral hiatus. Here the sacral cornuae were identified. Moving the transducer laterally from here, the lateral edge of the sacrum was identified. This bony edge was followed in a cephalad direction with the transducer maintained in a transverse orientation. A second bony contour, the ileum, was identified. The cleft between both bony contours represented the sacroiliac joint. This was found at 4.5 cm depth. Real-time imaging was used to direct a 22G spinal needle into the SIJ, where solution was injected under direct vision. The patient\\'s pain intensity decreased to a 2 out of 10 (numerical rating scale). Function improved and the patient was able to return to work. These improvements were maintained at 16 weeks. Ultrasound guidance does not expose patients and personnel to radiation and is readily accessible. Ultrasound-guided SIJ injections may have particular applications in the management of chronic lower back pain in certain clinical scenarios (e.g. pregnancy). Future studies to demonstrate efficacy and reproducibility are needed.
Reeves, Matt; Henry, Cary A.; Ruth, Michael J.
A gaseous reductant injection and mixing system is described herein. The system includes an injector for injecting a gaseous reductant into an exhaust gas stream, and a mixer attached to a surface of the injector. The injector includes a plurality of apertures through which the gaseous reductant is injected into an exhaust gas stream. The mixer includes a plurality of fluid deflecting elements.
Wald, John T; Maus, Timothy P; Diehn, Felix E; Kaufmann, Timothy J; Morris, Jonathan M; Murthy, Naveen S; Thielen, Kent R
Recent studies have described the safety and efficacy of computed tomography (CT)-guided cervical transforaminal epidural steroid injections with both the anterolateral and posterior approach. Although fluoroscopy is the most common form of image guidance for these procedures, CT guidance offers many advantages. However, some key features of CT guidance in these procedures need to be considered to ensure safe and technically successful outcomes. PMID:24074559
Baer, T; Bartmann, W; Bracco, C; Carlier, E; Chanavat, C; Drosdal, L; Garrel, N; Goddard, B; Kain, V; Mertens, V; Uythoven, J; Wenninger, J; Zerlauth, M
During the MD, the production mechanism of UFOs at the injection kicker magnets (MKIs) was studied. This was done by pulsing the MKIs on a gap in the circulating beam, which led to an increased number of UFOs. In total 43 UFO type beam loss patterns at the MKIs were observed during the MD. The MD showed that pulsing the MKIs directly induces UFO type beam loss patterns. From the temporal characteristics of the loss profile, estimations about the dynamics of the UFOs are made.
A method of neutron-gamma logging is described, in which water, injected in a cased well borehole with peforations, is irradiated with neutrons of 10 MeV or greater, and subsequent gamma radiation is detected by a pair of detectors along the borehole. Counting rates of detectors are analyzed in terms of two gamma ray energy windows. Linear flow velocity of fluid moving downward within the casing is used in conjunction with count rate data to determine volume flow rates of water moving in other directions. Apparatus includes a sonde with a neutron source and appropriate gamma sensors
Bennett, J R J; Gray, D A; Harold, M R; Maidment, J R M; Rees, G H; Wheldon, A G
Studies have commenced of an injector for LEP, the CERN 100 GeV e/sup +/-e/sup -/ storage ring design. The minimum energy for injection is 20 GeV, and a synchrotron injector is chosen in preference to a linac for cost reasons and to obtain faster ring filling. Factors involved in the design of the injector synchrotron are discussed and 2 alternative schemes are outlined for the filling of the 32 e/sup +/ and 32 e/sup -/ LEP bunches. (4 refs).
This Short Cut introduces you to how SQL injection vulnerabilities work, what makes applications vulnerable, and how to protect them. It helps you find your vulnerabilities with analysis and testing tools and describes simple approaches for fixing them in the most popular web-programming languages. This Short Cut also helps you protect your live applications by describing how to monitor for and block attacks before your data is stolen. Hacking is an increasingly criminal enterprise, and web applications are an attractive path to identity theft. If the applications you build, manage, or guar
Full Text Available Cecile Berteau,1 Orchidée Filipe-Santos,1 Tao Wang,2 Humberto E Rojas,2 Corinne Granger,1 Florence Schwarzenbach1 1Becton-Dickinson Medical Pharmaceutical Systems, Le Pont de Claix, France; 2Eli Lilly and Company, Indianapolis, IN, USA Aim: The primary objective of this study was to evaluate the impact of fluid injection viscosity in combination with different injection volumes and flow rates on subcutaneous (SC injection pain tolerance. Methods: The study was a single-center, comparative, randomized, crossover, Phase I study in 24 healthy adults. Each participant received six injections in the abdomen area of either a 2 or 3 mL placebo solution, with three different fluid viscosities (1, 810, and 1520 cP combined with two different injection flow rates (0.02 and 0.3 mL/s. All injections were performed with 50 mL syringes and 27G, 6 mm needles. Perceived injection pain was assessed using a 100 mm visual analog scale (VAS (0 mm/no pain, 100 mm/extreme pain. The location and depth of the injected fluid was assessed through 2D ultrasound echography images. Results: Viscosity levels had significant impact on perceived injection pain (P=0.0003. Specifically, less pain was associated with high viscosity (VAS =12.6 mm than medium (VAS =16.6 mm or low (VAS =22.1 mm viscosities, with a significant difference between high and low viscosities (P=0.0002. Target injection volume of 2 or 3 mL was demonstrated to have no significant impact on perceived injection pain (P=0.89. Slow (0.02 mL/s or fast (0.30 mL/s injection rates also showed no significant impact on perceived pain during SC injection (P=0.79. In 92% of injections, the injected fluid was located exclusively in SC tissue whereas the remaining injected fluids were found located in SC and/or intradermal layers. Conclusion: The results of this study suggest that solutions of up to 3 mL and up to 1520 cP injected into the abdomen within 10 seconds are well tolerated without pain. High viscosity injections were shown to be the most tolerated, whereas injection volume and flow rates did not impact perceived pain. Keywords: injection viscosity, injection speed, injection volume, subcutaneous, pain
After completing the diesel engine endurance testing, we detected various traces of thermal load on the walls of combustion chambers located in the engine pistons. The engines were fitted with ? combustion chambers. The thermal load of different intensity levels occurred where the spray of fuel, fuel vapor, and air interacted with the combustion chamber wall. The uneven thermal load distribution of the combustion chamber wall results from varying injection rates in each injection nozzle hole. The most widely applied controlling methods so far for injection rate measurement, such as the Zeuch and Bosch concepts, allow measurement of only the total injection rate in multihole nozzles, without providing any indication whatsoever of the injection rate differences in individual injection nozzle holes. The new deformational measuring method described in the article allows the injection rate to be measured in each hole of the multihole nozzle. The results of the measurements using this method showed that the differences occurred in injection rates of individual injection nozzle holes. These differences may be the cause of various thermal loads on the combustion chamber walls. The criterion for injection rate is the deformation of the membrane due to an increase in the fuel quantity in the measuring space and due to the pressure waves resulting from the fuel being injected into the measuring space. The membrane deformation is measured using strain gauges, glued to the membrane and forming the Wheatstone's bridge. We devoted special attention to the temperature compensation of the Wheatstone's bridge and the membrane, heated up during the measurements.
Aldaz Cifuentes, Santiago [Schlumberger Smith Completions, Celle (Germany)
This article presents the development and applications of modern completion systems for Selective Water Injection. It is based on a field study performed in Argentina adding records of successful technology application and development over time as well as benefits for the oil industry. A Selective Completion System used and developed by Schlumberger Smith Completions is defined as a set of tools characterized by isolating a single or more zones of interest along the oil well in order to take absolute control of the zone of interest. The principle of the technological development is based on replacing traditional mechanical packers by hydraulic systems bringing a new generation of tools developed for challenging well architecture. A Selective Completion System also implies the interaction of logging tools, tubing conveyed perforations and proper reservoir management systems. This article also highlights reservoir management concepts and water injection benefits for recovery factor improvements based on development from simple completion systems up to selective completion systems as part of the successful operational development of Schlumberger Smith Completions in Argentina. (orig.)
Alvaro Cavieres F
Full Text Available La hiperprolactinemia y las disfunciones sexuales son complicaciones frecuentes, pero poco estudiadas del tratamiento con risperidona. Objetivos: Determinar la prevalencia de hiperprolactinemia y disfunciones sexuales en un grupo de personas jÃ³venes con esquizofrenia, tratadas con risperidona. MÃ©todos: Un total de 40 pacientes (19 mujeres, edad promedio: 27 aÃ±os completaron el Cuestionario de Funcionamiento Sexual del Hospital General de Massachussets y el Cuestionario sobre Calidad de Vida: SatisfacciÃ³n y Placer. Todos los pacientes fueron evaluados con las escalas PANSS y UKU y se determinÃ³ su nivel plasmÃ¡tico de prolactina. Resultados: El 90% de los pacientes presenta hiperprolactinemia, con valores significativamente mÃ¡s altos para las mujeres. El 62,5% de los pacientes, informÃ³ padecer alguna disfunciÃ³n sexual, sin diferencias con la contraparte no afectada, en cuanto a gÃ©nero, edad ni tiempo de tratamiento. Aunque no se encontrÃ³ relaciÃ³n con la prolactinemia, ni con la dosis de risperidona, quienes reportaron alguna disfunciÃ³n sexual obtuvieron mayores puntajes de efectos adversos psÃquicos y neurolÃ³gicos en la escala UKU. Las disfunciones sexuales se asociaron con los sÃntomas negativos y generales de la PANSS y con menores puntajes en las subescalas de salud fÃsica y Ã¡nimo del Cuestionario sobre Calidad de Vida: SatisfacciÃ³n y Placer. Conclusiones: Los resultados confirman la elevada frecuencia de disfunciones sexuales e hiperprolactinemia en las personas enfermas de esquizofrenia. Nuevos estudios se requieren para clarificar, en la prÃ¡ctica clÃnica habitual, la asociaciÃ³n entre disfunciÃ³n sexual y el empleo de la risperidona, y su impacto en la calidad de vida de los pacientes.Hyperprolactinemia and Sexual dysfunction arefrequent, yetseldom studied, complications of the use of risperidone Objectives: To determine the prevalence and clinical correlates of sexual dysfunctions and hyperprolactinemia in a sample of youngpeople with schizophrenia treated with risperidone Methods: 40 outpatients (19females; mean age: 27years with schizophrenia treated with risperidone, participated in the study Sexual dysfunction and quality oflife were assessed with the Massachusetts General Hospital Sexual Functioning Questionnaire (MGH-SFQ and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q, respectively Allpatients were evaluated with the Positive and Negative Syndrome Scale and the UKU side effect rating scale. Blood samples were analyzed for prolactine. Results: Hyperprolactinemia was found in 90% ofpatients, with levÃ©is significantly higher in women. Sexual dysfunctions occurred in 25 (62.5% patients. Patients with and without sexual dysfunction, did not significantly differ in gender, age or years of treatment. Although no association was found with prolactinemia or the dose of risperidone, patients with sexual dysfunction reported more psychic and neurologic side effects, and had higher scores in the negative symptoms and general psychopatology subscales ofthe PANSS and lower scores in the physical health and mood items of the Q-LES-Q. Conclusions: Results confirm the high prevalence of hyperprolactinemia and sexual dysfunctions in people with schizophrenia. Further study is warranted in order to clarify the association between sexual dysfunction and risperidone treatment in clinical practice and its impact in the quality oflife ofthe patients.
A randomised, double-masked phase III/IV study of the efficacy and safety of Avastin® (Bevacizumab) intravitreal injections compared to standard therapy in subjects with choroidal neovascularisation secondary to age-related macular degeneration: clinical trial design
Bunce Catey; Patel Praveen J; Tufail Adnan
Abstract Background The management of neovascular age-related macular degeneration (nAMD) has been transformed by the introduction of agents delivered by intravitreal injection which block the action of vascular endothelial growth factor-A (anti-VEGF agents). One such agent in widespread use is bevacizumab which was initially developed for use in oncology. Most of the evidence supporting the use of bevacizumab for nAMD has come from interventional case series and this clinical trial was initi...
Full Text Available AIM: To study the efficacy of a single intravitreal injection of perfluoropropane(C3F8in releasing vitreomacular traction. METHODS: Twelve eyes of 12 consecutive patients with vitreomacular traction received a single intravitreal injection of 0.3mL 100%(C3F8were retrospectively analyzed. The best corrected vision acuity and the neural epithelium thickness of central macular were observed. RESULTS: One month following treatment, vitreomacular traction was released in 5 eyes(42%, mean final visual acuity(VAimproved 0.04 and mean central foveal thickness decreased by 69?m. The vision acuity before and after treatment were 0.20±0.07, 0.25±0.04 respectively.CONCLUSION: Intravitreal C3F8 injection could offer a minimally invasive alternative to pars plana vitrectomy in patients with vitreomacular traction.
Xie, Heng-Hui; Zhang, Wei-bo
Objective: To observe whether injection of medicine into low hydraulic resistance point along meridian brings about higher medicinal effect and to explore the efficacy of the theory that meridians are made up of channels featuring low hydraulic resistance by observing the diuretic effect of injecting furosemide or saline into the low hydraulic resistance point Shuifen (CV 9), vein and Zusanli (St 36) respectively. Methods: Acute edema was induced in pigs by rapid intravenous injection of 2 00...
Alireza Moghtaderi; Sepideh Sajadiyeh; Saeid Khosrawi; Farnaz Dehghan; Vahid Bateni
Background: Rotator cuff disease is a common cause of shoulder pain. There are studies about the effectiveness of sodium hyaluronate injection on shoulder and knee pain, but few studies demonstrating the efficacy of sodium hyaluronate ultrasonography guided injection for rotator cuff disease. This study evaluates effectiveness of ultrasonography guided subacromial sodium hyaluronate injection in patients with impingment syndrome without rotator cuff complete tear. Materials and Methods: T...
Eun Jung Kang, Soung Won Jeong, Jae Young Jang, Joo Young Cho, Sae Hwan Lee, Hyun Gun Kim, Sang Gyune Kim, Young Seok Kim, Young Koog Cheon, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
AIM: To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl® for treatment of gastric variceal bleeding and prophylaxis.METHODS: Between January 1994 and March 2010 at SoonChunHyang University Hospital, a total of 127 patients with gastric varices received Histoacryl® injections endoscopically. One hundred patients underwent endoscopic Histoacryl® injections because of variceal bleeding, the other 27 patients received such injections as a prophylactic procedu...
The article gives a brief description of environmental protection offshore by the separation of CO2 from produced natural gas on the Norwegian Sleipner field. The separation process is done by adding amine during the production phase. The liberated volume of CO2, which is about one million ton annually, is to be injected into the watery sandstone formation of Utsira which is about 100 metres below sea surface. The maximum content of CO2 will be 2.5% which is in accordance with the Troll agreement. The natural content of CO2 varies between 4 and 9.5%. Energy is released during the separation process. This energy is used for the operation of generators having a total output of 6 MW. The discharged volumes of CO2 is lower compared with traditional types of gas turbines. The lifetime of the field will be 40 years. 1 fig
Berteau, Cecile; Filipe-Santos, Orchidée; Wang, Tao; Rojas, Humberto E; Granger, Corinne; Schwarzenbach, Florence
Aim The primary objective of this study was to evaluate the impact of fluid injection viscosity in combination with different injection volumes and flow rates on subcutaneous (SC) injection pain tolerance. Methods The study was a single-center, comparative, randomized, crossover, Phase I study in 24 healthy adults. Each participant received six injections in the abdomen area of either a 2 or 3 mL placebo solution, with three different fluid viscosities (1, 810, and 1520 cP) combined with two different injection flow rates (0.02 and 0.3 mL/s). All injections were performed with 50 mL syringes and 27G, 6 mm needles. Perceived injection pain was assessed using a 100 mm visual analog scale (VAS) (0 mm/no pain, 100 mm/extreme pain). The location and depth of the injected fluid was assessed through 2D ultrasound echography images. Results Viscosity levels had significant impact on perceived injection pain (P=0.0003). Specifically, less pain was associated with high viscosity (VAS =12.6 mm) than medium (VAS =16.6 mm) or low (VAS =22.1 mm) viscosities, with a significant difference between high and low viscosities (P=0.0002). Target injection volume of 2 or 3 mL was demonstrated to have no significant impact on perceived injection pain (P=0.89). Slow (0.02 mL/s) or fast (0.30 mL/s) injection rates also showed no significant impact on perceived pain during SC injection (P=0.79). In 92% of injections, the injected fluid was located exclusively in SC tissue whereas the remaining injected fluids were found located in SC and/or intradermal layers. Conclusion The results of this study suggest that solutions of up to 3 mL and up to 1520 cP injected into the abdomen within 10 seconds are well tolerated without pain. High viscosity injections were shown to be the most tolerated, whereas injection volume and flow rates did not impact perceived pain. PMID:26635489
The translocation of 234Th from a simulated wound site and the efficacy of DTPA administration, as a function of the thorium compound injected as well as the DTPA treatment schedule, have been investigated in rats. Much more 234Th injected as citrate was translocated from the injection site than after administration as nitrate, whereas the distribution pattern of 234Th translocated to the various tissues was nearly identical for both 234Th compounds. Combined local and systematic treatment with DTPA was equally or more effective than each of the treatments alone in reducing the retention of 234Th at the injection site and in the organs. (author)
Caridad Margarita, García Peña; Lissette, Martínez Miranda; Antonio, Iraizoz Barrios; Vivian, Martínez Espinosa; Matilde, Torres García; Gissel María, León Guerrero.
Full Text Available Se desarrolló un método analítico por cromatografía líquida de alta resolución para la cuantificación y el ensayo de disolución de las tabletas de risperidona 3 mg. El método se basó en la separación del principio activo a través una columna cromatográfica Lichrosorb RP-18 (5 µm) (250 x 4 mm), con d [...] etección UV a 278 nm, para lo cual se empleó una fase móvil compuesta por acetonitrilo:buffer fosfato de potasio 0,05 M, de proporción 45:55. El método para la cuantificación del principio activo fue validado a través de la linealidad del sistema, especificad, exactitud y precisión. Mientras que en la validación del ensayo de disolución se evaluó la linealidad, precisión, especificidad e influencia del filtrado. Ambos métodos fueron sencillos, rápidos y económicos; además de específicos, lineales, precisos y exactos en el rango de concentraciones estudiadas. El método analítico alternativo desarrollado para la cuantificación y disolución de las tabletas de risperidona 3 mg, se comparó estadísticamente con el método propuesto en la Farmacopea de los Estados Unidos 30, y se demostró que no existían diferencias significativas entre los resultados obtenidos por cada método. Abstract in english A high-performance liquid chromatography analytical method was developed for quantification and in dissolution assay of 3 mg Risperidone tablets. Method was based in active principle separation through a Lichrosorb RP-18 (250 x 4 mm) chromatographic column with UV detection to 278 nm using a mobile [...] phase composed of 0.05 potassium phosphate buffer:acetonitrile, of 45:55 ratio. Method for active principle quantification was validated through linearity, specificity, precision and accuracy of system. Whereas in dissolution assay validation the linearity, precision, specificity and filtrate influence was assessed. Both methods were simple, fast and economic as well as specific, linear, precise and exact within the study concentrations rank. The alternative analytical method developed for 3 mg Risperidona tablets quantification and dissolution was statistically compared to method proposed by USA Pharmacopeia demonstrating that there were not significant differences among the results achieved by each method.
Caridad Margarita García Peña
Full Text Available Se desarrolló un método analítico por cromatografía líquida de alta resolución para la cuantificación y el ensayo de disolución de las tabletas de risperidona 3 mg. El método se basó en la separación del principio activo a través una columna cromatográfica Lichrosorb RP-18 (5 µm (250 x 4 mm, con detección UV a 278 nm, para lo cual se empleó una fase móvil compuesta por acetonitrilo:buffer fosfato de potasio 0,05 M, de proporción 45:55. El método para la cuantificación del principio activo fue validado a través de la linealidad del sistema, especificad, exactitud y precisión. Mientras que en la validación del ensayo de disolución se evaluó la linealidad, precisión, especificidad e influencia del filtrado. Ambos métodos fueron sencillos, rápidos y económicos; además de específicos, lineales, precisos y exactos en el rango de concentraciones estudiadas. El método analítico alternativo desarrollado para la cuantificación y disolución de las tabletas de risperidona 3 mg, se comparó estadísticamente con el método propuesto en la Farmacopea de los Estados Unidos 30, y se demostró que no existían diferencias significativas entre los resultados obtenidos por cada método.A high-performance liquid chromatography analytical method was developed for quantification and in dissolution assay of 3 mg Risperidone tablets. Method was based in active principle separation through a Lichrosorb RP-18 (250 x 4 mm chromatographic column with UV detection to 278 nm using a mobile phase composed of 0.05 potassium phosphate buffer:acetonitrile, of 45:55 ratio. Method for active principle quantification was validated through linearity, specificity, precision and accuracy of system. Whereas in dissolution assay validation the linearity, precision, specificity and filtrate influence was assessed. Both methods were simple, fast and economic as well as specific, linear, precise and exact within the study concentrations rank. The alternative analytical method developed for 3 mg Risperidona tablets quantification and dissolution was statistically compared to method proposed by USA Pharmacopeia demonstrating that there were not significant differences among the results achieved by each method.
To examine the underlying mechanisms of intracerebral or clinical actions of the atypical antipsychotic, risperidone (RIS), the effects of RIS on absolute regional cerebral blood flows (rCBFs) measured with 99mTc-HMPAO SPECT and correlations between the rCBFs and psychotic symptoms assessed with positive and negative syndrome scale (PANSS) were investigated in 10 drug-naive and unmedicated schizophrenic patients with acute hallucinatory and delusional state. Both the SPECT and PANSS were repeated before and after oral 2-week administration of RIS 3 mg/day in all of the 10 patients and after subsequent 2-week administration of RIS 4-6 mg/day in half of the patients. The rCBF values were significantly decreased in the left precentral gyrus alone after the low dose of RIS 3 mg/day in comparison with before the RIS dose. The rCBF values were significantly decreased in the right cingulate, postcentral, inferior parietal gyri and the left inferior temporal gyrus after the high dose of RIS 4-6 mg/day in comparison with before the low dose of RIS 3 mg/day. The psychiatric assessment with PANSS showed an improvement of positive and negative symptoms after the low RIS dose and still more after the high RIS dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the low RIS dose showed a positive correlation between the rCBF values in the right middle temporal gyrus and hallucinations (mainly auditory hallucination). These results suggest that chronic RIS administration dose-dependently produces a decrease of rCBF in the cerebral cortex in the manner that the low dose decreases rCBF in a few restricted cortical regions, while the high dose induces the rCBF reduction in more widespread cortical regions. The RIS-induced rCBF decrease in the cerebral cortex is considered to be attributable to a secondary inactivation in the cerebral cortex due to D2 dopamine receptor blockade of RIS in the striatum through the cortico-striatal thalamic pathway. Furthermore, the positive correlation between the rCBF values in the right middle temporal gyrus and hallucinations suggests that functional changes of the temporal lobe correlate with fluctuation of the hallucinations. (author)
Asokan, G. V.
The success of an epidemiological program against infectious diseases depends on an effective prophylactic vaccine. Although efficacy and effectiveness are used interchangeably, effectiveness depends upon efficacy. Few methods are in use to assess the efficacy of the vaccine, a randomized double blind controlled trial is the least ambiguous method for evaluation. Observational designs for vaccine efficacy include cohort and case control and are useful when comparing vaccines with very large e...
Prieto, Edna M.; Page, Jonathan M.; Harmata, Andrew J.
The design of injectable biomaterials has attracted considerable attention in recent years. Many injectable biomaterials, such as hydrogels and calcium phosphate cements, have nanoscale pores that limit the rate of cellular migration and proliferation. While introduction of macroporosity has been suggested to increase cellular infiltration and tissue healing, many conventional methods for generating macropores often require harsh processing conditions that preclude their use in injectable foa...
Kinkel, Mary D; Eames, Stefani C; Philipson, Louis H; Prince, Victoria E
A convenient method for chemically treating zebrafish is to introduce the reagent into the tank water, where it will be taken up by the fish. However, this method makes it difficult to know how much reagent is absorbed or taken up per fish. Some experimental questions, particularly those related to metabolic studies, may be better addressed by delivering a defined quantity to each fish, based on weight. Here we present a method for intraperitoneal (IP) injection into adult zebrafish. Injection is into the abdominal cavity, posterior to the pelvic girdle. This procedure is adapted from veterinary methods used for larger fish. It is safe, as we have observed zero mortality. Additionally, we have seen bleeding at the injection site in only 5 out of 127 injections, and in each of those cases the bleeding was brief, lasting several seconds, and the quantity of blood lost was small. Success with this procedure requires gentle handling of the fish through several steps including fasting, weighing, anesthetizing, injection, and recovery. Precautions are required to minimize stress throughout the procedure. Our precautions include using a small injection volume and a 35G needle. We use Cortland salt solution as the vehicle, which is osmotically balanced for freshwater fish. Aeration of the gills is maintained during the injection procedure by first bringing the fish into a surgical plane of anesthesia, which allows slow operculum movements, and second, by holding the fish in a trough within a water-saturated sponge during the injection itself. We demonstrate the utility of IP injection by injecting glucose and monitoring the rise in blood glucose level and its subsequent return to normal. As stress is known to increase blood glucose in teleost fish, we compare blood glucose levels in vehicle-injected and non-injected adults and show that the procedure does not cause a significant rise in blood glucose. PMID:20834219
Full Text Available Abstract Background Unsafe injection practices are prevalent among injection drug users (IDU and have resulted in numerous forms of drug-related harm including HIV/HCV transmission and other bacterial and viral infections. North America's first supervised injection facility (SIF was established in Vancouver in order to address injection-related harms among IDU. This study sought to examine injection drug users' experiences receiving safer injecting education in the context of a SIF. Methods Semi-structured qualitative interviews were conducted with 50 individuals recruited from a cohort of SIF users known as the Scientific Evaluation of Supervised Injection (SEOSI cohort. Audio recorded interviews elicited IDU perspectives regarding the provision of safer injecting education within the context of a SIF. Interviews were transcribed verbatim and a thematic analysis was conducted. Results Participant narratives indicate that significant gaps in knowledge regarding safer injecting practices exist among local IDU, and that these knowledge deficits result in unsafe injecting practices and negative health outcomes. However, IDU perspectives reveal that the SIF allows clients to identify and address these gaps in knowledge through a number of mechanisms that are unique to this facility, including targeted educational messaging that occurs as a part of the drug use cycle and not outside of it, in situ demonstration of safer injecting techniques that takes place the moment a client is experiencing difficulties, and enhanced opportunities to seek help from 'expert' healthcare professionals. Importantly, study participants indicated that the overall environment of the SIF promotes the adoption of safer injecting practices over time, both within and outside of the facility. Conclusion We conclude that the SIF has been particularly effective in transmitting educational messages targeting unsafe and unhygienic injection practices to a population of active IDU. Consistent with previous work, results of this study indicate that SIFs represent a unique 'micro-environment' that can facilitate the reduction of numerous drug related harms.
Full Text Available Aim: The purpose of this study was to evaluate the antimicrobial efficacy of tetracycline gutta percha (TGP and calcium hydroxide impregnated gutta percha against Enterococcus faecalis, an invitro study. Methodology: Inocula of E.faecalis were spread onto trypticase soy agar medium using sterile glass spreaders. Tetracycline gutta percha, Calcium hydroxide gutta percha and traditional gutta percha cones were aseptically transferred onto each of the inoculated plates using sterile forceps separately. The plates were incubated for 24, 48 and 72 hours at 370 Celsius aerobically. Following incubation the diameters of zone of bacterial inhibition (clear zone were measured in millimeter for each period of time. Results: Tetracycline gutta percha had the maximum antibacterial efficacy, exhibiting broader zones of inhibition, where as calcium hydroxide gutta percha had no effect on test bacteria. Conclusions: Under the conditions of this study tetracycline gutta percha offers maximum antibacterial advantage over Calcium hydroxide and traditional gutta percha.
Ä°lker ÅENGÃL; Bengi ÃZ; Ãzlem YOLERÄ°; NeÅe ÃLMEZ; Asuman MEMÄ°Å; UluÃ§, Engin
Objective: To determine and compare the efficacies of sodium hyaluronate injections and local modalities in patients with shoulder impingement syndrome.Materials and Methods: Patients (n=50) were treated with subacromial injections of sodium hyaluronate (n=25) once weekly for 3 weeks or a daily program of local modalities (n=25) for 2 weeks. Response to treatment was evaluated with the items of function in the Society of American Shoulder and Elbow Surgeons Basic Shoulder Evaluation Form and ...
F. Petrarchini; Luca, M.; Frezzotti, P; M. Alegente; M.E. Latronico; G. Esposti
Purpose. macular choroidal neovascularization (CNV) is one of the most vision-threatening complications of myopia, which can lead to severe vision loss. Our purpose was to evaluate the safety and efficacy of trans-corneal injection of ranibizumab in the treatment of myopic CNV in aphakic patients. Materials and Methods. ten eyes of 10 aphakic patients with CNV secondary to pathologic myopia treated with three trans- corneal injection of ranibizumab were evaluated. A complete ophthalmologic ex...
Li, Zonghuan; Yu, Aixi; Qi, Baiwen; Zhao, Yong; WANG, WEIYANG; Li, Ping; Ding, Junhui
The aim of this meta-analysis was to determine the efficacy of corticosteroid versus placebo injection for the treatment of plantar fasciitis. Databases (Medline, Embase, the Cochrane Library and Google Scholar) and study references were searched for randomized controlled trials comparing corticosteroid with placebo injection for plantar fasciitis. Studies that met the inclusion criteria were selected for the analysis. The risk of bias tool was used for the methodological assessment. Outcomes...
In this paper the authors report laboratory work and numerical simulation done in support of development and demonstration of injectable barriers formed from either of two fluids: colloidal silica or polysiloxane. Two principal problems addressed here are control of gel time and control of plume emplacement in the vadose zone. Gel time must be controlled so that the viscosity of the barrier fluid remains low long enough to inject the barrier, but increases soon enough to gel the barrier in place. During injection, the viscosity must be low enough to avoid high injection pressures which could uplift or fracture the formation. To test the grout gel time in the soil, the injection pressure was monitored as grouts were injected into sandpacks. When grout is injected into the vadose zone, it slumps under the influence of gravity, and redistributes due to capillary forces as it gels. The authors have developed a new module for the reservoir simulator TOUGH2 to model grout injection into the vadose zone, taking into account the increase of liquid viscosity as a function of gel concentration and time. They have also developed a model to calculate soil properties after complete solidification of the grout. The numerical model has been used to design and analyze laboratory experiments and field pilot tests. The authors present the results of computer simulations of grout injection, redistribution, and solidification
SQL Injection Attacks and Defense, First Edition: Winner of the Best Book Bejtlich Read Award "SQL injection is probably the number one problem for any server-side application, and this book unequaled in its coverage." -Richard Bejtlich, Tao Security blog SQL injection represents one of the most dangerous and well-known, yet misunderstood, security vulnerabilities on the Internet, largely because there is no central repository of information available for penetration testers, IT security consultants and practitioners, and web/software developers to turn to for help. SQL Injection Att
Vijay.R; Suman Makam; Shashikala K
Aim: The purpose of this study was to evaluate the antimicrobial efficacy of tetracycline gutta percha (TGP) and calcium hydroxide impregnated gutta percha against Enterococcus faecalis, an invitro study. Methodology: Inocula of E.faecalis were spread onto trypticase soy agar medium using sterile glass spreaders. Tetracycline gutta percha, Calcium hydroxide gutta percha and traditional gutta percha cones were aseptically transferred onto each of the inoculated plates using sterile forceps sep...
Pruvot, Benoist; Jacquel, Arnaud; Droin, Nathalie; Auberger, Patrick; Bouscary, Didier; Tamburini, Jerome; Muller, Marc; Fontenay, Michaela; Chluba, Johanna; Solary, Eric
Zebrafish were proposed as an alternative to mammalian models to assess the efficacy and toxicity of antileukemic drugs. Due to the limited number of transgenic zebrafish leukemia models, we explored human leukemic cell xenograft in zebrafish embryos. Human leukemic cell lines and blast cells sorted from patients with acute myelogenous leukemia were injected 48 hours post-fertilization and remained in the circulation of zebrafish embryos for several days without affecting their development. I...