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Sample records for injectable risperidone efficacy

  1. Risperidone long-acting injection: a review of its long term safety and efficacy

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    Michael K Rainer

    2008-08-01

    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

  2. Paliperidone palmitate versus oral risperidone and risperidone long-acting injection in patients with recently diagnosed schizophrenia: a tolerability and efficacy comparison.

    Science.gov (United States)

    Fu, Dong-Jing; Bossie, Cynthia A; Sliwa, Jennifer K; Ma, Yi-Wen; Alphs, Larry

    2014-01-01

    Early in the course of illness, patients with schizophrenia may be particularly susceptible to adverse events (AEs). In this post-hoc, subgroup analysis of a 13-week, double-blind, double-dummy, multicenter study, patients recently diagnosed with schizophrenia (? 5 years) were administered once-monthly flexible-dose paliperidone palmitate (PP) (n=161; initiation doses, 150 mg eq day 1 and 100 mg eq day 8) [PP doses can be expressed as milligram equivalents (mg eq) of paliperidone or as milligrams (mg) of PP. 150 mg eq paliperidone=234 mg PP; 100 mg eq paliperidone=156 mg PP. In the USA, dosing tends to be expressed in mg] or oral risperidone [during initiation of risperidone long-acting injection (RLAI) days 1-28] and biweekly flexible-dose RLAI (n=173; initial injection day 8). Assessments were performed at baseline and days 4, 15, 22, 36, 64, and 92. Because of RLAI's release profile, data through day 22 correspond to oral risperidone in the RLAI arm. During this period, the AE profile and onset of efficacy of PP and oral risperidone were similar. The overall AE rates at week 13 for PP and RLAI were 54.7 and 50.3%, respectively, for any AE; 11.2 and 8.1% for extrapyramidal symptom-related AEs; and 2.5 and 2.3% for prolactin-related AEs. No significant differences in the mean weight change, most metabolic parameters, or mean efficacy measures were observed at end point. In patients with recently diagnosed schizophrenia, the tolerability and efficacy of PP and RLAI were generally similar over 13 weeks. PMID:24113628

  3. Efficacy and safety of risperidone long-acting injection in elderly people with schizophrenia

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    Dhiren Singh; Amp Rsquo Connor, Daniel Amp Nbsp W. O.

    2009-01-01

    Dhiren Singh1,2, Daniel W O’Connor11Department 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...

  4. Combination treatment with risperidone long-acting injection and psychoeducational approaches for preventing relapse in schizophrenia

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    Zhao Y

    2013-10-01

    Full Text Available Yueren Zhao,1–3 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

  5. Paliperidone palmitate and risperidone long-acting injectable in subjects with schizophrenia recently treated with oral risperidone or other oral antipsychotics

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    Alphs L

    2013-03-01

    Full Text Available Larry Alphs,1 Cynthia A Bossie,1 Jennifer Kern Sliwa,2 Dong-Jing Fu,1 Yi-Wen Ma,3 Joseph Hulihan11CNS Medical Affairs, 2Medical Information, Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 3Biostatistics, B&P, Janssen Research & Development LLC, Titusville, NJ, USABackground: This post hoc subgroup analysis of a randomized, double-blind trial evaluated the response to treatment with two long-acting injectable atypical antipsychotics, ie, paliperidone palmitate and risperidone long-acting injectable (RLAI, in subjects with schizophrenia experiencing clinically significant symptoms despite recent treatment with oral risperidone only or other oral antipsychotics.Methods: Adult subjects were eligible for the 13-week, double-blind, double-dummy trial (NCT00589914 if they had an established diagnosis of schizophrenia for at least one year and a Positive and Negative Syndrome Scale (PANSS total score of 60–120 inclusive at screening. Subjects received either paliperidone palmitate (234 mg, day 1; 156 mg, day 8; then once-monthly flexible dosing or RLAI (25–50 mg biweekly, with oral risperidone supplementation on days 1–28, plus matched placebo injections/tablets.Results: This post hoc analysis reports data on 747 subjects who, within 2 weeks of starting double-blind study medication, had reportedly received oral risperidone only (paliperidone palmitate group, n = 126; RLAI group, n = 107, other oral antipsychotics (paliperidone palmitate group, n = 199; RLAI group, n = 203, or no antipsychotic (paliperidone palmitate group, n = 56; RLAI group, n = 56. Mean PANSS total scores improved significantly at end point across all subgroups (mean change from baseline ranged from ?17.5 to ?19.5, all P < 0.0001. Clinical Global Impression-Severity and Personal and Social Performance scale measures also significantly improved from baseline (all P < 0.0001.Conclusion: Treatment with paliperidone palmitate or RLAI resulted in a significant reduction in the symptoms of schizophrenia irrespective of previous recent treatment with oral risperidone only or other oral antipsychotics. For subjects who had previously received oral risperidone only, the difference in formulation was the main change in the intervention because the molecule delivered remained the same or similar. These data support the contribution of a long-acting formulation to improving the treatment response and suggest that nonadherence may be a significant contributor to inadequate efficacy of oral formulations in subjects with schizophrenia.Keywords: paliperidone palmitate, risperidone long-acting injection, schizophrenia

  6. Impact of CYP2D6 genotype on steady-state serum concentrations of risperidone and 9-hydroxyrisperidone in patients using long-acting injectable risperidone.

    Science.gov (United States)

    Hendset, Magnhild; Molden, Espen; Refsum, Helge; Hermann, Monica

    2009-12-01

    An increased risk of adverse effects and discontinuation of risperidone therapy is observed in patients with impaired cytochrome P450 2D6 (CYP2D6) function on oral risperidone therapy. The present study is the first to investigate the impact of CYP2D6 genotype on serum concentrations of risperidone and 9-hydroxyrisperidone in patients using injectable long-acting risperidone. Two hundred three patients were divided into groups according to administered risperidone formulation (long-acting injection; n = 90) and CYP2D6 genotype. Dose-adjusted serum concentrations were compared using the CYP2D6*1/*1 subgroup as reference. The total serum concentration of risperidone plus 9-hydroxyrisperidone was 80% (P < 0.03) and 32% (P < 0.03) higher, whereas the risperidone-9-hydroxyrisperidone ratios were 6.3-fold (P < 0.01) and 12.5-fold (P < 0.01) higher in the CYP2D6def/def (def means defective allele, ie, CYP2D6*3, *4, *5, or *6) subgroup for long-acting and oral risperidone, respectively. In conclusion, CYP2D6 genotype significantly affects the pharmacokinetics of both oral and long-acting risperidone formulations. PMID:19910717

  7. Maintenance therapy with once-monthly administration of long-acting injectable risperidone in patients with schizophrenia or schizoaffective disorder: a pilot study of an extended dosing interval

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    Naessens Ineke

    2007-01-01

    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.

  8. Costs and efficacy ofolanzapine and risperidone in schizophrenia

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    Vittorio Mapelli

    2007-06-01

    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.?

  9. Successful Treatment of Anorexia Nervosa in a 10-year-old Boy with Risperidone Long-acting Injection

    OpenAIRE

    Umehara, Hidehiro; Iga, Junichi; Ohmori, Tetsuro

    2014-01-01

    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...

  10. Long-acting injectable risperidone in partially adherent and nonadherent patients with schizophrenia

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    Louzã M

    2011-06-01

    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

  11. A randomized trial of paliperidone palmitate and risperidone long-acting injectable in schizophrenia.

    Science.gov (United States)

    Fleischhacker, W Wolfgang; Gopal, Srihari; Lane, Rosanne; Gassmann-Mayer, Cristiana; Lim, Pilar; Hough, David; Remmerie, Bart; Eerdekens, Marielle

    2012-02-01

    Paliperidone palmitate (PP) is a recently (USA) approved injectable new-generation antipsychotic. This 53-wk, Phase-III double-blind study was designed to assess the non-inferiority of PP to risperidone long-acting injectable (RIS-LAI) in schizophrenia treatment. Acutely symptomatic patients (n=749), with a Positive and Negative Syndrome Scale (PANSS) total score between 60 and 120 were randomly allocated to gluteal injections of either (a) PP: 50 mg eq. on days 1 and 8, and flexible dosing [25-100 mg eq. (i.e. 39-156 mg USA dosing)] once-monthly; or (b) RIS-LAI: bi-weekly injections of 25 mg on days 8 and 22, and flexible dosing (25-50 mg) starting from day 36, with allowed oral supplementation. Patients (n=747) were 59% men, 92% white, mean (s.d.) age of 41 (11.95) yr and 45% (n=339) completed the study. Mean (s.d.) change from baseline to endpoint in PANSS total score was: -11.6 (21.22) PP; and -14.4 (19.76) RIS-LAI (per-protocol analysis set, primary measure); least-squares means difference was -2.6 (95% CI -5.84 to 0.61), with a prespecified 5-point non-inferiority margin. PP's suboptimal dosing regimen (<150 mg eq. initial dose) resulted in lower median plasma levels of the active moiety in PP-treated vs. RIS-LAI-treated patients. Insomnia was the most common treatment-emergent adverse event, with a similar incidence in both groups (15%). PP did not demonstrate comparable efficacy to RIS-LAI, which may be attributable to the initiation dosing strategy employed. Tolerability of both treatments was comparable to previous studies, with no new safety signals detected. PMID:21777507

  12. Risperidone long-acting injection in the treatment of schizophrenia spectrum illnesses: A retrospective chart review of 19 patients in the Vancouver Community Mental Health Organization (Vancouver, Canada)

    OpenAIRE

    Ganesan, Soma; Mckenna, Mario; Procyshyn, Ric M.; Zipursky, Sheldon

    2007-01-01

    Background: Schizophrenia is a chronic debilitating disease that affects ~110,000 Canadians (0.55% lifetime prevalence). Risperidone long-acting injection (RLAI) is the first injectable, long-acting, atypical antipsychotic drug marketed in Canada.

  13. An open-label, multicenter evaluation of the long-term safety and efficacy of risperidone in adolescents with schizophrenia

    Directory of Open Access Journals (Sweden)

    Pandina Gahan

    2012-06-01

    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, Children’s 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

  14. Premorbid functioning and treatment response in recent-onset schizophrenia: prospective study with risperidone long-acting injectable.

    Science.gov (United States)

    Rabinowitz, Jonathan; Napryeyenko, Oleksandr; Burba, Benjaminas; Martinez, Guadalupe; Neznanov, Nikolay G; Fischel, Tsvi; Baylé, Franck J; Cavallaro, Roberto; Smeraldi, Enrico; Schreiner, Andreas

    2011-02-01

    Premorbid functioning may be associated with treatment response, but this is confounded by a lack of prospective longitudinal data and controls for medication compliance. This study tested the hypothesis that good premorbid functioning will be associated with better antipsychotic treatment response after controlling for drug adherence by using a long-acting injectable antipsychotic. This was a 6-month, open label, multicenter, phase IV trial in recent-onset schizophrenia treated with flexible doses of risperidone long-acting injectable (25-50 mg every 14 days). Premorbid functioning was assessed with the Premorbid Adjustment Scale (PAS)-Structured Interview; efficacy was evaluated with clinician-rated Positive and Negative Syndrome Scale, Clinical Global Impression scale of Severity of Illness, Clinical Global Impression scale of Change, Global Assessment of Functioning Scale, and trial participant completed SF-36. Analyses controlled for baseline scores and demographics. With the use of a priori PAS scoring criteria, the participants' premorbid functioning was categorized as stable-good (n = 142), stable-poor (n = 116), and deteriorating (n = 36). At baseline, the stable-good group had the best functioning on most efficacy measures. All groups showed significant improvement on efficacy measures with treatment. Improvement was significantly higher for the stable-good group. The PAS global assessment of highest level of functioning scale (excellent, n = 75; good, n = 117; fair, n = 78; and poor, n = 31) showed a strong association with baseline functioning and improvement and had a significant linear association with meeting Remission in Schizophrenia Working Group symptom criteria at baseline (P = 0.003) and attained and sustained remission for 3 months during study (47.7%, 49.3%, 29.6%, and 22.2%; P = 0.006). Good premorbid functioning corresponds with better treatment response in recent-onset psychosis as captured on both clinician and patient-reported measures. PMID:21192147

  15. Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effects.

    Science.gov (United States)

    Boettger, Soenke; Jenewein, Josef; Breitbart, William

    2014-09-01

    Objective: The aim of this study was to compare the efficacy and side-effect profile of the typical antipsychotic haloperidol with that of the atypical antipsychotics risperidone, olanzapine, and aripiprazole in the management of delirium. Method: The Memorial Delirium Assessment Scale (MDAS), the Karnofsky Performance Status (KPS) scale, and a side-effect rating were recorded at baseline (T1), after 2-3 days (T2), and after 4-7 days (T3). Some 21 cases were case-matched by age, preexisting dementia, and baseline MDAS scores, and subsequently analyzed. Results: The baseline characteristics of the medication groups were not different: The mean age of the patients ranged from 64.0 to 69.6 years, dementia was present in between 23.8 and 28.6%, and baseline MDAS scores were 19.9 (haloperidol), 18.6 (risperidone), 19.4 (olanzapine), and 18.0 (aripiprazole). The doses of medication at T3 were 5.5 mg haloperidol, 1.3 mg risperidone, 7.1 mg olanzapine, and 18.3 mg aripiprazole. Over one week, the decline in MDAS scores between medications was equal, and no differences between individual MDAS scores existed at T2 or T3. After one week, the MDAS scores were 6.8 (haloperidol), 7.1 (risperidone), 11.7 (olanzapine), and 8.3 (aripiprazole). At T2, delirium resolution occurred in 42.9-52.4% of cases and at T3 in 61.9-85.7%; no differences in assessments between medications existed. Recorded side effects were extrapyramidal symptoms (EPSs) in haloperidol- and risperidone-managed patients (19 and 4.8%, respectively) and sedation with olanzapine (28.6%). Significance of Results: Haloperidol, risperidone, aripiprazole, and olanzapine were equally effective in the management of delirium; however, they differed in terms of their side-effect profile. Extrapyramidal symptoms were most frequently recorded with haloperidol, and sedation occurred most frequently with olanzapine. PMID:25191793

  16. Are the Long-Acting Intramuscular Formulations of Risperidone or Paliperidone Palmitate Associated with Post-Injection Delirium/Sedation Syndrome? An Assessment of Safety Databases

    Science.gov (United States)

    Alphs, Larry; Gopal, Srihari; Karcher, Keith; Kent, Justine; Kern Sliwa, Jennifer; Kushner, Stuart; Nuamah, Isaac; Singh, Jaskaran

    2011-01-01

    Long-acting injectable (LAI) formulations of antipsychotics are valuable treatment alternatives for patients with psychotic disorders, and understanding their safe use is critical. Post-injection delirium/sedation syndrome (PDSS) has been reported following treatment with one atypical antipsychotic LAI. Clinical databases of risperidone LAI and paliperidone palmitate were explored to identify if cases of PDSS had been observed. No cases of PDSS were identified in 15 completed trials of 3,164 subjects (approximately 115,000 injections) or the postmarketing safety database of risperidone LAI. Only one case of PDSS was identified among 10 completed trials (3,817 subjects, 33,906 injections) of paliperidone palmitate—that case having been reported in a patient randomized to treatment with placebo. Examination of these prospective databases finds no evidence that risperidone LAI and paliperidone palmitate are associated with PDSS and suggest that findings seen with another antipsychotic LAI are not generalizable. PMID:21047303

  17. Clinical utility of the risperidone formulations in the management of schizophrenia

    Directory of Open Access Journals (Sweden)

    Madaan V

    2011-10-01

    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

  18. Are the Long-Acting Intramuscular Formulations of Risperidone or Paliperidone Palmitate Associated with Post-Injection Delirium/Sedation Syndrome? An Assessment of Safety Databases

    OpenAIRE

    Alphs, Larry; Gopal, Srihari; Karcher, Keith; Kent, Justine; Kern Sliwa, Jennifer; Kushner, Stuart; Nuamah, Isaac; Singh, Jaskaran

    2011-01-01

    Long-acting injectable (LAI) formulations of antipsychotics are valuable treatment alternatives for patients with psychotic disorders, and understanding their safe use is critical. Post-injection delirium/sedation syndrome (PDSS) has been reported following treatment with one atypical antipsychotic LAI. Clinical databases of risperidone LAI and paliperidone palmitate were explored to identify if cases of PDSS had been observed.

  19. Preparation and in-vitro characterization of Risperidone-cyclodextrin inclusion complexes as a potential injectable product

    Directory of Open Access Journals (Sweden)

    D Shukla

    2009-12-01

    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.

  20. Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery.

    Science.gov (United States)

    Prakanrattana, U; Prapaitrakool, S

    2007-10-01

    This randomised, double-blinded, placebo-controlled study was primarily aimed to evaluate the potential of risperidone to prevent postoperative delirium following cardiac surgery with cardiopulmonary bypass and the secondary objective was to explore clinical factors associated with postoperative delirium. One-hundred-and-twenty-six adult patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomly assigned to receive either 1 mg of risperidone or placebo sublingually when they regained consciousness. Delirium and other outcomes were assessed. The confusion assessment method for intensive care unit was used to assess postoperative delirium. The incidence of postoperative delirium in the risperidone group was lower than the placebo group (11.1% vs. 31.7% respectively, P=0.009, relative risk = 0.35, 95% confidence interval [CI] = 0.16-0.77). Other postoperative outcomes were not statistically different between the groups. In exploring the factors associated with delirium, univariate analysis showed many factors were associated with postoperative delirium. However multiple logistic regression analysis showed a lapse of 70 minutes from the time of opening eyes to following commands and postoperative respiratory failure were independent risk factors (P=0.003, odds ratio [OR] = 4.57, 95% CI = 1.66-12.59 and P=0.038, OR = 13.78, 95% CI = 1.15-165.18 respectively). A single dose of risperidone administered soon after cardiac surgery with cardiopulmonary bypass reduces the incidence of postoperative delirium. Multiple factors tended to be associated with postoperative delirium, but only the time from opening eyes to following commands and postoperative respiratory failure were independent risk factors in this study. PMID:17933157

  1. Efficacy and safety of long acting injectable atypical antipsychotics: a review.

    Science.gov (United States)

    De Berardis, Domenico; Marini, Stefano; Carano, Alessandro; Lang, Antonella Padovan; Cavuto, Marilde; Piersanti, Monica; Fornaro, Michele; Perna, Giampaolo; Valchera, Alessandro; Mazza, Monica; Iasevoli, Felice; Martinotti, Giovanni; Di Giannantonio, Massimo

    2013-08-01

    Schizophrenia is a chronic, severe and recurrent brain disorder that requires continuous, long-term treatment with antipsychotic medication to minimize relapse and provide clinical benefit to patients. For patients with schizophrenia, non-adherence to medication is a major risk factor for relapse and re-hospitalization. Long-acting injectable formulations of second-generation antipsychotics (SGAs-LAIs) provide constant medication delivery and the potential for improved adherence. Currently, three drugs are available for the treatment of schizophrenia, risperidone longacting injectable, olanzapine pamoate and paliperidone palmitate. Several studies have also demonstrated efficacy and safety of such drugs in patients with acute schizophrenia. In the present paper the literature on LAI atypical antipsychotics will be reviewed and practical advice will be given concerning the use of these drugs in the clinical practice. PMID:23343445

  2. Changes in prolactin levels and sexual function in young psychotic patients after switching from long-acting injectable risperidone to paliperidone palmitate.

    Science.gov (United States)

    Montalvo, Itziar; Ortega, Laura; López, Xavi; Solé, Montse; Monseny, Rosa; Franch, Joan; Vilella, Elisabet; Labad, Javier

    2013-01-01

    Hyperprolactinaemia is a significant side effect of antipsychotic medications and may cause sexual dysfunction. The aim of our study was to assess the effect of switching from long-acting injectable (LAI) risperidone to paliperidone palmitate (PP) on sexual function and prolactin levels in patients with psychosis. We carried out a prospective observational study during a 3-month period that involved 11 patients with psychosis treated with risperidone-LAI who suffered from hyperprolactinaemia and who were then switched to PP. Two assessments were completed: the first one before the switch and the second one 3 months after the switch. These assessments measured sexual function using the Arizona Sexual Experience Scale and assessed prolactin levels. Our results showed a significant decrease in serum prolactin levels (P=0.041). We observed a four-fold reduction in clinically significant sexual dysfunction that is suggestive of benefit, although the sample size is too small to be sure. Our study suggests that prolactin levels seem to decrease after switching from risperidone-LAI to PP in patients with a psychotic disorder. PMID:23232756

  3. Switching from risperidone long-acting injectable to paliperidone long-acting injectable or oral antipsychotics: analysis of a Medicaid claims database.

    Science.gov (United States)

    Voss, Erica A; Ryan, Patrick B; Stang, Paul E; Hough, David; Alphs, Larry

    2015-05-01

    This report examines relapse risk following a switch from risperidone long-acting injectable (RLAI) to another long-acting injectable antipsychotic [paliperidone palmitate (PP)] versus a switch to oral antipsychotics (APs). Truven Health's MarketScan Multistate Medicaid Database compared relapses following switches from RLAI. New user cohorts for these two groups were created on the basis of first incidence of exposure to the 'switched to' drug. Groups were balanced using 1:1 propensity score matching. Time-to-event analysis assessed schizophrenia-related hospital/emergency department visits. A total of 188 patients switched from RLAI to PP, and 131 patients switched from RLAI to oral AP. Propensity score-matched cohort included 109 patients who switched to PP and 109 patients who switched to an oral AP. Patients who switched from RLAI to PP had fewer events (26 vs. 32), longer time to an event (mean 70 vs. 47 days), and lower risk of relapse (hazard ratio, 0.54; 95% confidence interval, 0.32-0.92; P=0.024) compared with those who switched from RLAI to oral AP. Switching from RLAI to PP may be associated with a lower risk for relapse and longer duration of therapy compared with switching to oral AP. Given the limitations of observational studies, these results should be confirmed by other prospective evaluations. PMID:25730525

  4. Paliperidone palmitate and risperidone long-acting injectable in subjects with schizophrenia recently treated with oral risperidone or other oral antipsychotics

    OpenAIRE

    Alphs L; Ca, Bossie; Jk, Sliwa; Dj, Fu; Yw, Ma; Hulihan J

    2013-01-01

    Larry Alphs,1 Cynthia A Bossie,1 Jennifer Kern Sliwa,2 Dong-Jing Fu,1 Yi-Wen Ma,3 Joseph Hulihan11CNS Medical Affairs, 2Medical Information, Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 3Biostatistics, B&P, Janssen Research & Development LLC, Titusville, NJ, USABackground: This post hoc subgroup analysis of a randomized, double-blind trial evaluated the response to treatment with two long-acting injectable atypical antipsychotics, ie, paliperidone palmitate and risper...

  5. Comparative Effectiveness of Risperidone Long-Acting Injectable vs First-Generation Antipsychotic Long-Acting Injectables in Schizophrenia : Results From a Nationwide, Retrospective Inception Cohort Study

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Jensen, Signe O W

    2015-01-01

    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.

  6. Risperidone Versus Risperidone Plus Sodium Valproate for Treatment of Bipolar Disorders: A Randomized, Double-Blind Clinical-Trial

    Directory of Open Access Journals (Sweden)

    S. Mohammad Moosavi

    2014-06-01

    Full Text Available Objective: This study compared the efficacy of risperidone monotherapy with risperidone plus valproate in bipolar I disorder, manic phase. Some studies showed the efficacy of risperidone monotherapy in the treatment of bipolar disorder, so we examined this effectiveness in this clinical-trial study. Method: This 7-week, randomized, single-blind study included 48 bipolar I inpatients manic phase without psychotic features divided in risperidone group (n = 23 and risperidone plus sodium valproate group (n = 25. According to clinical symptoms, 3 categories: complete remission, partial remission and no remission were mentioned in weekly follow-up. Remission rate compared with survival analysis. Results: The results showed a significant difference in remission rate between risperidone monotherapy and risperidone plus sodium valproate at the 1st, 2nd and the 3rd week (p = 0.012, 0.023, 0.027 respectively, It means the remission rate in risperidone plus valproate group was higher in the first three weeks, but at the end of the seventh week, the difference was not statistically significant. There was no significant difference between the two groups in the development of adverse effects. Conclusions: Risperidone can be effective and well tolerated in both acute manic episodes of bipolar mood disorders.

  7. Profile of paliperidone palmitate once-monthly long-acting injectable in the management of schizophrenia: long-term safety, efficacy, and patient acceptability – a review

    Science.gov (United States)

    González-Rodríguez, Alexandre; Catalán, Rosa; Penadés, Rafael; Garcia-Rizo, Clemente; Bioque, Miquel; Parellada, Eduard; Bernardo, Miquel

    2015-01-01

    Background and objectives Short-term studies focused on once-monthly paliperidone palmitate (PP) at doses of 25 mg eq, 50 mg eq, 75 mg eq, 100 mg eq, or 150 mg eq have shown its efficacy and tolerability in the treatment of schizophrenia patients. However, few open-label and long-term studies are available regarding this new pharmacological formulation. Thus, our main aim was to review the scientific evidence on efficacy, safety, tolerability, and preference of PP in these populations. Method Electronic searches were conducted by using PubMed and ISI Web of Knowledge databases. All relevant studies published from 2009 until January 2015 were included without any language restriction if patients met diagnostic criteria for schizophrenia, and adequate information on efficacy, safety, and tolerability of once-monthly PP was available. Results Nineteen studies were identified irrespective of the study design and duration of the follow-up period. Randomized, double-blind, placebo-controlled trials found that schizophrenia patients receiving PP showed a significant improvement in psychotic symptoms and similar adverse events compared to placebo and suggested that all doses of PP were efficacious and well tolerated. Other studies demonstrated noninferiority of PP compared to risperidone long-acting injectable in recently diagnosed schizophrenia patients, chronically ill patients, as well as in acute and nonacute symptomatic schizophrenia patients, and a similar proportion of treatment-emergent adverse events between both groups were also noted. Conclusion Several studies have demonstrated that schizophrenia patients treated with PP show higher rates of improvement of psychotic symptoms compared to placebo, and similar efficacy and tolerability outcomes were noted when comparing PP to risperidone long-acting injectable or oral, paliperidone extended release.

  8. Risperidone Treatment in 12 Children With Developmental Disorders and Attention-Deficit/Hyperactivity Disorder

    OpenAIRE

    Eapen, Valsamma; Gururaj, A. K.

    2005-01-01

    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).

  9. Early-life risperidone administration alters maternal-offspring interactions and juvenile play fighting.

    Science.gov (United States)

    Gannon, Matthew A; Brown, Clifford J; Stevens, Rachel M; Griffith, Molly S; Marczinski, Cecile A; Bardgett, Mark E

    2015-03-01

    Risperidone is an antipsychotic drug that is approved for use in childhood psychiatric disorders such as autism. One concern regarding the use of this drug in pediatric populations is that it may interfere with social interactions that serve to nurture brain development. This study used rats to assess the impact of risperidone administration on maternal-offspring interactions and juvenile play fighting between cage mates. Mixed-sex litters received daily subcutaneous injections of vehicle or 1.0 or 3.0mg/kg of risperidone between postnatal days (PNDs) 14-42. Rats were weaned and housed three per cage on PND 21. In observations made between PNDs 14-17, risperidone significantly suppressed several aspects of maternal-offspring interactions at 1-hour post-injection. At 23 h post-injection, pups administered risperidone had lower activity scores and made fewer non-nursing contacts with their moms. In observations of play-fighting behavior made once a week between PNDs 22-42, risperidone profoundly decreased many forms of social interaction at 1h post-injection. At 23h post-injection, rats administered risperidone made more non-social contacts with their cage mates, but engaged in less social grooming. Risperidone administration to rats at ages analogous to early childhood through adolescence in humans produces a pattern of abnormal social interactions across the day that could impact how such interactions influence brain development. PMID:25600754

  10. Risperidone Improves Behavioral Symptoms in Children with Autism in a Randomized, Double-Blind, Placebo-Controlled Trial

    Science.gov (United States)

    Pandina, Gahan J.; Bossie, Cynthia A.; Youssef, Eriene; Zhu, Young; Dunbar, Fiona

    2007-01-01

    Subgroup analysis of children (5-12 years) with autism enrolled in an 8-week, double-blind, placebo-controlled trial of risperidone for pervasive developmental disorders. The primary efficacy measure was the Aberrant Behavior Checklist-Irritability (ABC-I) subscale. Data were available for 55 children given risperidone (n = 27) or placebo (n =…

  11. Risperidone Dosing in Children and Adolescents with Autistic Disorder: A Double-Blind, Placebo-Controlled Study

    Science.gov (United States)

    Kent, Justine M.; Kushner, Stuart; Ning, Xiaoping; Karcher, Keith; Ness, Seth; Aman, Michael; Singh, Jaskaran; Hough, David

    2013-01-01

    Efficacy and safety of 2 risperidone doses were evaluated in children and adolescents with autism. Patients (N = 96; 5-17 years), received risperidone (low-dose: 0.125 mg/day [20 to 45 kg] or high-dose: 1.25 mg/day [20 to 45 kg]) or placebo. Mean baseline (range 27-29) to endpoint change…

  12. Efficacy and safety of risperidone oral solution in agitation associated with dementia in the elderly / Eficácia e segurança de risperidona solução oral na agitação associada a demência em idosos

    Scientific Electronic Library Online (English)

    Jerson, Laks; Eliasz, Engelhardt; Valeska, Marinho; Marcia, Rozenthal; Fernando de Castro e, Souza; Josué, Bacaltchuk; Alberto, Stoppe Jr.; R.C.R., Ferreira; Cassio, Bottino; Mônica, Scalco.

    2001-12-01

    Full Text Available FUNDAMENTOS: Sintomas psicológicos e do comportamento nas demências (BPSD) contribuem para a sobrecarga dos cuidadores e institucionalização dos idosos. Neurolépticos são prescritos para agitação. Efeitos colaterais dos típicos são prejudiciais, sendo os atípicos indicáveis. OBJETIVO: Avaliar eficác [...] ia e tolerabilidade da risperidona solução oral (RSO), dose única diária, em idosos demenciados ambulatoriais com BPSD (agitação). MÉTODO: Pacientes (n=26), 76,35±8,63 anos, critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais 4.ed. (DSM-IV) para demência. RSO administrada, com dose inicial de 0,25 mg e incrementos de 0,25 mg toda semana. Foram utilizados mini-mental (MEEM) para estado cognitivo, behavioral and emotional activities manifested in dementia (BEAM-D) e clinical and global impression (CGI) para BPSD, extrapyramidal symptom rating scale (ESRS) para sintomas extrapiramidais. Efeitos colaterais cardiovasculares foram avaliados clinicamente. RESULTADOS: Houve redução de 26% na agitação, sem efeitos colaterais cardiovasculares, numa faixa de 1,0 a 1,25 mg. Efeitos colaterais foram mais prevalentes acima de 2,5 mg. CONCLUSÃO: Risperidona melhorou agitação com boa tolerabilidade entre 0,5 e 1,25 mg. Dose única diária e aumentos de 0,25 mg podem ser mais aceitáveis para pacientes e cuidadores. Abstract in english BACKGROUND: Behavioral and psychological symptoms in dementia (BPSD) contribute to caregiver burden and institutionalization of elderly. Neuroleptics are prescribed to control agitation. Side effects of typical neuroleptics are harmful, making atypical neuroleptics an indication. OBJECTIVES: To eval [...] uate efficacy and tolerability of risperidone oral solution (ROS) given once daily to demented elderly outpatients with BPSD (agitation). METHOD: Patients (n=26), 76.35±8.63 years, Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV) criteria for dementia. RSO was given, starting dose of 0.25 mg and increments of 0.25 mg every week. Mini-Mental State Examination (MMSE) assessed cognitive status, Behavioral and Emotional Activities Manifested in Dementia (BEAM-D) and Clinical Global Impression (CGI) measured BPSD, Extrapiramidal Symptom Rating Scale (ESRS) evaluated extrapyramidal symptoms. Cardiovascular side effects were evaluated clinically. RESULTS: There was a 26% reduction in agitation and no cardiovascular side effects in the range from 1.0 to 1.25 mg. Side effects were more prevalent above 2.5 mg. CONCLUSION: Risperidone oral solution improved agitation with good tolerability from 0.5 to 1.25 mg. A single dose with increments of 0.25 mg may be more acceptable to patients and caregivers.

  13. Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

    Directory of Open Access Journals (Sweden)

    Schooler Nina

    2011-02-01

    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 Impressions–Severity (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.

  14. POST MARKETING SURVEILLANCE STUDY ON RISPERIDONE IN PATIENTS SUFFERING FROM SCHIZOPHRENIA

    OpenAIRE

    J R Zaveri; Vipul Chaudhari

    2011-01-01

    Schizophrenia is one of the commonest psychiatric ailments. It has been estimated that approximately 1% of the population and 15% of the adults suffers from this disease. Risperidone, atypical antipsychotic, acts mainly by 5HT2 blockade action. Produce virtually no extra pyramidal side effects at low dose, has a broad efficacy. But extra pyramidal dysfunction can appear at higher doses. We conducted a post marketing surveillance study on risperidone in 40 patients suffering from schizophrenia...

  15. A Comparative Study between Olanzapine and Risperidone in the Management of Schizophrenia

    OpenAIRE

    Shoja shafti, Saeed; Gilanipoor, Mahsa

    2014-01-01

    Introduction. Since a variety of comparisons between risperidone and olanzapine have resulted in diverse outcomes, so safety and efficacy of them were compared again in a new trial. Method. Sixty female schizophrenic patients entered into one of the assigned groups for random allocation to olanzapine or risperidone (n = 30 in each group) in a double-blind, 12-week clinical trial. Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) were used as...

  16. 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

    Scientific Electronic Library Online (English)

    Rogelio, Apiquian; Rodrigo, Córdoba; Mario, Louzã; Ana, Fresán.

    2013-02-01

    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

  17. Risperidone and Explosive Aggressive Autism.

    Science.gov (United States)

    Horrigan, Joseph P.; Barnhill, L. Jarrett

    1997-01-01

    In this study, 11 males with autism and mental retardation were administered risperidone. Substantial clinical improvement was noted almost immediately; patients with aggression, self-injury, explosivity, and poor sleep hygiene were most improved. The modal dose for optimal response was 0.5 mg bid. Weight gain was a significant side effect.…

  18. Risperidone versus zuclopenthixol in the treatment of schizophrenia with substance abuse comorbidity: a long-term randomized, controlled, crossover study

    Scientific Electronic Library Online (English)

    Gabriel, Rubio; Isabel, Martínez; Ana, Recio; Guillermo, Ponce; Francisco, López-Muñoz; Cecilio, Alamo; Miguel Ángel, Jiménez-Arriero; Tomás, Palomo.

    2006-09-01

    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.

  19. Risperidone versus zuclopenthixol in the treatment of schizophrenia with substance abuse comorbidity: a long-term randomized, controlled, crossover study

    Directory of Open Access Journals (Sweden)

    Gabriel Rubio

    2006-09-01

    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 risperidone 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.

  20. Valproate-Risperidone versus Valproate-Lithium combination in acute mania

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    M Barekatain

    2005-09-01

    Full Text Available Background: We evaluated the efficacy of valproate plus risperidone versus valproate plus lithium combination in the treatment of acute mania. Methods: In 2-week, randomized, double-blind, parallel group study, 46 acute manic patients according to DSM-IV criteria were randomly assigned to receive combination of valproate 20 mg/ kg/day plus risperidone 2-4 mg/day (n=23 or lithium600-1200 mg/day (n=23. The assessment of efficacy measures were according to Young Mania Rating Scale (YMRS and Clinical Global Impressions-Severity (CGI-S and Improvement (CGI-I scale. Other effectiveness measures included YMRS response (YMRS reduction >50 % and YMRS remission (YMRS total scores <12. Results: In each group, 16 of 23 patients (70 % completed the study. YMRS response, CGI-Improvement, and reduction in the total scores of YMRS and CGI-S observed in both groups, significantly greater for valproate-risperidone than valproate-lithium combination group (P=0.006, P=0.015, P=0.004, and P=0.007, respectively.YMRS remission were shown in both groups without statistical significance (P=0.073. The total scores of YMRS at 4th, 8th, and 14th days of trial were lower in valproate-risperidone than valproate-lithium combination group (P=0.017, P=0.005, and P=0.004, respectively. The rate of adverse events and mean weight gain in both groups were not statistically different. Conclusion: In acute manic patients, both combinations of valproate with lithium or with risperidone had efficacy in acutely manic patients, but valproate-risperidone combination was more effective. Both treatments were safe and well tolerated. Considering the small sample size and limited period of observation, further studies need to be conducted to find out the best combination in the treatment of acute mania. Key words: Acute mania, Valproate, Risperidone, Lithium, Combination Therapy

  1. Valproate-Risperidone versus Valproate-Lithium combination in acute mania

    OpenAIRE

    Barekatain, M.; Fatemi, A.; Bashardoost, N.; Darougheh, A.; Salehi, M.; Gh, Asadollahi

    2005-01-01

    Background: We evaluated the efficacy of valproate plus risperidone versus valproate plus lithium combination in the treatment of acute mania. Methods: In 2-week, randomized, double-blind, parallel group study, 46 acute manic patients according to DSM-IV criteria were randomly assigned to receive combination of valproate 20 mg/ kg/day plus risperidone 2-4 mg/day (n=23) or lithium600-1200 mg/day (n=23). The assessment of efficacy measures were according to Young Mania Rating Scale (YMRS) ...

  2. Efficacy observation of danshen injection iontophoresis treatment for vitreous hemorrhage

    Directory of Open Access Journals (Sweden)

    Jing Hao

    2013-11-01

    Full Text Available AIM: To probe into the clinical value of danshen injection iontophoresis in treatment of vitreous hemorrhage. METHODS: Eighty-eight vitreous hemorrhage patients(88 eyeswere selected from June 2012 to June 2013 in our hospital. The patients were divided into observation group and control group randomly, with 44 cases(44 eyesin each group. The patients in control group were treated with xueshuantong clinical drug treatment. The patients in observation group were treated with danshen injection iontophoresis clinical drug treatment. The clinical treatment and visual recovery situations of the patients in two groups were compared and analyzed. RESULTS: The cure rate and total effective rate of observation group were 75% and 95%. The cure rate and total effective rate of control group were 59% and 77%. There were statistically significant differences(PPCONCLUSION: Danshen injection iontophoresis therapy has positive role in improving clinical outcomes and promoting visual function for patients with vitreous hemorrhage.

  3. A Comparison of Risperidone and Buspirone for Treatment of Behavior Disorders in Children with Phenylketonuria

    Directory of Open Access Journals (Sweden)

    Afshin FAYYAZI

    2014-12-01

    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(12:29–32.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: 18–25.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; 17:1–8.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; 18:227–236.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; 37:367–373.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; 16:575–587.Nagaraj R, Singhi P, Malhi P. Risperidone in children with autism: randomized, placebo controlled, double blind study. J. Child Neurol 2006; 21:450–455.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: 337–346.Jensen P, Buitelaar J, Pandina G, Binder C,

  4. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    OpenAIRE

    Jae Wook Kim; Jae Hong Park; Ki Nam Park; Seung Won Lee

    2014-01-01

    Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acousti...

  5. Review of risperidone for the treatment of pediatric and adolescent bipolar disorder and schizophrenia

    Directory of Open Access Journals (Sweden)

    Jeffrey R Bishop

    2008-03-01

    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

  6. POST MARKETING SURVEILLANCE STUDY ON RISPERIDONE IN PATIENTS SUFFERING FROM SCHIZOPHRENIA

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    J R Zaveri

    2011-04-01

    Full Text Available Schizophrenia is one of the commonest psychiatric ailments. It has been estimated that approximately 1% of the population and 15% of the adults suffers from this disease. Risperidone, atypical antipsychotic, acts mainly by 5HT2 blockade action. Produce virtually no extra pyramidal side effects at low dose, has a broad efficacy. But extra pyramidal dysfunction can appear at higher doses. We conducted a post marketing surveillance study on risperidone in 40 patients suffering from schizophrenia at Psychiatric department of Civil Hospital, Ahmedabad. In this study we specially studied its efficacy and safety. The results of this study are consistent with phase III clinical studies on risperidone carried out in Indian patients except its effects on food intake. As far as the efficacy of risperidone in patient with schizophrenia is concerned, it provided good symptomatic relief In term of safety, 7 patients out of 40, experience adverse effects like decrease appetite, constipation, insomnia, EPS and NMS. Patient with NMS was admitted in hospital and was died later on. [National J of Med Res 2011; 1(2.000: 34-36

  7. MRI in children given gadodiamide injection: safety and efficacy in CNS and body indications.

    Science.gov (United States)

    Lundby, B; Gordon, P; Hugo, F

    1996-11-01

    The safety and efficacy of the MRI contrast medium gadodiamide injection (OMNISCAN) in children is summarised. Four open and three double-blind, multinational, multicentre comparative trials have been undertaken. Overall, 353 patients (15 days to 18 years, plus one 21 years) received gadodiamide injection, and 128 (2-18 years) received gadopentetate dimeglumine (Magnevist), intravenously at 0.1 mmol/kg body weight, to aid the identification of CNS and body lesions. Adverse events were reported in 13 (4%) patients given gadodiamide injection and 8 (6%) given gadopentetate dimeglumine; few patients reported injection-associated discomfort. The post-contrast scan gave more diagnostic information in 223 (63%) patients given gadodiamide injection (CNS and body indications). In the comparative trials, the post-contrast scan gave more diagnostic information for 91 (65%) and 82 (64%) patients given gadodiamide injection and gadopentetate dimeglumine, respectively (CNS indications only). Gadodiamide injection (0.1 mmol/kg body weight) was safe and effective in infants, children and adolescents. PMID:9003923

  8. Risperidone in the treatment of conduct disorder in preschool children without intellectual disability

    OpenAIRE

    Durak Sibel; Basay Omer; Basay Burge; Ercan Eyup S; Ozbaran Burcu

    2011-01-01

    Abstract Background The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition Textrevision) highlights the especially poor outcomes of early-onset conduct disorder (CD). The strong link between the patient's age at treatment and its efficacy points the importance of early intervention. Risperidone is one of the most commonly studied medications used to treat CD in children and adolescents. The aim of this study is to obtain preliminary data about the efficacy and toler...

  9. Comparative efficacy and safety of local and systemic methotrexate injection in cesarean scar pregnancy

    Directory of Open Access Journals (Sweden)

    Peng P

    2015-01-01

    Full Text Available Ping Peng,1 Ting Gui,1 Xinyan Liu,1 Weilin Chen,1 Zhenzhen Liu2 1Department of Obstetrics and Gynecology, 2Department of Ultrasonography, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Objective: To investigate the efficacy of methotrexate (MTX injection in treatment of cesarean scar pregnancy (CSP. Method: A randomized controlled study was performed in 104 CSP patients receiving either local or systemic MTX injection at the Peking Union Medical College Hospital from the year 2008 to 2013. Results: Complete cure was defined as regression of ultrasonographic findings and normalization of serum ?-hCG within 60 days. It was regarded as delayed cure if additional dilation and curettage (D&C was needed. The overall cure rate (complete cure plus delayed cure was 69.2% versus 67.3% for local injection versus systemic administration (P>0.05. The median time for serum ?-hCG remission and uterine mass disappearance after systemic administration (42 [21–69] days and 40 [20–67] days were significantly lower than those receiving local injection (56 [24–92] days and 53 [23–88] days, with P=0.029 and 0.046, respectively. The mean pretreatment serum ?-hCG (human chorionic gonadotropin level and lesion size in cured group (21,941±18,351 mIU/mL and 2.9±1.3 cm, respectively were significantly lower than those in the failed group (37,047±30,864 mIU/mL and 3.6±1.3 with P=0.038 and 0.044, respectively. Conclusion: MTX injection is effective in CSP treatment. Systemic administration shows similar overall cure rate compared to local injection, but requires shorter time for serum ?-hCG remission and uterine mass disappearance. Keywords: cesarean scar pregnancy, methotrexate injection, local, systemic

  10. Efficacy of intravitreal ranibizumab injection combined with macular grid photocoagulation for diabetic macular edema

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    Hu-Lin Jiang

    2014-07-01

    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.

  11. Risperidone

    Science.gov (United States)

    ... mania (frenzied, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and depression that happen ... and balance); difficulty swallowing; breast cancer; angina (chest pain); irregular heartbeat; high or low blood pressure; heart ...

  12. Efficacy of musculoskeletal injections by primary care providers in the office: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Bhagra A

    2013-04-01

    Full Text Available Anjali Bhagra,1 Husnain Syed,1 Darcy A Reed,1 Thomas H Poterucha,1 Stephen S Cha,2 Tammy J Baumgartner,1 Paul Y Takahashi1 1Department of Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA Background: Musculoskeletal joint pain of varied etiology can be diagnosed and treated with joint and soft-tissue corticosteroid injections. Purpose: The purpose of our study was to compare patients’ bodily pain and quality of life (QOL, in addition to the procedural benefit and patient satisfaction, before and after musculoskeletal injections in the office setting. Patients and methods: Patients were eligible for recruitment if they were over age 18 and had an injection for musculoskeletal pain from a primary care provider in an office procedural practice. Included in our analysis were knee joint/bursa, trochanteric bursa, and shoulder joint/bursa injection sites. The variables measured were pain, benefit from the injection, QOL physical and mental components, and patient satisfaction. This was a retrospective cohort study approved by the institutional review board. Results: Patients’ pain was assessed by the patients using a six-point Likert scale (none, very mild, mild, moderate, severe, and very severe. We noted that self-perception of pain decreased from 3.10 (± standard deviation at baseline 0.96 before to 2.36 (± standard deviation after the infection 1.21 (P = 0.0001 after the injection. In terms of the impact on QOL, our patients had a pre-injection physical score of 37.25 ± 8.39 and a mental score at 52.81 ± 8.98. After the injections, the physical score improved to 42.35 ± 9.07 (P = 0.0001 and the mental to 53.54 ± 8.20 (P = 0.0001 for the overall group. Ninety-six percent of the patients reported they were satisfied or extremely satisfied in the procedure clinic. Conclusion: In this study, we found significant pain relief and improved physical QOL in patients undergoing an injection in the knee joint/bursa, shoulder joint/bursa, or trochanteric bursa by primary care providers in the office setting. Keywords: injections, musculoskeletal, quality of life, joints, efficacy

  13. Cognitive-Behavioral Therapy vs Risperidone for Augmenting Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder

    Science.gov (United States)

    Simpson, Helen Blair; Foa, Edna B.; Liebowitz, Michael R.; Huppert, Jonathan D.; Cahill, Shawn; Maher, Michael J.; McLean, Carmen P.; Bender, James; Marcus, Sue M.; Williams, Monnica T.; Weaver, Jamie; Vermes, Donna; Van Meter, Page E.; Rodriguez, Carolyn I.; Powers, Mark; Pinto, Anthony; Imms, Patricia; Hahn, Chang-Gyu; Campeas, Raphael

    2014-01-01

    IMPORTANCE Obsessive-compulsive disorder (OCD) is one of the world’s most disabling illnesses according to the World Health Organization. Serotonin reuptake inhibitors (SRIs) are the only medications approved by the Food and Drug Administration to treat OCD, but few patients achieve minimal symptoms from an SRI alone. In such cases, practice guidelines recommend adding antipsychotics or cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP). OBJECTIVE To compare the effects of these 2 SRI augmentation strategies vs pill placebo for the first time, to our knowledge, in adults with OCD. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial (conducted January 2007–August 2012) at 2 academic outpatient research clinics that specialize in OCD and anxiety disorders. Patients (aged 18–70 years) were eligible if they had OCD of at least moderate severity despite a therapeutic SRI dose for at least 12 weeks prior to entry. Of 163 who were eligible, 100 were randomized (risperidone, n = 40; EX/RP, n = 40; and placebo, n = 20), and 86 completed the trial. INTERVENTIONS While continuing their SRI at the same dose, patients were randomized to the addition of 8 weeks of risperidone (up to 4 mg/d), EX/RP (17 sessions delivered twice weekly), or pill placebo. Independent assessments were conducted every 4 weeks. MAIN OUTCOME AND MEASURE The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to measure OCD severity. RESULTS Patients randomized to EX/RP had significantly greater reduction in week 8 Y-BOCS scores based on mixed-effects models (vs risperidone: mean [SE], ?9.72 [1.38]; P<.001 vs placebo: mean [SE], ?10.10 [1.68]; P < .001). Patients receiving risperidone did not significantly differ from those receiving placebo (mean [SE], ?0.38 [1.72]; P=.83). More patients receiving EX/RP responded (Y-BOCS score decrease ?25%: 80% for EX/RP, 23% for risperidone, and 15% for placebo; P < .001). More patients receiving EX/RP achieved minimal symptoms (Y-BOCS score ?12: 43% for EX/RP, 13% for risperidone, and 5% for placebo; P = .001). Adding EX/RP was also superior to risperidone and placebo in improving insight, functioning, and quality of life. CONCLUSIONS AND RELEVANCE Adding EX/RP to SRIs was superior to both risperidone and pill placebo. Patients with OCD receiving SRIs who continue to have clinically significant symptoms should be offered EX/RP before antipsychotics given its superior efficacy and less negative adverse effect profile. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00389493. PMID:24026523

  14. Comparison of efficacy of kinesiological taping and subacromial injection therapy in subacromial impingement syndrome.

    Science.gov (United States)

    Suba??, Volkan; Cak?r, Tuncay; Ar?ca, Zuhal; Sar?er, Rahime Nur; Bilgilisoy Filiz, Meral; Kolda? Do?an, Sebnem; Toraman, Naciye Füsun

    2014-11-18

    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 (n?=?35, injection group) or group 2 (n?=?35, 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 3 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 (p?>?0.05). No significant differences were detected between the groups except for active flexion degree in favor of group 1 (p?=?0.004). 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

  15. Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture

    OpenAIRE

    Santosh Kumar; Nitin Garg; Shrawan Kumar Singh; Arup Kumar Mandal

    2014-01-01

    Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture. Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethro...

  16. Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol.

    Science.gov (United States)

    Nishikawa, Tadashi; Araki, Yoichiro; Hayashi, Teruo

    2015-01-01

    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 often limited. This report involves an 18-year-old patient who experienced two episodes of intractable hiccups triggered by stress, which lasted for weeks or even months. In both episodes, haloperidol was initially used, but there was no significant effect. In contrast, risperidone, the second-generation antipsychotic that possesses a dopamine-serotonin antagonist property, completely abolished the hiccups 6 hours after administration. This is one of few case reports in which two antipsychotics were challenged for a single patient with hiccups, and the effects of the drugs were obviously different. Our finding suggests that, in addition to dopaminergic system, the serotonergic systems may be involved in the pathophysiology of some hiccup cases and that the serotonin-acting antipsychotics such as risperidone should be considered as a choice in the drug treatment of intractable hiccups. PMID:25763097

  17. Postmortem Femoral Blood Concentrations of Risperidone

    DEFF Research Database (Denmark)

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration of the drug and metabolite ranged from below the limit of quantification to 0.058 mg/kg (median 0.0098 mg/kg). This concentration range, which largely corresponds to published in vivo plasmalevels under therapy, may serve as a reference for judgment of postmortem cases involving risperidone. In one case, risperidone was judged to be a contributing factor to death, and the sum of concentrations was 0.29 mg/kg. This concentration is of the same order of magnitude as observed for plasma levels in clinical intoxication cases. For the remaining seven cases, the cause of death was unclear. The measurements observed here do not suggest that risperidone is subject to major postmortem redistribution.

  18. Effectiveness of different dosing regimens of risperidone and olanzapine in schizophrenia.

    Science.gov (United States)

    Takeuchi, Hiroyoshi; Fervaha, Gagan; Lee, Jimmy; Agid, Ofer; Remington, Gary

    2015-03-01

    The objective of this study was to evaluate the effectiveness and impact of once- versus twice-daily dosing of risperidone and olanzapine on clinical outcomes in patients with schizophrenia. Data from phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study were used. Patients with schizophrenia were randomly allocated to treatment with risperidone and olanzapine, and were also randomly assigned to once-daily (N=173 and 169, respectively) or twice-daily (N=168 and 167, respectively) dosing and followed for up to 18 months. Discontinuation rate and time to discontinuation were used as primary outcome measures to compare the two groups. The following outcome measures were also analyzed: efficacy, safety, medication adherence, adverse events, and concomitant psychotropic medications. No significant differences in discontinuation rates and time to discontinuation were observed between the once- and twice-daily dosing groups (P>0.05) in patients receiving risperidone or olanzapine. The once-daily dosing group demonstrated significantly lower mean daily doses of risperidone and olanzapine across phase 1, and lower rates of hospitalization for exacerbation of schizophrenia, sleepiness, and orthostatic faintness in patients receiving olanzapine (Polanzapine were not significantly different. However, in view of the lower mean dose and better side effect profile, it is advisable to adhere to a once-daily dosing regimen, especially in the case of olanzapine. PMID:25649680

  19. Double-blind comparison of ziprasidone and risperidone in the treatment of Chinese patients with acute exacerbation of schizophrenia

    Directory of Open Access Journals (Sweden)

    Hongyan Zhang

    2011-03-01

    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 40–80 mg twice daily or risperidone 1–3 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

  20. Haloperidol and risperidone in the treatment of delirium and its subtypes

    OpenAIRE

    Soenke Boettger; William Breitbart; Steven Passik

    2011-01-01

    Background and Objectives: To compare the safety and efficacy of haloperidol and risperidone in the treatment of delirium and its subtypes Methods: We collected sociodemographic data and medical variables in addition to systematically rating all patients with delirium with the Memorial Delirium Assessment Scale (MDAS), Karnofsky Performance Status Scale (KPS) and abbreviated Udvalg for Kliniske Undersogelser (UKU) at baseline (T1), 2-3 days (T2) and 4-7 days (T3) and created an IRB-approved d...

  1. Risperidone in the treatment of conduct disorder in preschool children without intellectual disability

    Directory of Open Access Journals (Sweden)

    Durak Sibel

    2011-04-01

    Full Text Available Abstract Background The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition Textrevision highlights the especially poor outcomes of early-onset conduct disorder (CD. The strong link between the patient's age at treatment and its efficacy points the importance of early intervention. Risperidone is one of the most commonly studied medications used to treat CD in children and adolescents. The aim of this study is to obtain preliminary data about the efficacy and tolerability of risperidone treatment in otherwise typically developing preschool children with conduct disorder and severe behavioral problems. Method We recruited 12 otherwise normally developing preschoolers (ten boys and two girls with CD for this study. We could not follow up with 4 children at control visits properly; thus, 8 children (six girls, two boys; mean age: 42.4 months completed the study. We treated the patients with risperidone in an open-label fashion for 8 weeks, starting with a daily dosage of 0.125 mg/day or 0.25 mg/day depending on the patient's weight (20 kg children: 0.25 mg/day. Dosage titration and increments were performed at 2-week interval clinical assessments. The Turgay DSM-IV Based Disruptive Behavior Disorders Child and Adolescent Rating & Screening Scale (T-DSM-IV-S as well as the Clinical Global Impression Scale (CGI assessed treatment efficacy; the Extrapyramidal Symptom Rating Scale (ESRS and laboratory evaluations assessed treatment safety. Results The mean daily dosage of risperidone at the end of 8 weeks was 0.78 mg/day (SD: 0.39 with a maximum dosage of 1.50 mg/day. Based on the CGI global improvement item, we classified all patients as "responders" (very much or much improved. Risperidone was associated with a 78% reduction in the CGI Severity score. We also detected significant improvements on all of the subscales of the T-DSM-IV-S. Tolerability was good, and serious adverse effects were not observed. We detected statistically significant prolactin level increments (p Conclusion The results of this study suggest that risperidone may be an effective and well-tolerated atypical antipsychotic for the treatment of CD in otherwise normally developing preschool children. The findings of the study should be interpreted as preliminary data considering its small sample size and open-label methodology.

  2. Combined use of ozone and collagenase injection for the treatment of lumbar disc herniation:comparison of therapeutic efficacy with simple ozone injection

    International Nuclear Information System (INIS)

    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)

  3. Population pharmacokinetic modeling and simulation to guide dose selection for RBP-7000, a new sustained-release formulation of risperidone.

    Science.gov (United States)

    Laffont, Celine M; Gomeni, Roberto; Zheng, Bo; Heidbreder, Christian; Fudala, Paul J; Nasser, Azmi F

    2015-01-01

    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

  4. Injection

    International Nuclear Information System (INIS)

    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)

  5. Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture.

    Science.gov (United States)

    Kumar, Santosh; Garg, Nitin; Singh, Shrawan Kumar; Mandal, Arup Kumar

    2014-01-01

    Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture. Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethrotomy followed by injection of tri-inject at the urethrotomy site. Tri-inject was prepared by diluting the combination of triamcinolone 40?mg, mitomycin C 2?mg, and hyaluronidase 3000 in 5-10?mL of saline according to length of stricture. An indwelling 18?Fr silicone catheter was left in place for a period of 7-21 days. All patients were followed up for 6-18 months postoperatively on the basis of history, uroflowmetry, and, if required, retrograde urethrogram and micturating urethrogram every 3 months. Results. The overall recurrence rate after first OIU is 19.4% (20 out of 103 patients), that is, a success rate of 80.6%. Overall recurrence rate after second procedure was 5.8% (6 out of 103 patients), that is, a success rate of 94.2%. Conclusion. Optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) is a safe and effective minimally invasive therapeutic modality for short segment anterior urethral strictures. PMID:25349604

  6. Efficacy of moxidectin 6-month injectable and milbemycin oxime/lufenuron tablets against naturally acquired trichuris vulpis infections in dogs.

    Science.gov (United States)

    Bowman, Dwight D; Legg, Walter; Stansfield, David G

    2002-01-01

    Efficacy of moxidectin injection (ProHeart 6 Sustained Release Injectable for Dogs, Fort Dodge Animal Health) against naturally acquired infections of Trichuris vulpis was compared with that of milbemycin oxime/lufenuron tablets (Sentinel Flavor Tabs, Novartis Animal Health). Eighteen dogs infected with T. vulpis were ranked by egg counts and randomly allocated to treatment with moxidectin (170 micro g/kg), milbemycin (500 micro g/kg)/lufenuron (10 mg/kg), or to an untreated control group (six dogs per treatment). Dogs were euthanized for worm counting 7 days after treatment. Efficacy of milbemycin/lufenuron against T. vulpis was 99.6 %, compared with 67.5 % for moxidectin. The commercial formulation of milbemycin oxime/lufenuron provided excellent control of whipworm infection, whereas moxidectin demonstrated variable efficacy against this parasite. PMID:12447836

  7. Efficacy of injections of phosphatidylcholine into fat deposits-a non-surgical alternative to liposuction in body-contouring

    Directory of Open Access Journals (Sweden)

    Karl-G Heinrich

    2005-01-01

    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.

  8. Efficacy and mechanism of Salvia miltiorrhizae injection in the treatment of rats with severe acute pancreatitis.

    Science.gov (United States)

    Zhang, Ruiping; Zhang, Xiping; Zhang, Jie; Wu, Junsheng; Ye, Qian; Xu, Rujun; Ye, Jing; Fang, Xin; Jin, Lu; He, Jiao; Yuan, Wenqin

    2009-04-01

    To study the efficacy and mechanism of Salvia miltiorrhizae injection in the treatment of severe acute pancreatitis. SAP rat models were prepared and randomly divided into model control group and treated group. The sham-operated group was also set. At 3, 6 and 12 h after operation, the mortality rate, ascitic volumes, pathological changes in the pancreas, contents of amylase and endotoxin in plasma as well as IL-6, IL-18, ET-1 and NO in serum, the staining intensity of Bax and NF-kappaB p56 proteins, and the changes in apoptosis index of pancreatic cells in rats in each group were observed. The pathological severity scores (at 3, 6 and 12 h after operation), contents of plasma endotoxin (at 6 and 12 h after operation) and serum IL-6 (at 6 and 12 h after operation) were significantly lower than those in model control group (P Salvia miltiorrhizae is able to reduce the contents of plasma endotoxin and serum IL-6, promote the expression of Bax protein in pancreas, improve the pathological changes in the pancreas, and decrease the mortality rate of rats, thereby showing therapeutic effect on rats with SAP. PMID:19238530

  9. Interaction between escitalopram and risperidone

    OpenAIRE

    Rao, Pradeep; Bhagat, Nishant; Shah, Bharat; Bazegha, Momin

    2005-01-01

    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 drug–drug 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 relativ...

  10. 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

    Scientific Electronic Library Online (English)

    Tamara, Melnik; Bernardo Garcia, Soares; Maria Eduarda dos Santos, Puga; Álvaro Nagib, Atallah.

    2010-05-01

    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.

  11. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    Science.gov (United States)

    Kim, Jae Wook; Park, Jae Hong; Park, Ki Nam; Lee, Seung Won

    2014-01-01

    Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5?U for the EMG group and 1.8 ± 0.4?U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable. PMID:25383369

  12. Efficacy of moxidectin 6-month injectable and milbemycin oxime/lufenuron tablets against naturally acquired toxocara canis infections in dogs.

    Science.gov (United States)

    Bowman, Dwight D; Legg, Walter; Stansfield, David G

    2002-01-01

    The efficacy of moxidectin injection (ProHeart 6 Sustained Release Injectable for Dogs, Fort Dodge Animal Health) against naturally acquired infections of Toxocara canis was compared with that of milbemycin oxime/lufenuron tablets (Sentinel Flavor Tabs, Novartis Animal Health). Eighteen dogs with naturally acquired infections of T. canis were ranked by egg counts and randomly assigned to treatment with moxidectin (170 micro g/kg), milbemycin (500 micro g/kg)/lufenuron (10 mg/kg), or to an untreated control group (six dogs per treatment). Dogs were euthanized 7 days after treatment for recovery, identification, and enumeration of parasites by species. There was no apparent efficacy for moxidectin against T. canis. Conversely, milbemycin oxime/lufenuron was 91.5 % effective against naturally occurring infections of this canine parasite. PMID:12447835

  13. Haloperidol and risperidone in the treatment of delirium and its subtypes

    Directory of Open Access Journals (Sweden)

    Soenke Boettger

    2011-06-01

    Full Text Available Background and Objectives: To compare the safety and efficacy of haloperidol and risperidone in the treatment of delirium and its subtypes Methods: We collected sociodemographic data and medical variables in addition to systematically rating all patients with delirium with the Memorial Delirium Assessment Scale (MDAS, Karnofsky Performance Status Scale (KPS and abbreviated Udvalg for Kliniske Undersogelser (UKU at baseline (T1, 2-3 days (T2 and 4-7 days (T3 and created an IRB-approved delirium database. For this secondary analysis we extracted all data containing haloperidol (HAL and risperidone (RIS. Results: We were able to retrieve 32 patients treated with haloperidol (HAL and risperidone (RIS each. Both samples did not significantly differ in respect to age, cancer diagnoses or etiologies. The MDAS scores at baseline were higher in HAL treated subjects (20.2 compared to RIS treated subjects (17.7. The treatment results between HAL and RIS were not significantly different: Over the course of treatment MDAS scores improved from 20.2 to 8.3 (HAL and 17.7 to 7.5 in (RIS, delirium resolution rates were 68.8% (HAL and 84.4% (RIS. In hypoactive delirium the MDAS scores improved from 18.5 to 9.3 (HAL and from 15.3 to 6.6 (RIS, delirium resolution rates were 64.3% (HAL and 91.3% (RIS. In hyperactive delirium the MDAS scores improved from 22.5 to 6.6 (HAL and 20.1 to 8.4 (RIS, delirium resolution rates were 72.2% (HAL and 75% (RIS. There were no significant differences in KPS scores at all observation times. Treatment with HAL caused more EPS. Conclusions: Both haloperidol and risperidone may be equally effective in the treatment of delirium and its subtypes. Treatment with haloperidol resulted in more side effects.

  14. Haloperidol and risperidone in the treatment of delirium and its subtypes

    Scientific Electronic Library Online (English)

    Soenke, Boettger; William, Breitbart; Steven, Passik.

    2011-06-01

    Full Text Available Background and Objectives: To compare the safety and efficacy of haloperidol and risperidone in the treatment of delirium and its subtypes Methods: We collected sociodemographic data and medical variables in addition to systematically rating all patients with delirium with the Memorial Delirium Asse [...] ssment Scale (MDAS), Karnofsky Performance Status Scale (KPS) and abbreviated Udvalg for Kliniske Undersogelser (UKU) at baseline (T1), 2-3 days (T2) and 4-7 days (T3) and created an IRB-approved delirium database. For this secondary analysis we extracted all data containing haloperidol (HAL) and risperidone (RIS). Results: We were able to retrieve 32 patients treated with haloperidol (HAL) and risperidone (RIS) each. Both samples did not significantly differ in respect to age, cancer diagnoses or etiologies. The MDAS scores at baseline were higher in HAL treated subjects (20.2) compared to RIS treated subjects (17.7). The treatment results between HAL and RIS were not significantly different: Over the course of treatment MDAS scores improved from 20.2 to 8.3 (HAL) and 17.7 to 7.5 in (RIS), delirium resolution rates were 68.8% (HAL) and 84.4% (RIS). In hypoactive delirium the MDAS scores improved from 18.5 to 9.3 (HAL) and from 15.3 to 6.6 (RIS), delirium resolution rates were 64.3% (HAL) and 91.3% (RIS). In hyperactive delirium the MDAS scores improved from 22.5 to 6.6 (HAL) and 20.1 to 8.4 (RIS), delirium resolution rates were 72.2% (HAL) and 75% (RIS). There were no significant differences in KPS scores at all observation times. Treatment with HAL caused more EPS. Conclusions: Both haloperidol and risperidone may be equally effective in the treatment of delirium and its subtypes. Treatment with haloperidol resulted in more side effects.

  15. A Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Adolescents and Young Adults with Anorexia Nervosa: A Pilot Study

    Science.gov (United States)

    Hagman, Jennifer; Gralla, Jane; Sigel, Eric; Ellert, Swan; Dodge, Mindy; Gardner, Rick; O'Lonergan, Teri; Frank, Guido; Wamboldt, Marianne Z.

    2011-01-01

    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…

  16. Preparation and Biological Evaluation of Radioiodinated Risperidone and Lamotrigine as Models for Brain Imaging

    International Nuclear Information System (INIS)

    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 % ± 3.75 and 97.5 % ± 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 % ± 0.38 and 2.45 % ± 0.18 of the injected activity/g tissue organ, at 10

  17. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis.

    LENUS (Irish Health Repository)

    Atchia, Ismaël

    2011-01-01

    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.

  18. Acute Administration of Clozapine and Risperidone Altered Dopamine Metabolism More in Rat Caudate than in Nucleus Accumbens: A Dose-Response Relationship

    OpenAIRE

    Batool, Farhat; Haleem, Muhammad A.; Haleem, Darakhshan J.

    2009-01-01

    The present study compares the extrapyramidal and neurochemical effects of clozapine and risperidone in rat caudate (corpus striatum) and nucleus accumbens (ventral striatum) dose-dependently. Animals injected with clozapine (2.5, 5.0 and 10.0 mg/kg IP) or risperidone (1.0, 2.5 and 5.0 mg/kg IP) in acute were sacrificed 1 h later to collect brain samples. Extrapyramidal side effects (EPS) in terms of locomotor activity and catalepsy were monitored in each animal after the drug or vehicle admi...

  19. The Efficacy of Local Injection of Methylprednisolone and Lidocaine with and Without Splint, in Treating Patients with De Quervain's Tenosynovitis

    Directory of Open Access Journals (Sweden)

    Saleh

    2012-02-01

    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.

  20. A Case of Diabetic Ketoacidosis Associated with Risperidone Treatment

    OpenAIRE

    Zeynel Beyhan; Erol Bolu; Sinan Yetkin; Mustafa ?ahin; Deniz Engin Gök; Levent Kebapç?lar; Mahmut Yaz?c?; Abdullah Ta?l?p?nar; Mustafa Kutlu

    2008-01-01

    The association between schizophrenia and diabetes has been previously documented. Case reports have also demonstrated that initiation of atypical antipsychotic agents may induce or exacerbate diabetes mellitus. A 26-year-old man without a family history of diabetes mellitus presented with deep coma after 5 months of treatment with risperidone. He was diagnosed with diabetic ketoacidosis, was given insulin and saline infusion, and his antipsychotic agent was changed from risperidone to zipras...

  1. A comparison of low-dose risperidone to paroxetine in the treatment of panic attacks: a randomized, single-blind study

    Directory of Open Access Journals (Sweden)

    Galynker Igor I

    2009-05-01

    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

  2. Adverse effects of risperidone on eye movement activity: a comparison of risperidone and haloperidol in antipsychotic-naive schizophrenic patients.

    Science.gov (United States)

    Sweeney, J A; Bauer, K S; Keshavan, M S; Haas, G L; Schooler, N R; Kroboth, P D

    1997-03-01

    Risperidone is a novel and clinically effective atypical antipsychotic medication with a unique biochemical profile. To contrast the neurophysiological effects of this new medication with those of a typical antipsychotic medication, we performed quantitative measurements of saccadic eye movements in a series of antipsychotic-naive schizophrenic patients treated with either risperidone or haloperidol. Patients were tested before and after 1 month of treatment, and a matched group of healthy subjects was tested twice over a similar time interval. Risperidone, but not haloperidol, was associated with prolonged latency and decreased peak velocity and accuracy of saccadic eye movements that was detectable 4 weeks after treatment initiation. The adverse effects of risperidone may be due to the lack of development of acute tolerance to its powerful serotonergic (5-HT2A) antagonism, which could be responsible for the disruption of brainstem physiology in regions controlling saccadic eye movements. PMID:9138438

  3. Costs and efficacy ofolanzapine and risperidone in schizophrenia

    OpenAIRE

    Vittorio Mapelli

    2007-01-01

    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 diff...

  4. Once-monthly paliperidone injection for the treatment of schizophrenia

    Directory of Open Access Journals (Sweden)

    Delia Bishara

    2010-09-01

    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 39–234 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

  5. Injection-associated pain in femoral arteriography: A European multicenter study comparing safety, tolerability, and efficacy of iodixanol and iopromide

    International Nuclear Information System (INIS)

    Purpose. To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. Methods. A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. Results. The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p<0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19.8% in the iopromide group (p<0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p=NS). Overall diagnostic information was optimal for 94.1% in the iodixanol group and 95.3% in the iopromide group (p=NS). Conclusions. Iodixanol 270 mg I/ml causes significantly less injection-associated pain during femoral arteriography and is as safe and efficatious as iopromide 300 mg I/ml

  6. Long acting risperidone in Australian patients with chronic schizophrenia: 24-month data from the e-STAR database

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    Lambert Tim

    2012-03-01

    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.

  7. Comparison of the efficacy of two combined therapies for peptic ulcer bleeding: adrenaline injection plus haemoclipping versus adrenaline injection followed by bipolar electrocoagulation

    Science.gov (United States)

    ?widnicka-Siergiejko, Agnieszka; Wróblewski, Eugeniusz; Baniukiewicz, Andrzej; D?browski, Andrzej

    2014-01-01

    Introduction Peptic ulcer remains the most frequent cause of upper gastrointestinal bleeding. Treatment of bleeding with simultaneous combination of two endoscopic techniques has proved to be more efficient than monotherapy. None of the published comparative studies of various contact coagulation modalities have confirmed the superiority of one of these techniques over the others. Aim To compare the therapeutic outcomes of the use of a device enabling both injection of adrenaline solution and bipolar electrocoagulation (A + BE) to those of combined adrenaline injection with mechanical therapy (haemostatic clips) (A + HC) in the treatment of peptic ulcer bleeding. Material and methods Fifty-two subjects with bleeding ulcers were assigned to the A + BE group, and 55 patients were treated with A + HC. Results Overall, treatment failed in 20 patients (20/107, 18.7%): in 10 individuals from the A + BE group (10/52; 18.2%) and in 10 individuals from the A + HC group (10/55; 19.2%) (p > 0.05). Primary haemostasis was not obtained in 7 patients (6.5%): in 4 patients in the A + BE group and in 3 patients in the A + HC group (p > 0.05). Ten individuals (9.3%) experienced recurrent bleeding during hospitalisation: 4 patients from the A + BE group and 6 patients from the A + HC group (p > 0.05). Finally, in 96.3% of the patients (n = 103) the endoscopic treatment proved efficient with regards to obtaining haemostasis during hospitalisation. Surgical intervention was required in 4 individuals (3.7%): 2 patients in the A + BE group and 2 patients treated with A + HC (p > 0.05). Three patients (2.8%) – all from the A + HC group – died during hospitalisation. No significant intergroup differences were documented with regards to the mean number of transfused blood units and the mean length of hospital stay. Conclusions The efficacy of combined endoscopic treatment of ulcer bleeding with a probe enabling simultaneous bipolar electrocoagulation and adrenaline injection seems comparable to the widely used dual technique of adrenaline injection and haemostatic clipping. PMID:25653731

  8. Efficacy evaluation of Shengmai Injection in treating coronary heart disease based on random walk model

    Directory of Open Access Journals (Sweden)

    Zhu-ye GAO

    2008-09-01

    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.

  9. Efficacy of lumbar epidural corticosteroid injections on clinical status of the patients with radiculopathy

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    Jülide Öncü

    2014-01-01

    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

  10. Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial

    OpenAIRE

    Wechsberg Wendee M; Krupitsky Evgeny; Romanova Tatiana; Zvartau Edwin; Kline Tracy L; Browne Felicia A; Ellerson Rachel; Bobashev Georgiy; Zule William A; Jones Hendrée E

    2012-01-01

    Abstract Background With HIV prevalence estimated at 20% among female injecting drug users (IDUs) in St. Petersburg, Russia, there is a critical need to address the HIV risks of this at-risk population. This study characterized HIV risks associated with injecting drug use and sex behaviors and assessed the initial feasibility and efficacy of an adapted Woman-Focused intervention, the Women's CoOp, relative to a Nutrition control to reduce HIV risk behaviors among female IDUs in an inpatient d...

  11. RP-HPLC estimation of risperidone in tablet dosage forms

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    Bladania S

    2008-01-01

    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.

  12. Once-monthly paliperidone injection for the treatment of schizophrenia

    Science.gov (United States)

    Bishara, Delia

    2010-01-01

    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 39–234 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

  13. Once-monthly paliperidone injection for the treatment of schizophrenia.

    Science.gov (United States)

    Bishara, Delia

    2010-01-01

    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 D(2) and serotonin 5HT(2A) receptors. As with other atypical antipsychotics, it exhibits a high 5HT(2A):D(2) affinity ratio. It also has binding activity as an antagonist at ?(1)-and ?(2) adrenergic receptors and H(1) 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 39-234 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

  14. The evaluation of efficacy of subtenon triamcinolone injection combined with focal laser photocoagulation in diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Hüseyin Öksüz

    2012-06-01

    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

  15. Risperidone oral solution versus standard tablets for the acute treatment of patients with schizophrenia.

    Science.gov (United States)

    Kusumi, Ichiro; Honda, Minoru; Ito, Koichi; Uemura, Keiichi; Kumazawa, Yukie; Ishikane, Tomohito; Niide, Yasushi; Koyama, Tsukasa

    2011-03-30

    The time required to attain the maximum plasma level of risperidone (RIS) is shorter for RIS oral solution (OS) than for RIS standard tablets (ST), although both forms have equal bioavailability. The objective of this study was to clarify whether RIS-OS shows a faster onset of efficacy and lower adverse events than RIS-ST. The two forms of risperidone were compared with respect to effectiveness including a speed of response, efficacy and tolerability. An open-label, 24-week, multicentre, randomized, flexible-dose study comparing the RIS-OS (mean dose, 3.7 mg; N=44) to the RIS-ST (mean dose, 3.7 mg; N=37) in acutely ill patients with schizophrenia showed no differences. Outcome measures included psychopathology, tolerability (extrapyramidal symptoms and serum prolactin), and Drug Attitude Inventory. This study was conducted between October 2006 and October 2008. Both RIS-OS- and RIS-ST-treated patients showed statistically significant reductions from the baseline in the mean scores of the Positive and Negative Syndrome Scale (PANSS)-total and PANSS-excite component, with no statistically significant differences between the treatment groups. The accumulated treatment response ratio was similar between the two groups. There was no significant difference in the Drug-Induced Extrapyramidal Symptom Scale score or serum prolactin increase between the treatment groups, but RIS-OS appeared to induce less serum prolactin increase than RIS-ST in drug-naïve female patients. Because there is no theoretical reason why this should be so, these results will require confirmation from a double-blind study in a larger sample. No significant difference was observed in the subjective drug attitude between the two groups. The original hypothesis that RIS-OS shows an earlier onset of efficacy or less adverse events than RIS-ST was not supported in this study. Subsequent studies should carefully establish the differences among various forms of antipsychotic drugs. PMID:21168464

  16. Olanzapine vs. Risperidone in Patients with First-Episode Schizophrenia and a Lifetime History of Cannabis Use Disorders: 16-Week Clinical and Substance Use outcomes

    OpenAIRE

    Sevy, Serge; Robinson, Delbert G; Sunday, Suzanne; Napolitano, Barbara; Miller, Rachel; McCormack, Joanne; Kane, John M.

    2011-01-01

    The purpose of this study is to compare the efficacy of olanzapine and risperidone for the acute treatment of first-episode schizophrenia patients with cannabis use disorders. This secondary analysis of a previously published study included forty-nine first-episode patients with a diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a co-occurring lifetime diagnosis of cannabis use disorders randomly assigned to treatment with either olanzapine (n=28) or risp...

  17. Efficacy of musculoskeletal injections given by primary care providers in the office

    Directory of Open Access Journals (Sweden)

    Eghbal Eftekhaari T

    2013-09-01

    Full Text Available Tasnim Eghbal Eftekhaari,1 Mirzaali Nazarnezhad,1 Iman Ghasemzadeh2 1Clinical Research Development Unit, Hormozgan University of Medical Sciences Bandar Abbas, Iran; 2Infectious Disease Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IranPatients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians qualified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints.1 However, patients usually present to a primary care physician and embark on treatment there, despite having the option of referral to a subspecialist fully trained in this procedure.View original paper by Bhagra and colleagues.

  18. Risperidone-induced mania: An emergent complication of treatment.

    Science.gov (United States)

    Kavoor, Anjana Rao; Mitra, Sayantanava; Mondal, Supriya Kumar; Das, Basudeb

    2014-10-01

    The occurrence of manic/hypomanic switch in patients being treated with risperidone has been reported by various authors, and they have described a variety of strategies for their management. In this report, we describe two cases of induction of elevated mood symptoms in patients treated with risperidone. We propose that the emergence of these symptoms may be a complication of treatment with this drug in susceptible individuals, of which the clinicians should be aware, mainly in those diagnosed with schizophrenia and bipolar disorder. We then discuss a few findings that might be useful in the management of such cases. We thereby also propose a mechanism for such an induction. PMID:25422570

  19. Treatment of depressive symptoms in patients with schizophrenia: a randomized, open-label, parallel-group, flexible-dose subgroup analysis of patients treated with extended-release quetiapine fumarate or risperidone.

    Science.gov (United States)

    Kasper, Siegfried; Montagnani, Gino; Trespi, Graziella; Di Fiorino, Mario

    2015-01-01

    The present analysis assessed the efficacy of extended-release quetiapine fumarate (quetiapine XR) versus risperidone in patients with schizophrenia and depressive symptoms [Hamilton Depression Rating Scale (HAM-D) score?20 and a HAM-D item 1 score?2]. This was a subanalysis of patients with schizophrenia from a randomized, open-label, parallel-group, flexible-dose study (NCT00640562) that also enrolled patients with schizoaffective disorder. The primary endpoint of this noninferiority study was change from baseline to week 12 in Calgary Depression Scale for Schizophrenia score (per protocol population). Overall, 114 patients received quetiapine XR (n=60; 400-800?mg/day) or risperidone (n=54; 4-6?mg/day). Change in Calgary Depression Scale for Schizophrenia score was greater for quetiapine XR than for risperidone [least squares means: -7.2 vs. -4.8; treatment difference 2.4 (95% confidence interval 0.3-4.6; Pinsomnia, asthenia, hyperprolactinemia, and somnolence. Abnormally high prolactin levels were reported for 57.6 and 8.1% of patients receiving risperidone and quetiapine XR, respectively. Quetiapine XR was superior to risperidone at reducing depressive symptoms in patients with schizophrenia. PMID:25356632

  20. Effects of amisulpride, risperidone and chlorpromazine on auditory and visual latent inhibition, prepulse inhibition, executive function and eye movements in healthy volunteers.

    Science.gov (United States)

    Barrett, S L; Bell, R; Watson, D; King, D J

    2004-06-01

    In view of the evidence that cognitive deficits in schizophrenia are critically important for long-term outcome, it is essential to establish the effects that the various antipsychotic compounds have on cognition, particularly second-generation drugs. This parallel group, placebo-controlled study aimed to compare the effects in healthy volunteers (n = 128) of acute doses of the atypical antipsychotics amisulpride (300 mg) and risperidone (3 mg) to those of chlorpromazine (100 mg) on tests thought relevant to the schizophrenic process: auditory and visual latent inhibition, prepulse inhibition of the acoustic startle response, executive function and eye movements. The drugs tested were not found to affect auditory latent inhibition, prepulse inhibition or executive functioning as measured by the Cambridge Neuropsychological Test Battery and the FAS test of verbal fluency. However, risperidone disrupted and amisulpride showed a trend to disrupt visual latent inhibition. Although amisulpride did not affect eye movements, both risperidone and chlorpromazine decreased peak saccadic velocity and increased antisaccade error rates, which, in the risperidone group, correlated with drug-induced akathisia. It was concluded that single doses of these drugs appear to have little effect on cognition, but may affect eye movement parameters in accordance with the amount of sedation and akathisia they produce. The effect risperidone had on latent inhibition is likely to relate to its serotonergic properties. Furthermore, as the trend for disrupted visual latent inhibition following amisulpride was similar in nature to that which would be expected with amphetamine, it was concluded that its behaviour in this model is consistent with its preferential presynaptic dopamine antagonistic activity in low dose and its efficacy in the negative symptoms of schizophrenia. PMID:15260903

  1. Paliperidone palmitate injection for the acute and maintenance treatment of schizophrenia in adults

    Directory of Open Access Journals (Sweden)

    Kim S

    2012-07-01

    Full Text Available Shiyun Kim,1 Hugo Solari,2 Peter J Weiden,2 Jeffrey R Bishop11Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, 2Department of Psychiatry, University of Illinois at Chicago College of Medicine, Chicago, IL, USAPurpose: To review the use of paliperidone palmitate in treatment of patients with schizophrenia.Methods: Published clinical trial data for the development and utilization of paliperidone palmitate for the treatment of schizophrenia were assessed in this review. Four short-term, randomized, double-blind, placebo-controlled trials investigated the efficacy of paliperidone palmitate in acute exacerbation of schizophrenia. Paliperidone palmitate was also studied as a maintenance treatment to prevent or delay relapse in stable schizophrenia. In addition, paliperidone palmitate was compared to risperidone long-acting injection for noninferiority in three studies.Results: Paliperidone palmitate has been shown to be effective in reducing symptoms as measured by the Positive and Negative Syndrome Scale total scores in the four acute treatment studies. In the maintenance treatment studies, paliperidone palmitate was found to be more effective than placebo in preventing or delaying the time to first relapse in stable schizophrenia patients. In addition, paliperidone palmitate was shown to be noninferior to risperidone long-acting injection in two studies. It was shown to be reasonably well tolerated in all clinical trials. Acute treatment phase should be initiated with a dose of 234 mg on day one and 156 mg on day eight, followed by a recommended monthly maintenance dose of 39–234 mg based on efficacy and tolerability results from the clinical studies.Conclusion: Providing an optimal long-term treatment can be challenging. Paliperidone palmitate can be used as an acute treatment even in outpatient setting, and it has shown to be well tolerated by patients. Also, it does not require overlapping oral antipsychotic supplementation while being initiated, and is dosed once per month.Keywords: schizophrenia, antipsychotic, long-acting injection, paliperidone

  2. One-Shot Percutaneous Ethanol Injection of Liver Tumors Under General Anesthesia: Preliminary Data on Efficacy and Complications

    International Nuclear Information System (INIS)

    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

  3. Long-acting injectable antipsychotics: focus on olanzapine pamoate

    Directory of Open Access Journals (Sweden)

    JP Lindenmayer

    2010-05-01

    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

  4. Relationship between Addiction Relapse and Self-Efficacy Rates in Injection Drug Users Referred to Maintenance Therapy Center of Sari, 1391

    Directory of Open Access Journals (Sweden)

    Zahra Abdollahi

    2014-01-01

    Full Text Available 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 to regard the slip as a temporary setback and to reinstate control, whereas those who have low self-efficacy are more likely to proceed to a full-blown relapse. This study was carried out to determine relationship between relapse and self-efficacy and other factors in injected drug users. Materials and Methods: We conducted this study in 200 addicts in the center of counseling behavioral disease in health center of sari city (methadone maintenance therapy center or MMTC. A cross-sectional study was carried out on all of these addicts. Results: The average age in addictions was38 and its range was 20-60.72%of them were married and the first drug used was opium. All of them had relapse at least one time .we found a relationship between relapse and self-efficacy as well as the relationship between self-efficacy with the age of the first of drug use, dose, and procrastination for treatment, marriage, employment and job was significant. Conclusion: This study found that there was a significant difference between relapse and self-efficacy as well as other related factors. It is important to include drug users and common society organizations representing them in every stage of the governmental policy and program development process to make them responsive to the needs of the community.

  5. Low perceived benefits and self-efficacy are associated with hepatitis C virus (HCV) infection-related risk among injection drug users.

    Science.gov (United States)

    Cox, Joseph; De, Prithwish; Morissette, Carole; Tremblay, Claude; Stephenson, Randolph; Allard, Robert; Graves, Lisa; Roy, Elise

    2008-01-01

    Hepatitis C prevention counselling and education are intended to increase knowledge of disease, clarify perceptions about vulnerability to infection, and increase personal capacity for undertaking safer behaviours. This study examined the association of drug equipment sharing with psychosocial constructs of the AIDS Risk Reduction Model, specifically, knowledge and perceptions related to hepatitis C virus (HCV) among injection drug users (IDUs). Active IDUs were recruited between April 2004 and January 2005 from syringe exchange and methadone maintenance treatment programs in Montreal, Canada. A structured, interviewer-administered questionnaire elicited information on drug preparation and injection practices, self-reported hepatitis C testing and infection status, and AIDS Risk Reduction Model constructs. Separate logistic regression models were developed to examine variables in relation to: (1) the sharing of syringes, and (2) the sharing of drug preparation equipment (drug containers, filters, and water). Among the 321 participants, the mean age was 33 years, 70% were male, 80% were single, and 91% self-identified as Caucasian. In the multivariable analyses, psychosocial factors linked to syringe sharing were lower perceived benefits of safer injecting and greater difficulty to inject safely. As with syringe sharing, the sharing of drug preparation equipment was associated with lower perceived benefits of safer injecting but also with low self-efficacy to convince others to inject more safely. Interventions should aim to heighten awareness of the benefits of risk reduction and provide IDUs with the skills necessary to negotiate safer injecting with their peers. PMID:17920741

  6. Comparison of the efficacy of weekly vs. twice a week intralesional injections of meglumine antimoniate in the treatment of anthroponotic cutaneous leishmaniasis: a randomized clinical trial

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    Ali Khamesipour

    2010-12-01

    Full Text Available "nBackground and Aim: Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate (Glucantime® is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis (ACL."n"nMethods: This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime® and the other group treated with intralesional Glucantime® twice a week. Type and size of each lesion (induration, ulcer and scar were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure."n"nResults: A total of 48 patients completed the study; complete cure was seen in 24 of 27 (89% patients who received weekly intralesional MA with a mean duration of healing equals to 70±10 days. Complete cure was seen in 24 of 31 (77% patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58±5 days. There was no significant difference between the two groups (P=0.23."n"nConclusion: It seems that the efficacy of intralesional injections of Glucantime® once a week is similar to efficacy of twice a week Glucantime® injections.

  7. Comparison of safety and efficacy of the early injection of atropine during dobutamine stress echocardiography with the conventional protocol.

    Science.gov (United States)

    Tsutsui, Jeane M; Osório, Altamiro F F; Lario, F Abio C; Fernandes, Daniela R A; Sodre, Gustavo; Andrade, José L; Ramires, José A F; Mathias, Wilson

    2004-12-01

    Although dobutamine-atropine stress echocardiography (DASE) is an established method for evaluating patients who have coronary artery disease (CAD), it can increase test duration and a patient's exposure to large doses of dobutamine. New protocols, including the early injection of atropine during dobutamine stress echocardiography (EA-DSE), have been proposed to decrease test duration. This study compared the safety, efficacy, and accuracy of EA-DSE with those of DASE. We retrospectively evaluated 3,163 patients who underwent DASE and 1,664 patients who underwent EA-DSE over a period of 12 years. In EA-DSE, atropine at a dose 50% stenosis) was assessed in patients who underwent quantitative angiography

  8. Using Glycopyrrolate as an alternative option in case of Risperidone induced sialorrhoea

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    Dr. Hemanta Dutta

    2015-03-01

    Full Text Available Drug induced hypersalivation has been playing an unique factor in terms of noncompliance of antipsychotics. Hypersalivation has been described commonly with clozapine. Although Risperidone is also seen to be notorious to be causing hypersalivation. Use of Glycopyrrolate in Risperidone induced hypersalivation has not been covered though reported studies till yet. Here we are depicting the use of Glycopyrrolate as an alternative treatment option for hypersalivation induced by Risperidone.

  9. Multi-drug overdose risperidone, ziprasidone, valproate, trihexyphenidyl, and clonazepam

    DEFF Research Database (Denmark)

    Rajamani, Anto Praveen Rajkumar; Jebaraj, P

    2007-01-01

    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.

  10. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing phase IV study

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    Bashaireh K

    2015-04-01

    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 1–4 in the tibio–femoral 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

  11. The Efficacy of Botulinum Toxin Type a Injection in the Hamstring and Calf Muscles With and Without Serial Foot Casting in Gait Improvement in Children With Cerebral Palsy

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    Shamsodini A

    2011-11-01

    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.

  12. Case Report: Valproic Acid and Risperidone Treatment Leading to Development of Hyperammonemia and Mania

    Science.gov (United States)

    Carlson, Teri; Reynolds, Charles A.; Caplan, Rochelle

    2007-01-01

    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…

  13. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing Phase IV study

    Science.gov (United States)

    Bashaireh, Khaldoon; Naser, Ziad; Hawadya, Khaled Al; Sorour, Sorour; Al-Khateeb, Rami Nabeel

    2015-01-01

    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 1–4) in the tibio–femoral 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. PMID:25897212

  14. Ablation of lumbar sympathetic ganglia by absolute ethanol injection and paravertebral catheter placement under CT guidance: evaluation of the efficacy

    International Nuclear Information System (INIS)

    Objective: To evaluate the ablation of lumbar sympathetic ganglia by using single injection of absolute ethanol and retaining a paravertebral catheter under CT guidance for the treatment of lower extremity ischemia. Methods: Single absolute ethanol injection of L2 sympathetic ganglia was done in 25 cases (group B), single absolute ethanol injection of L2 sympathetic ganglia together with placement of a paravertebral catheter at L3 was carried out in 23 cases (group BT). All the procedures were performed under CT guidance. Three days after the procedure, the pain severity of the lower limbs was evaluated based on VAS method. If the patient in group BT still had a VAS score ?4 on the third day, 3 ml of 1% lidocaine was infected via the retained catheter in the prone position. If VAS score became ?3 at 5 min after the injection, additional 5 ml of ethanol was given through the catheter. The pain severity was evaluated again one week later. VAS score, analgesic dose and temperature of lower limbs were recorded. Results: One week after the procedure the excellent rate and effective rate for group B were 32% and 80% respectively, while for group BT were 60.9% and 95.7% respectively, with a significant difference between two groups (P<0.01). Conclusion: For the ablation of lumbar sympathetic ganglia the combination of single absolute ethanol injection with paravertebral catheter placement under CT guidance is superior to the single absolute ethanol injection. This technibsolute ethanol injection. This technique is more individual with better results and is more likely to be accepted by the patients. (authors)

  15. Comparison of Efficacy and Tolerability of Hylan G-F 20 in Patients with and without Effusions at the Time of Initial Injection.

    Science.gov (United States)

    Waddell, Bradford S; Waddell, W Hunter; Waddell, David D

    2015-06-01

    An effusion at the onset of viscosupplementation has been thought to diminish the efficacy and increase adverse event rates. This study compares efficacy of hylan G-F 20 in patients with and without an effusion. Patients with knee osteoarthritis (OA) received three weekly injections of hylan G-F 20. A total of 50 patients with an effusion requiring aspiration were compared with 50 matched patients without an effusion. Outcome measurements included Western Ontario and McMaster's Universities Osteoarthritis index (WOMAC) and visual analog scale (VAS). Patients were followed for 26 weeks. Both effusion and control group VAS was significantly lowered at all time points. WOMAC scores improved (p?improved at all visits (p?efficacy of hylan G-F 20 or increase adverse event rates. PMID:24807194

  16. The effects of ketamine and risperidone on eye movement control in healthy volunteers.

    Science.gov (United States)

    Schmechtig, A; Lees, J; Perkins, A; Altavilla, A; Craig, K J; Dawson, G R; William Deakin, J F; Dourish, C T; Evans, L H; Koychev, I; Weaver, K; Smallman, R; Walters, J; Wilkinson, L S; Morris, R; Williams, S C R; Ettinger, U

    2013-01-01

    The non-competitive N-methyl-D-aspartate receptor antagonist ketamine leads to transient psychosis-like symptoms and impairments in oculomotor performance in healthy volunteers. This study examined whether the adverse effects of ketamine on oculomotor performance can be reversed by the atypical antipsychotic risperidone. In this randomized double-blind, placebo-controlled study, 72 healthy participants performed smooth pursuit eye movements (SPEM), prosaccades (PS) and antisaccades (AS) while being randomly assigned to one of four drug groups (intravenous 100?ng?ml(-1) ketamine, 2?mg oral risperidone, 100 ?ng?ml(-1) ketamine plus 2?mg oral risperidone, placebo). Drug administration did not lead to harmful adverse events. Ketamine increased saccadic frequency and decreased velocity gain of SPEM (all P or = 0.07). An effect of risperidone was observed for amplitude gain and peak velocity of PS and AS, indicating hypometric gain and slower velocities compared with placebo (both P risperidone interactions were found (all P > or = 0.26). The results confirm that the administration of ketamine produces oculomotor performance deficits similar in part to those seen in schizophrenia. The atypical antipsychotic risperidone did not reverse ketamine-induced deteriorations. These findings do not support the cognitive enhancing potential of risperidone on oculomotor biomarkers in this model system of schizophrenia and point towards the importance of developing alternative performance-enhancing compounds to optimise pharmacological treatment of schizophrenia. PMID:24326395

  17. A Placebo-Controlled Study of Raloxifene Added to Risperidone in Men with Chronic Schizophrenia.

    Science.gov (United States)

    Khodaie-Ardakani, Mohammad-Reza; Khosravi, Mohsen; Zarinfard, Razieh; Nejati, Somayeh; Mohsenian, Ali; Tabrizi, Mina; Akhondzadeh, Shahin

    2015-06-01

    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 (Peffects were comparable between two groups.This study indicates raloxifene as a potential adjunctive treatment strategy for chronic schizophrenia in men. PMID:26069170

  18. Risperidone Versus Yokukansan in the Treatment of Severe Alzheimer’s Disease

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    Yuko Furuhashi

    2011-05-01

    Full Text Available PURPOSE: Patients with AD commonly exhibit behavioral and psychological symptoms of dementia (BPSD. This study is aimed to compare the efficacy of yokukansan (YKS and risperidone (RIS on BPSD in patients with severe Alzheimer’s disease (AD. METHODS: Thirty eight inpatients with AD were investigated. Patients were randomly as-signed to the YKS group (N = 18 or the RIS group (N = 20 and treated for 4 weeks. The primary outcomes were changes in the scores on the Neuropsychiatric Inventory (NPI, the Mini-Mental State Examination (MMSE, the Bar-thel Index, and the Cohen-Mansfield Agitation Inventory (CMAI. The frequency of extrapyramidal symptoms (EPS and other adverse events were recorded at every visit. RESULTS: All participants in both groups completed the trial. The Barthel Index did not significantly change either in the RIS group or the YKS group. The MMSE scores did not change either in the RIS group or the YKS group. Significant improvements in mean total NPI and CMAI scores showed in both groups. Between the YKS and the RIS groups, there were no significant differences in the NPI or the CMAI scores. EPS and other serious adverse effects were not observed in either group. CONCLUSIONS: In this 4-week trial, YKS treatment significantly improved BPSD in the patients with severe AD. The present study suggests that YKS is as effective as RIS on BPSD with severe AD.

  19. Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial

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    Wechsberg Wendee M

    2012-01-01

    Full Text Available Abstract Background With HIV prevalence estimated at 20% among female injecting drug users (IDUs in St. Petersburg, Russia, there is a critical need to address the HIV risks of this at-risk population. This study characterized HIV risks associated with injecting drug use and sex behaviors and assessed the initial feasibility and efficacy of an adapted Woman-Focused intervention, the Women's CoOp, relative to a Nutrition control to reduce HIV risk behaviors among female IDUs in an inpatient detoxification drug treatment setting. Method Women (N = 100 were randomized into one of two one-hour long intervention conditions--the Woman-Focused intervention (n = 51 or a time and attention-matched Nutrition control condition (n = 49. Results The results showed that 57% of the participants had been told that they were HIV-positive. At 3-month follow-up, both groups showed reduced levels of injecting frequency. However, participants in the Woman-Focused intervention reported, on average, a lower frequency of partner impairment at last sex act and a lower average number of unprotected vaginal sex acts with their main sex partner than the Nutrition condition. Conclusion The findings suggest that improvements in sexual risk reduction are possible for these at-risk women and that more comprehensive treatment is needed to address HIV and drug risks in this vulnerable population.

  20. Applying a mathematical model to estimate the fractional accessibility to quenching of serum albumin by risperidone

    Science.gov (United States)

    Carqueja, Marilena; Cortez, Celia Martins

    2014-10-01

    In this work we report the results from application of a mathematical model to estimate the fractional accessibility to fluorescence quenching by risperidone in human and bovine sera albumins. Risperidone is an atypical antipsychotic drug used to treat many kinds of psychiatric disorders. Results showed that but the fractional accessibility for trypyophan 134, sub domain 1B, is about 3 times higher than that to tryptophan 212, showing that the primary binding site for risperidone is close to tryptophan 134, in domain IB of BSA.

  1. Dose-associated changes in safety and efficacy parameters observed in a 24-week maintenance trial of olanzapine long-acting injection in patients with schizophrenia

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    Watson Susan B

    2011-02-01

    Full Text Available Abstract Background In a recently published 24-week maintenance study of olanzapine long-acting injection (LAI in schizophrenia (Kane et al., 2010, apparent dose-associated changes were noted in both efficacy and safety parameters. To help clinicians balance safety and efficacy when choosing a dose of olanzapine LAI, we further studied these changes. Methods Outpatients with schizophrenia who had maintained stability on open-label oral olanzapine for 4 to 8 weeks were randomly assigned to "low" (150 mg/2 weeks; N = 140, "medium" (405 mg/4 weeks; N = 318, or "high" (300 mg/2 weeks; N = 141 dosages of olanzapine LAI for 24 weeks. Potential relationships between dose and several safety or efficacy measures were examined via regression analysis, the Jonckheere-Terpstra test (continuous data, or the Cochran-Armitage test (categorical data. Results Safety parameters statistically significantly related to dose were mean weight change (low: +0.67 [SD = 4.38], medium: +0.89 [SD = 3.87], high: +1.70 [SD = 4.14] kg, p = .024; effect size [ES] = 0.264 high vs. low dose, mean change in prolactin (low: -5.61 [SD = 12.49], medium: -2.76 [SD = 19.02], high: +3.58 [SD = 33.78] ?g/L, p = .001; ES = 0.410 high vs. low dose, fasting triglycerides change from normal at baseline to high (low: 3.2%, medium: 6.0%, high: 18.9%, p = .001; NNT = 7 high vs. low dose and fasting high-density lipoprotein cholesterol change from normal at baseline to low (low: 13.8%, medium: 19.6%, high: 30.7%, p = .019; NNT = 6 high vs. low dose. Efficacy measures significantly related to dose included Positive and Negative Syndrome Scale total score mean change (low: +2.66 [SD = 14.95], medium: -0.09 [SD = 13.47], high: -2.19 [SD = 13.11], p Conclusions Analyses of several safety and efficacy parameters revealed significant associations with dose of olanzapine LAI, with the highest dose generally showing greater efficacy as well as greater adverse changes in metabolic safety measures. When considering olanzapine LAI, as with all antipsychotics, it is important to carefully consider the potential benefits and risks for an individual patient. Trial Registration ClinicalTrials.gov: NCT00088491

  2. Efficacy and acceptability of depo-medroxyprogesterone acetate injection. As a method of contraception in Saudi Arabia.

    OpenAIRE

    A. A. Sobande; H. M. Al-Bar; E. I. Archibong; A. A. Sadek

    2000-01-01

    OBJECTIVES To determine the efficacy and acceptability of Depo-Medroxyprogesterone acetate (depo-provera) among the women using that method of contraception at King Faisal Military Hospital in the south-west region of Saudi Arabia. METHODS A preliminary retrospective and questionnaire analysis of 165 Saudi women who had depo-provera as a method of contraception at the contraception clinic of King Faisal Military Hospital over a period of 2 months. RESULTS The mean age of the wo...

  3. Efficacy and safety of metronidazole injection for the treatment of infectious peritonitis, abdominal abscess and pelvic inflammatory diseases in Japan.

    Science.gov (United States)

    Mikamo, Hiroshige; Matsumizu, Miyako; Nakazuru, Yoshiomi; Nagashima, Masahito

    2015-02-01

    Although metronidazole (MNZ) has been used worldwide for more than 4 decades as a standard therapy for trichomoniasis, anaerobic and amebic infections, resistance to MNZ is still low. MNZ is available as oral, intravenous, and vaginal formulations, but the intravenous formulation of MNZ has not been approved in Japan. We conducted a phase 3 study to evaluate the efficacy and safety of intravenous MNZ combined with ceftriaxone (CTRX) in Japanese subjects with infectious peritonitis, abdominal abscess or pelvic inflammatory diseases (PIDs) to obtain regulatory approval. A combination of MNZ/CTRX at doses of 500 mg 3 or 4 times a day/1 or 2 g twice a day was administered intravenously to a total of 38 hospitalized subjects. MNZ/CTRX was well tolerated and exhibited excellent clinical and bacteriological efficacy with clinical efficacy rates of 100% (20/20) in infectious peritonitis or abdominal abscess subjects and 90.0% (9/10) in PID subjects, and the eradication rates in infectious peritonitis or abdominal abscess subjects and PID subjects were 100% (16/16) and 100% (4/4), respectively, at the test of cure. MNZ/CTRX was effective in 1 subject in whom a metallo-?-lactamase-producing Bacteroides fragilis strain (MIC of MNZ, 2 ?g/ml) was identified. The most common treatment-related adverse event was diarrhea (23.7%), followed by nausea (5.3%). No new safety signals were identified. MNZ/CTRX demonstrated excellent efficacy and was well tolerated in Japanese infectious peritonitis, abdominal abscess and PID subjects. This treatment regimen can be useful for anaerobic infections. Clinical registration number: NCT01473836. PMID:25442806

  4. Long-acting injectable antipsychotics for the maintenance treatment of bipolar disorder.

    Science.gov (United States)

    Gigante, Alexandre Duarte; Lafer, Beny; Yatham, Lakshmi N

    2012-05-01

    Depot antipsychotics have been used as a strategy to reduce non-adherence to medications in schizophrenia and bipolar disorder (BD). This article reviews the literature on the efficacy and safety of first- and second-generation depot antipsychotics (FGDA and SGDA, respectively) for the maintenance treatment of BD. Although FGDA have been studied in BD, they have not been approved for use in this disease. Among the SGDA, only depot risperidone has been studied and approved for the maintenance treatment of BD. We found eight studies on FGDA (three on flupenthixol, two on depot haloperidol, one on fluphenazine and flupenthixol, two on a mix of diverse antipsychotics) and ten studies on SGDA (all on depot risperidone). Differences in efficacy and safety were found between the two classes of depot antipsychotics. Although FGDA may be effective in reducing manic relapses, they possibly increase the risk of worsening depression. Depot risperidone is effective as a maintenance treatment in BD with effect noted predominantly for preventing mania. However, no worsening in depression was observed. Depot risperidone also is better tolerated than FGDA, mainly in relation to extrapyramidal symptoms. Studies with the new depot antipsychotics, olanzapine pamoate and paliperidone palmitate, are needed in BD patients. Further, there is currently little information on the metabolic changes (apart from bodyweight gain) that may occur with the use of depot risperidone in patients with bipolar disorder, and this issue needs further investigation. PMID:22494448

  5. Efficacy of olanzapine long-acting injection in patients with acutely exacerbated schizophrenia: an insight from effect size comparison with historical oral data

    Directory of Open Access Journals (Sweden)

    Detke Holland C

    2012-05-01

    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 (0–6 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.

  6. Pain and Efficacy Rating of a Microprocessor-Controlled Metered Injection System for Local Anaesthesia in Minor Hand Surgery

    OpenAIRE

    Nimigan, Andr Amp S.; Bing Siang Gan

    2011-01-01

    Purpose. Little attention has been given to syringe design and local anaesthetic administration methods. A microprocessor-controlled anaesthetic delivery device has become available that may minimize discomfort during injection. The purpose of this study was to document the pain experience associated with the use of this system and to compare it with use of a conventional syringe. Methods. A prospective, randomized clinical trial was designed. 40 patients undergoing carpal tunnel release wer...

  7. Induction of Drug Transporters Alters Disposition of Risperidone - A Study in Mice

    Directory of Open Access Journals (Sweden)

    David Holthoewer

    2010-06-01

    Full Text Available Pharmacokinetic interactions, e.g. modulation of drug transporters like P-glycoprotein at the blood-brain barrier, can be a reason for treatment non-response. This study focuses on the influence of induction of drug transporters on the disposition of the antipsychotic drugs risperidone and 9-hydroxyrisperidone. Brain and serum concentrations of risperidone and its active metabolite 9-hydroxyrisperidone, which are known P-glycoprotein substrates, were measured after drug transporter induction with rifampicin, dexamethasone or 5-pregnene-3beta-ol-20-on-16alpha-carbonitrile using high performance liquid chromatography. Disposition of risperidone and 9-hydroxyrisperidone was dramatically decreased in mouse brain and serum after drug transporter induction. The metabolism of risperidone was also affected.

  8. Acute and long-term safety and tolerability of risperidone in children with autism.

    Science.gov (United States)

    Aman, Michael G; Arnold, L Eugene; McDougle, Christopher J; Vitiello, Benedetto; Scahill, Lawrence; Davies, Mark; McCracken, James T; Tierney, Elaine; Nash, Patricia L; Posey, David J; Chuang, Shirley; Martin, Andres; Shah, Bhavik; Gonzalez, Nilda M; Swiezy, Naomi B; Ritz, Louise; Koenig, Kathleen; McGough, James; Ghuman, Jaswinder K; Lindsay, Ronald L

    2005-12-01

    Treatment-emergent adverse events (AEs) were monitored during an 8-week, double-blind, placebo-controlled trial of risperidone (0.5-3.5 mg/day) in 101 children and adolescents with a lifetime diagnosis of autistic disorder. In addition, 37 placebo nonresponders received open-label risperidone for another 8 weeks. Of all the risperidone responders (n=65), 63 entered an open extension of another 16 weeks (6 months total risperidone exposure), and 32 of them were rerandomized to either continued risperidone therapy (n=16) or gradual replacement with placebo (n=16) over 8 weeks. We collected the following measures of safety and tolerability: (1) laboratory blood assessments (CBC with differential, electrolytes, and liver function tests) and urinalyses, (2) vital signs, (3) Side Effects Review of AEs thought to be associated with risperidone, (4) sleep records, (5) Simpson Angus Neurological Rating Scale (SARS), (6) Abnormal Involuntary Movement Scale (AIMS), and (7) height and weight. No clinically significant changes were found on the lab tests. During the 8-week acute trial, the most common AEs on the Side Effects Review, scored as moderate or higher, were as follows (placebo and risperidone, respectively): Somnolence (12% and 37%), enuresis (29% and 33%), excessive appetite (10% and 33%), rhinitis (8% and 16%), difficulty waking (8% and 12%), and constipation (12% and 10%). "Difficulty falling asleep" and anxiety actually favored the risperidone condition at statistically significant levels. The same AEs tended to recur through 6 months of treatment, although often at reduced levels. Using Centers for Disease Control (CDC) standardized scores, both weight and body mass index (BMI) increased with risperidone during the acute trial (0.5 and 0.6 SDs, respectively, for risperidone; 0.0 and 0.1 SDs, respectively, for placebo) and into open-label extension (0.19 and 0.16 SDs, respectively), although the amount of gain decelerated with time. Extrapyramidal symptoms, as assessed by the SARS, were no more common for drug than placebo, although drooling was reported more often in the risperidone group. There were no differences between groups on the AIMS. Two subjects had seizures (one taking placebo), but these were considered unrelated to active drug. Most AEs were mild to moderate and failed to interfere with therapeutic changes; there were no unanticipated AEs. The side effects of most concern were somnolence and weight gain. PMID:16379507

  9. Development of novel risperidone implants using blends of polycaprolactones and in vitro in vivo correlation studies

    OpenAIRE

    Navitha, Aerrolla; Jogala, Satheesh; Krishnamohan, Chinnala; Aukunuru, Jithan

    2014-01-01

    The objective of this study was to develop a novel implant containing risperidone intended for long-term treatment in Schizophrenia utilizing in vitro in vivo correlation (IVIVC) studies. Different implants (F1-F8) containing an antipsychotic drug, risperidone, were prepared using a hot melt extrusion technique by taking polycaprolactones of different molecular weights (Mwt. 15000, 45000, 80000) either alone or as their blends, and PLGA (75:25). The implants contained 40% of the drug. After f...

  10. Antipsychotic discontinuation syndrome following risperidone withdrawal: a case report from rural India

    OpenAIRE

    Sravanti L Sanivarapu; Krishnamurthy CN

    2014-01-01

    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...

  11. Patient and Health Care Provider Perspectives on Long Acting Injectable Antipsychotics in Schizophrenia and the Introduction of Olanzapine Long-Acting Injection

    OpenAIRE

    Wehring, Heidi J.; Sheryl Thedford; Maju Koola; Kelly, Deanna L

    2011-01-01

    Olanzapine long acting injection has joined risperidone and paliperidone as the second generation long acting antipsychotic injection options for treatment of patients with schizophrenia. Long acting injections are important alternatives to oral medications for patients who have difficulty adhering to daily or multiple daily medication administrations, yet may be underutilized or not well understood. Patient perceptions, adherence, and preferences are important issues for health care provider...

  12. Comparison of efficacy of lignocaine anesthesia of vocal cords by spray as you go through a bronchoscope with lignocaine injection through the cricothyroid membrane

    International Nuclear Information System (INIS)

    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)

  13. Development of a novel 3-month drug releasing risperidone microspheres

    Science.gov (United States)

    Yerragunta, Bhanusree; Jogala, Satheesh; Chinnala, Krishna Mohan; Aukunuru, Jithan

    2015-01-01

    Objective: The purpose of this study was to develop an ideal microsphere formulation of risperidone that would prolong the drug release for 3 months in vivo and avoid the need for co-administration of oral tablets. Materials and Methods: Polycaprolactones (PCL) were used as polymers to prepare microspheres. The research included screening and optimizing of suitable commercial polymers of variable molecular weights: PCL-14000, PCL-45000, PCL-80000 or the blends of these polymers to prepare microspheres with zero-order drug-releasing properties without the lag phase. In the present study, the sustained release risperidone microspheres were prepared by o/w emulsion solvent evaporation technique and the yield was determined. Microspheres were evaluated for their drug content and in vitro drug release. Microspheres prepared using a blend of PCL-45000 and PCL-80000 at a ratio of 1:1 resulted in the release of the drug in a time frame of 90 days, demonstrated zero-order drug release without lag time and burst release. This formulation was considered optimized formulation. Optimized formulation was characterized for solid state of the drug using differential scanning calorimetry, surface morphology using scanning electron microscopy and in vivo drug release in rats. Results: The surface of the optimized formulation was smooth, and the drug changed its physical form in the presence of blends of polymers and upon fabrication of microspheres. The optimized formulation also released the drug in vivo for a period of 90 days. Conclusions: From our study, it was concluded that these optimized microspheres showed great potential for a better depot preparation than the marketed Risperdal Consta™ and, therefore, could further improve patient compliance. PMID:25709335

  14. A Randomized Open Label Comparison of the Effects ofRisperidone and Haloperidol on Sexual Function

    Directory of Open Access Journals (Sweden)

    S. Jaber Mousavi

    2009-12-01

    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 .

  15. 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

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel

    2012-01-01

    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.

  16. Upcoming agents for the treatment of schizophrenia: mechanism of action, efficacy and tolerability.

    Science.gov (United States)

    Bishara, Delia; Taylor, David

    2008-01-01

    Since the introduction of a group of atypical antipsychotics in the 1990s, there has been a decline in the rate of new antipsychotics being introduced into clinical practice. However, with increasing safety and efficacy concerns over currently available drugs and a dearth of options available for atypical depot formulations, there is a considerable need for the development of new formulations and agents. This review examines the profile of seven antipsychotic drugs currently in the premarketing stage of development and summarizes their mechanism of action, clinical potential and safety.Asenapine is an antipsychotic with activity for multiple receptors and has potential to improve negative and cognitive symptoms of schizophrenia. Bifeprunox is a partial dopamine D2 and serotonin 5-HT(1A) receptor agonist showing a less than convincing efficacy profile, but which may offer safety advantages over available agents by means of a reduced risk of metabolic complications. Iloperidone is a D2 and 5-HT(2A) receptor antagonist requiring further studies to establish its effectiveness. It has a high affinity for alpha(1)-adrenoceptors, which can lead to associated haemodynamic adverse effects. Nemonapride is essentially a typical antipsychotic drug, similar in structure to sulpiride, which has been available for some time in Japan. It has efficacy against positive symptoms and has shown some antidepressant and anxiolytic properties, although efficacy data for it are somewhat limited. Norclozapine (N-desmethylclozapine) is a major metabolite of clozapine formed by its demethylation. Its partial agonist activity at D2 receptors has raised interest in it as an antipsychotic in its own right. In addition, it appears to have muscarinic agonist activity, which is believed to be responsible for the observed positive effects it has on cognition. It was envisaged to be effective as an adjunct to other agents or at high doses in the treatment of refractory schizophrenia, although a recent randomized, controlled study showed that it was no more effective than placebo in patients with schizophrenia experiencing an acute psychotic episode. Olanzapine pamoate depot injection has shown comparable efficacy to oral olanzapine in several studies. However, it has provoked considerable safety concerns by its association with inadvertent intravascular injection events in numerous patients. This accidental intravascular administration of olanzapine pamoate leads to excessive sedation, confusion, dizziness and altered speech. Post-injection observation periods and postmarketing surveillance are planned following the introduction of the depot. Paliperidone palmitate is the palmitate ester of paliperidone, the major metabolite of risperidone, and is formulated as a long-acting injection for intramuscular use. Its pharmacology is comparable to risperidone, having D2 and 5-HT(2A) receptor antagonist activity. Efficacy studies have shown positive results, and because paliperidone has no antagonistic activity at cholinergic receptors, it has low potential for anticholinergic adverse effects, including cognitive dysfunction. However, with higher doses, the frequency of extrapyramidal side effects and orthostatic hypotension have been shown to be greater than with placebo. PMID:18973393

  17. Serum concentrations and side effects in psychiatric patients during risperidone therapy

    DEFF Research Database (Denmark)

    Olesen, O V; Licht, R W

    1998-01-01

    Steady state serum concentrations of risperidone and 9-hydroxyrisperidone (9-OH-risperidone), the active moiety, were measured in 42 patients. The concentration-to-dose ratios (C/D) varied by a factor of 20, from 1.8 to 36.8 (nmol/l)/(mg/24 hours), and 90% of the active moiety was constituted of 9-OH-risperidone. No correlation between the serum concentration of the active moiety and the side effects evaluated by the UKU Side Effect Scale was found. The absence of CYP2D6 (poor metabolizers) or the coadministration of drugs other than benzodiazepines increased the ratio between parent compound and metabolite but did not significantly influence the C/D of the total active moiety. A therapeutic range for serum risperidone has not been established, but 6 mg/day is considered the optimum dose for most patients. The authors found that in 90% of 22 patients administered 6 mg/day risperidone, the serum levels were within 50 to 150 nmol/l.

  18. Risperidone – Solid-state characterization and pharmaceutical compatibility using thermal and non-thermal techniques

    International Nuclear Information System (INIS)

    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

  19. A Risperidone-Induced Prolactinoma Resolved when a Woman with Schizoaffective Disorder Switched to Ziprasidone: A Case Report

    OpenAIRE

    Arcari, Gail T.; Mendes, Asante K.; Sothern, Robert B.

    2012-01-01

    Antipsychotic drug therapy, e.g., risperidone, can be associated with endocrine abnormalities, including an increase in serum prolactin level (sPrl) due to a drug-induced benign pituitary tumor (prolactinoma). A few case reports have noted a resolution of hyperprolactinemia and prolactinoma after cessation of risperidone treatment. We report a similar finding for a woman with schizoaffective disorder, manic type.

  20. Analysis and stability of polymorphs in tablets: The case of Risperidone.

    Science.gov (United States)

    Karabas, I; Orkoula, M G; Kontoyannis, C G

    2007-02-28

    Identification of the crystal phase of an active pharmaceutical ingredient (API) in a pharmaceutical tablet is of outmost importance since different polymorphs exhibit different physicochemical properties. Furthermore, some of the crystal phases are protected by patents. Identification of Risperidone polymorph A in film coated commercial tablets was attempted using IR spectroscopy, Raman spectroscopy and X-ray powder diffraction (XRPD). The stability of this polymorph through time and during the manufacturing process was also examined. The inability of IR and Raman techniques to identify the presence of polymorph A in the tablets, despite their lower detection limits for Risperidone, left the XRPD as the only technique that could be used for identifying the presence of Risperidone A against the other crystal phases in the presence of the excipients. Polymorph A was proved to be stable during the manufacturing process and after a storage period of 2 years. PMID:19071461

  1. Cognitive differences in schizophrenia on long-term treatments with clozapine, risperidone and typical antipsychotics.

    Science.gov (United States)

    Han, Mei; Zhang, Xiang Yang; Chen, Da Chun; Tan, Yun Long; Song, Chong Sheng; Yu, Ying Hua; Huang, Xu Feng

    2015-03-01

    Cognitive deficits are a core feature of schizophrenia. There is ongoing debate on whether cognition is affected by antipsychotic drugs (APDs). This study examined the effect of long-term treatment with APDs on cognition in schizophrenia. Cognitive function was assessed in 418 patients with schizophrenia on long-term treatment with APDs (215 on clozapine, 91 on risperidone and 112 on typical APDs) and 159 healthy controls using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Schizophrenia symptomatology was assessed using the Positive and Negative Syndrome Scale (PANSS). We found that cognitive test scores were significantly lower in all patients compared with the healthy controls on almost all of the total and subscores of RBANS (all Planguage performance than those taking risperidone (Ptypes of APDs and the PANSS negative scores. Our results show that individuals taking clozapine performed worse in immediate and delayed memory than those taking typical APDs, but exemplified better language performance than those taking risperidone. PMID:25568968

  2. Antipsychotic discontinuation syndrome following risperidone withdrawal: a case report from rural India

    Directory of Open Access Journals (Sweden)

    Sravanti L. Sanivarapu

    2014-02-01

    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

  3. DEVELOPMENT AND VALIDATION OF SPECTROPHOTOMETRIC METHOD FOR DETERMINATION OF RISPERIDONE BY MBTH

    OpenAIRE

    S. Archana*, Y. Naga Prasanna, P. Pavitra, D. Santhi Krupa, M. Hema Sri

    2013-01-01

    ABSTRACT: A simple and sensitive visible spectrophotometric method is described for the assay of risperidone (RSP) in pure and solid dosage forms. The method involves oxidative coupling of risperidone with MBTH in presence of ferric chloride dissolved in HCl and apple green chromogen is formed and exhibits absorption maxima at 595.8nm. Regression analysis of Beer-Lambert plots showed good correlation in the concentration ranges (10-80) ?g/mL. Regression coefficient was found to be 0.992. The...

  4. Once-monthly paliperidone injection for the treatment of schizophrenia

    OpenAIRE

    Delia Bishara

    2010-01-01

    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...

  5. Onset of efficacy with acute long-acting injectable paliperidone palmitate treatment in markedly to severely ill patients with schizophrenia: post hoc analysis of a randomized, double-blind clinical trial

    OpenAIRE

    Ma Yi-Wen; Sliwa Jennifer K; Bossie Cynthia A; Alphs Larry; Turner Norris

    2011-01-01

    Abstract Background This post hoc analysis (trial registration: ClinicalTrials.gov NCT00590577) assessed onset of efficacy and tolerability of acute treatment with once-monthly paliperidone palmitate (PP), a long-acting atypical antipsychotic initiated by day 1 and day 8 injections, in a markedly to severely ill schizophrenia population. Methods Subjects entering the 13-week, double-blind trial were randomized to PP (39, 156, or 234 mg [25, 100, and 150 mg eq of paliperidone, respectively]) o...

  6. The Therapeutic Effectiveness of Risperidone on Negative Symptoms of Schizophrenia in Comparison with Haloperidol: A Randomized Clinical Trial

    Science.gov (United States)

    Mirabzadeh, Arash; Kimiaghalam, Pooneh; Fadai, Farbod; Samiei, Mercedeh; Daneshmand, Reza

    2014-01-01

    Introduction A number of research studies have shown that the new generation of neuroleptic medications can more effectively contribute to treating negative symptoms of schizophrenia compared with the first generation by influence cognitive functioning. The present study examined the therapeutic effectiveness of manufactured Risperidone and Haloperidol in Iran on treating the negative symptoms of schizophrenia. Methods This randomized clinical trial (RCT) study examined 100 hospitalized patients who met DSM-IV. TR criteria for schizophrenia were sampled at Razi psychiatric hospital in Tehran, Iran. After two weeks of stopping neuroleptic medications, the patients were randomly assigned into two groups, Risperidone and Haloperidol group. During 8 weeks of the study, baseline and weekly assessments were performed by completing brief psychiatric report scale (BPRS). Results Both Risperidone and Haloperidol were effective in treating the negative symptoms of schizophrenia and improvements in both groups were initiated in the second week of treatment. The most prominent response rate was the second week in Haloperidol group and the eighth week in Risperidone group but this difference was not statistically significant. Discussion Prescribing Risperidone or Haloperidol for treating negative symptoms of schizophrenia can be influenced by other criteria including side effects, previous treatment histories of patients and their families and a patient’s or physician’ preference in prescribing a medication. Studies in other countries show that Haloperidol has better therapeutic effects in treating the negative symptoms of schizophrenia in comparison with Risperidone. Further studies on the therapeutic effectiveness of Risperidone and Haloperidol are suggested. PMID:25337382

  7. Polipectomía endoscópica de colon: efectividad y seguridad de la técnica de inyectar y cortar / Efficacy and safety of the inject and cut technique for endoscopic colonic polypectomy

    Scientific Electronic Library Online (English)

    William, Otero R; Alejandro, Concha M; Martín, Gómez Z.

    2013-03-30

    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

  8. Schizophrenia relapse and the clinical usefulness of once-monthly aripiprazole depot injection

    OpenAIRE

    Wang, Sheng-Min; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A.; Masand, Prakash S; Pae, Chi-Un

    2014-01-01

    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...

  9. Emotion perception in schizophrenia: an eye movement study comparing the effectiveness of risperidone vs. haloperidol.

    Science.gov (United States)

    Williams, Leanne M; Loughland, Carmel M; Green, Melissa J; Harris, Anthony W F; Gordon, Evian

    2003-08-30

    We used a psychophysiological marker of visual attention (the visual scanpath) to investigate the effects of atypical (risperidone) vs. typical (haloperidol) antipsychotic medication on facial emotion perception in schizophrenia (n=28) and healthy control (n=28) groups. Of the schizophrenia subjects, 15 were prescribed risperidone. Visual scanpaths to 'happy', 'sad' and 'neutral' faces were recorded using video-oculography, and concurrent emotion-recognition accuracy was assessed using multiple-option tasks. Compared to control subjects, both schizophrenia subgroups showed a restriction in visual scanning (reduced total fixation number and decreased scanpath length). Haloperidol-treated schizophrenia subjects exhibited an additional and consistent pattern of reduced attention (fixation) to salient features for neutral and happy. By contrast, risperidone-treated subjects showed a relatively greater attention to salient features for these expressions, in which they did not differ from controls. Recognition accuracy for happy and neutral showed a similar lack of impairment. These findings suggest that risperidone may play a specific role in schizophrenia in the ability to attend to salient features, and to integrate this information into an accurate percept for neutral and positive expressions in particular. PMID:14500110

  10. Risperidone treatment for ADHD in children and adolescents with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Joseph Biederman

    2008-03-01

    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 4–15 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

  11. Comparison of SGA oral medications and a long-acting injectable SGA: the PROACTIVE study.

    Science.gov (United States)

    Buckley, Peter F; Schooler, Nina R; Goff, Donald C; Hsiao, John; Kopelowicz, Alexander; Lauriello, John; Manschreck, Theo; Mendelowitz, Alan J; Miller, Del D; Severe, Joanne B; Wilson, Daniel R; Ames, Donna; Bustillo, Juan; Mintz, Jim; Kane, John M

    2015-03-01

    Until relatively recently, long-acting injectable (LAI) formulations were only available for first-generation antipsychotics and their utilization decreased as use of oral second-generation antipsychotics (SGA) increased. Although registry-based naturalistic studies show LAIs reduce rehospitalization more than oral medications in clinical practice, this is not seen in recent randomized clinical trials. PROACTIVE (Preventing Relapse Oral Antipsychotics Compared to Injectables Evaluating Efficacy) relapse prevention study incorporated efficacy and effectiveness features. At 8 US academic centers, 305 patients with schizophrenia or schizoaffective disorder were randomly assigned to LAI risperidone (LAI-R) or physician's choice oral SGAs. Patients were evaluated during the 30-month study by masked, centralized assessors using 2-way video, and monitored biweekly by on-site clinicians and assessors who knew treatment assignment. Relapse was evaluated by a masked Relapse Monitoring Board. Differences between LAI-R and oral SGA treatment in time to first relapse and hospitalization were not significant. Psychotic symptoms and Brief Psychiatric Rating Scale total score improved more in the LAI-R group. In contrast, the LAI group had higher Scale for Assessment of Negative Symptoms Alogia scale scores. There were no other between-group differences in symptoms or functional improvement. Despite the advantage for psychotic symptoms, LAI-R did not confer an advantage over oral SGAs for relapse or rehospitalization. Biweekly monitoring, not focusing specifically on patients with demonstrated nonadherence to treatment and greater flexibility in changing medication in the oral treatment arm, may contribute to the inability to detect differences between LAI and oral SGA treatment in clinical trials. PMID:24870446

  12. Onset of efficacy with acute long-acting injectable paliperidone palmitate treatment in markedly to severely ill patients with schizophrenia: post hoc analysis of a randomized, double-blind clinical trial

    Directory of Open Access Journals (Sweden)

    Ma Yi-Wen

    2011-04-01

    Full Text Available Abstract Background This post hoc analysis (trial registration: ClinicalTrials.gov NCT00590577 assessed onset of efficacy and tolerability of acute treatment with once-monthly paliperidone palmitate (PP, a long-acting atypical antipsychotic initiated by day 1 and day 8 injections, in a markedly to severely ill schizophrenia population. Methods Subjects entering the 13-week, double-blind trial were randomized to PP (39, 156, or 234 mg [25, 100, and 150 mg eq of paliperidone, respectively] or placebo. This subgroup analysis included those with a baseline Clinical Global Impressions-Severity (CGI-S score indicating marked to severe illness. PP subjects received a 234-mg day 1 injection (deltoid, followed by their assigned dose on day 8 and monthly thereafter (deltoid or gluteal. Thus, data for PP groups were pooled for days 4 and 8. Measures included Positive and Negative Syndrome Scale (PANSS, CGI-S, Personal and Social Performance (PSP, and adverse events (AEs. Analysis of covariance (ANCOVA and last-observation-carried-forward (LOCF methodologies, without multiplicity adjustments, were used to assess changes in continuous measures. Onset of efficacy was defined as the first time point a treatment group showed significant PANSS improvement (assessed days 4, 8, 22, 36, 64, and 92 versus placebo, which was maintained through end point. Results A total of 312 subjects met inclusion criterion for this subgroup analysis. After the day 1 injection, mean PANSS total scores improved significantly with PP (all received 234 mg versus placebo at day 4 (P = 0.012 and day 8 (P = 0.007. After the day 8 injection, a significant PANSS improvement persisted at all subsequent time points in the 234-mg group versus placebo (P P P P Conclusions In this markedly to severely ill population, acute treatment with 234 mg PP improved psychotic symptoms compared with placebo by day 4. After subsequent injections, observed improvements are suggestive of a dose-dependent effect. No unexpected tolerability findings were noted.

  13. Low-Dose Risperidone-Induced Oculogyric Crises in an Adolescent Male with Autism, Tourette’s and Developmental Delay

    OpenAIRE

    Masliyah, Tamara; Ad-Dab’bagh, Yasser

    2011-01-01

    This article will review the case of a young patient with mental retardationa, autistic disorder, and Tourette Syndrome who exhibited a favourable treatment response preferentially to risperidone. His presentation, however, was complicated by an exquisite sensitivity to risperidone displayed in the form of recurrent oculogyric crises. In this article, we will outline a review of the case, a survey of the incidence and risk factors of oculogyric crises, as well as a review of the literature on...

  14. Evaluating the Effect of 8-Week Treatment With Risperidone On Fasting Blood Glucose of Patients with Schizophrenia

    OpenAIRE

    Firouzeh Raisi; Hadi Okhovatpoor; Simin Dashti-Khavidaki; Hossein Khalili; Padideh Ghaeli

    2007-01-01

     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...

  15. Evaluating the Effect of 8-Week Treatment With Risperidone On Fasting Blood Glucose of Patients with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Firouzeh Raisi

    2007-08-01

    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.

  16. Long-term safety and efficacy of olanzapine long-acting injection in patients with schizophrenia or schizoaffective disorder: a 6-year, multinational, single-arm, open-label study

    OpenAIRE

    McDonnell, David P.; Landry, John; Detke, Holland C.

    2014-01-01

    The objective of this study was to assess the long-term safety and efficacy of olanzapine long-acting injection (LAI). A 6-year, single-arm, open-label extension study of olanzapine LAI was conducted at 127 sites in 25 countries. Patients were 18–76 years of age, were diagnosed with schizophrenia or schizoaffective disorder (N=931), and had been previously enrolled in one of three clinical trials of olanzapine LAI. Patients received flexibly dosed (45-405 mg) olanzapine LAI every 2–4 week...

  17. Long-term safety and efficacy of olanzapine long-acting injection in patients with schizophrenia or schizoaffective disorder: a 6-year, multinational, single-arm, open-label study.

    Science.gov (United States)

    McDonnell, David P; Landry, John; Detke, Holland C

    2014-11-01

    The objective of this study was to assess the long-term safety and efficacy of olanzapine long-acting injection (LAI). A 6-year, single-arm, open-label extension study of olanzapine LAI was conducted at 127 sites in 25 countries. Patients were 18-76 years of age, were diagnosed with schizophrenia or schizoaffective disorder (N=931), and had been previously enrolled in one of three clinical trials of olanzapine LAI. Patients received flexibly dosed (45-405 mg) olanzapine LAI every 2-4 weeks. The mean duration of exposure was ?3 years. A total of 393 (42.2%) patients completed the study. The mean weight change was +2.1 kg (Polanzapine after long-term treatment. There were 36 occurrences of post-injection delirium/sedation syndrome, all resolving within 72 h. The mean Positive and Negative Syndrome Scale total and subscale scores did not change significantly over the course of the study, indicating clinical stability. Olanzapine LAI appeared effective as a long-term maintenance treatment, with a safety profile generally consistent with the known profile of oral olanzapine, except for injection-related events (including post-injection delirium/sedation syndrome). PMID:24850228

  18. Comparison between risperidone, an atypical antipsychotic agent and haloperidol, a conventional agent used to treat schizophrenia

    International Nuclear Information System (INIS)

    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)

  19. DEVELOPMENT AND VALIDATION OF SPECTROPHOTOMETRIC METHOD FOR DETERMINATION OF RISPERIDONE BY MBTH

    Directory of Open Access Journals (Sweden)

    S. Archana*, Y. Naga Prasanna, P. Pavitra, D. Santhi Krupa, M. Hema Sri

    2013-03-01

    Full Text Available ABSTRACT: A simple and sensitive visible spectrophotometric method is described for the assay of risperidone (RSP in pure and solid dosage forms. The method involves oxidative coupling of risperidone with MBTH in presence of ferric chloride dissolved in HCl and apple green chromogen is formed and exhibits absorption maxima at 595.8nm. Regression analysis of Beer-Lambert plots showed good correlation in the concentration ranges (10-80 ?g/mL. Regression coefficient was found to be 0.992. The proposed method is applied to commercial available tablets and the results are statistically evaluated and validated by recovery studies. The proposed methods have been successfully applied to the analysis of the bulk drug and its tablet dosage form. The methods have been statistically evaluated and were found to be precise and accurate.

  20. Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

    OpenAIRE

    Psarros Constantin; Kostoulas Constantin; Masdrakis Vasilis; Dikeos Dimitris G; Papageorgiou Charalabos C; Papadimitriou George N; Theleritis Christos G; Soldatos Constantin R

    2006-01-01

    Abstract Background The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. Case presentation A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to...

  1. Development of novel risperidone implants using blends of polycaprolactones and in vitro in vivo correlation studies.

    Science.gov (United States)

    Navitha, Aerrolla; Jogala, Satheesh; Krishnamohan, Chinnala; Aukunuru, Jithan

    2014-04-01

    The objective of this study was to develop a novel implant containing risperidone intended for long-term treatment in Schizophrenia utilizing in vitro in vivo correlation (IVIVC) studies. Different implants (F1-F8) containing an antipsychotic drug, risperidone, were prepared using a hot melt extrusion technique by taking polycaprolactones of different molecular weights (Mwt. 15000, 45000, 80000) either alone or as their blends, and PLGA (75:25). The implants contained 40% of the drug. After fabrication, the implants were characterized for various in vitro properties such as drug release and physical strength. Prior to conducting drug release studies, optimum drug release method was developed based on IVIVC studies. An optimized formulation based on drug release and physical strength at the end of fabrication was selected from the various implants fabricated. The bioactivity, reversibility, and IVIVC of optimized formulation were determined using pharmacokinetic studies in rats. Short-term stability studies were conducted with optimized formulation. Drug release depended on polymer molecular weight. Implant fabricated using 50:50 polycaprolactone 45,000 and polycaprolactone 80,000 was considered optimized implant. Optimized formulation selected released the drug for 3-months in vitro and was physically rigid. The optimized implant was able to release the drug in vivo for a period of 3 months, the implants are reversible throughout the delivery interval and, a 100% IVIVC was achieved with optimized implant, suggesting the development of 3-month drug-releasing implant for risperidone. The optimized implant was stable for 6 months at room temperature (25°C) and 45°C. A novel implant for risperidone was successfully prepared and evaluated. PMID:24959417

  2. Review of risperidone for the treatment of pediatric and adolescent bipolar disorder and schizophrenia

    OpenAIRE

    Bishop, Jeffrey R.; Pavuluri, Mani N

    2008-01-01

    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 ...

  3. Molecular Docking studies of D2 Dopamine receptor with Risperidone derivatives

    OpenAIRE

    Bhargava, Kiran; Nath, Rajendra; Seth, Prahlad Kumar; Pant, Kamlesh Kumar; Dixit, Rakesh Kumar

    2014-01-01

    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...

  4. Effervescent tablet formulation for enhanced patient compliance and the therapeutic effect of risperidone.

    Science.gov (United States)

    Mohammed, Kareem Abu Bakr; Ibrahim, Howida Kamal; Ghorab, Mahmoud Mohammed

    2014-05-15

    Abstract 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

  5. FORMULATION DEVELOPMENT AND EVALUATION OF EXTENDED RELEASE MINI TABLETS OF RISPERIDONE

    Directory of Open Access Journals (Sweden)

    B.Vishnu Vardhan Reddy

    2012-02-01

    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 Carr’s index, Hausner’s 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.

  6. The Effect of Risperidone on Cognitive Symptoms of Schizophrenia : A Comparison with Haloperidol

    Directory of Open Access Journals (Sweden)

    R. Daneshmand, M.D.

    2007-09-01

    Full Text Available Background and purpose: Several studies have demonstrated, that atypical antipsychotics attenuate cognitive symptoms of schizophrenia more than first generation of antipsychotics. Because there was no comprehensive and reliable study on evaluating these effects in Iranian population, the research group decided to compare the effects of haloperidol and risperidone, both Iranian drug laboratories' products, on the cognitive symptoms of patients with schizophrenia.Materials and Methods: 66 patients with the diagnosis of schizophrenia, according to DSM-IVTR criteria, who were hospitalized in Razi's Psychiatric Center, Tehran, were included in the study. After 2 weeks of wash-out period, patients were randomized in two groups, treated with haloperidol and risperidone, and in 8 week period basic and weekly MMSE were performed for all.Results: Both drugs improved cognitive symptoms of patients, and the course of improvement started in the 2nd week of treatment with no significant statistical difference.Conclusion: The study didn't confirm the preferentiality of risperidone vs. haloperidol on the cognitive symptoms of schizophrenia, which was demonstrated in western articles. Therefore, choosing each drug for treating patients must fulfill on other goals, such as the profile of their side effects.

  7. Rapid High Performance Liquid Chromatographic Determination of Risperidone in Human Plasma

    Directory of Open Access Journals (Sweden)

    Seyyed Mohsen Foroutan

    2006-01-01

    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.

  8. Efficacy of olanzapine long-acting injection in patients with acutely exacerbated schizophrenia: an insight from effect size comparison with historical oral data

    OpenAIRE

    Detke Holland C; Zhao Fangyi; Witte Michael M

    2012-01-01

    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...

  9. Long-acting injectable formulations of antipsychotic drugs for the treatment of schizophrenia.

    Science.gov (United States)

    Park, Eun Ji; Amatya, Sarmila; Kim, Myung Sun; Park, Jong Hoon; Seol, Eunyoung; Lee, Heeyong; Shin, Young-Hee; Na, Dong Hee

    2013-06-01

    Antipsychotic drugs have been used to treat patients with schizophrenia and other psychotic disorders. Long-acting injectable antipsychotic drugs are useful for improving medication compliance with a better therapeutic option to treat patients who lack insight or adhere poorly to oral medication. Several long-acting injectable antipsychotic drugs are clinically available. Haloperidol decanoate and fluphenazine decanoate are first-generation depot drugs, but the use of these medicines has declined since the advent of second-generation depot agents, such as long-acting risperidone, paliperidone palmitate, and olanzapine pamoate. The second-generation depot drugs are better tolerated and have fewer adverse neurological side effects. Long-acting injectable risperidone, the first depot formulation of an atypical antipsychotic drug, was prepared by encapsulating risperidone into biodegradable microspheres. Paliperidone palmitate is an aqueous suspension of nanocrystal molecules, and olanzapine pamoate is a microcrystalline salt of olanzapine and pamoic acid suspended in aqueous solution. This review summarizes the characteristics and recent research of formulations of each long-acting injectable antipsychotic drug. PMID:23543652

  10. Onset of efficacy with acute long-acting injectable paliperidone palmitate treatment in markedly to severely ill patients with schizophrenia: post hoc analysis of a randomized, double-blind clinical trial

    Science.gov (United States)

    2011-01-01

    Background This post hoc analysis (trial registration: ClinicalTrials.gov NCT00590577) assessed onset of efficacy and tolerability of acute treatment with once-monthly paliperidone palmitate (PP), a long-acting atypical antipsychotic initiated by day 1 and day 8 injections, in a markedly to severely ill schizophrenia population. Methods Subjects entering the 13-week, double-blind trial were randomized to PP (39, 156, or 234 mg [25, 100, and 150 mg eq of paliperidone, respectively]) or placebo. This subgroup analysis included those with a baseline Clinical Global Impressions-Severity (CGI-S) score indicating marked to severe illness. PP subjects received a 234-mg day 1 injection (deltoid), followed by their assigned dose on day 8 and monthly thereafter (deltoid or gluteal). Thus, data for PP groups were pooled for days 4 and 8. Measures included Positive and Negative Syndrome Scale (PANSS), CGI-S, Personal and Social Performance (PSP), and adverse events (AEs). Analysis of covariance (ANCOVA) and last-observation-carried-forward (LOCF) methodologies, without multiplicity adjustments, were used to assess changes in continuous measures. Onset of efficacy was defined as the first time point a treatment group showed significant PANSS improvement (assessed days 4, 8, 22, 36, 64, and 92) versus placebo, which was maintained through end point. Results A total of 312 subjects met inclusion criterion for this subgroup analysis. After the day 1 injection, mean PANSS total scores improved significantly with PP (all received 234 mg) versus placebo at day 4 (P = 0.012) and day 8 (P = 0.007). After the day 8 injection, a significant PANSS improvement persisted at all subsequent time points in the 234-mg group versus placebo (P < 0.05). PANSS improvements were greater from day 36 through end point in the 156-mg group (P < 0.05) and only at end point in the 39-mg group (P < 0.05). CGI-S and PSP scores improved significantly in the 234-mg and 156-mg PP groups versus placebo at end point (P < 0.05 for both, respectively); improvement in the 39-mg group was not significant. The most common AEs for PP-treated subjects (?10%, any treatment group) were headache, insomnia, schizophrenia exacerbation, injection site pain, and agitation. Conclusions In this markedly to severely ill population, acute treatment with 234 mg PP improved psychotic symptoms compared with placebo by day 4. After subsequent injections, observed improvements are suggestive of a dose-dependent effect. No unexpected tolerability findings were noted. PMID:21481243

  11. Dopamine transporter density assessed with [123]IPT SPECT before and after risperidone treatment in children with tourette's disorder

    International Nuclear Information System (INIS)

    Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled N-(3-iodopropen-2-yl)-2?-carbomethoxy-3beta-(4-chlorophenyl)tropane ([123I]IPT) single photon emission computed tomography (SPECT). [123I]IPT SPECT imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of [123I]IPT. Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. Thgnificantly improved with risperidone. These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system

  12. 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

    Directory of Open Access Journals (Sweden)

    Bunce Catey

    2008-10-01

    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

  13. Lack of a pharmacokinetic interaction between mirtazapine and the newer antipsychotics clozapine, risperidone and olanzapine in patients with chronic schizophrenia.

    Science.gov (United States)

    Zoccali, Rocco; Muscatello, Maria Rosaria; Torre, Diletta La; Malara, Giovanni; Canale, Andrea; Crucitti, Domenico; D'Arrigo, Concetta; Spina, Edoardo

    2003-10-01

    The effect of mirtazapine on steady-state plasma concentrations of the newer atypical antipsychotics clozapine, risperidone and olanzapine was investigated in 24 patients with chronic schizophrenia. In order to treat residual negative symptoms, additional mirtazapine (30 mg per day) was administered for six consecutive weeks to nine patients stabilized on clozapine therapy (200-650 mg per day), eight on risperidone (3-8 mg per day) and seven on olanzapine (10-20mg per day). There were only minimal and statistically insignificant changes in mean plasma concentrations of clozapine and its metabolite norclozapine, risperidone and its metabolite 9-hydroxyrisperidone, and olanzapine during the study period. Mirtazapine co-administration with either clozapine, risperidone or olanzapine was well tolerated. In the overall sample, a slight improvement in negative symptomatology, as assessed by the Scale for Assessment of Negative Symptoms, was observed at final evaluation (Pmirtazapine in chronic schizophrenia, our findings indicate that mirtazapine has a negligible effect on the metabolism of clozapine, risperidone and olanzapine and can be added safely to an existing treatment with these antipsychotics. PMID:12902213

  14. Efficacy of a Multi-level Intervention to Reduce Injecting and Sexual Risk Behaviors among HIV-Infected People Who Inject Drugs in Vietnam: A Four-Arm Randomized Controlled Trial

    Science.gov (United States)

    Go, Vivian F.; Frangakis, Constantine; Minh, Nguyen Le; Latkin, Carl; Ha, Tran Viet; Mo, Tran Thi; Sripaipan, Teerada; Davis, Wendy W.; Zelaya, Carla; Vu, Pham The; Celentano, David D.; Quan, Vu Minh

    2015-01-01

    Introduction Injecting drug use is a primary driver of HIV epidemics in many countries. People who inject drugs (PWID) and are HIV infected are often doubly stigmatized and many encounter difficulties reducing risk behaviors. Prevention interventions for HIV-infected PWID that provide enhanced support at the individual, family, and community level to facilitate risk-reduction are needed. Methods 455 HIV-infected PWID and 355 of their HIV negative injecting network members living in 32 sub-districts in Thai Nguyen Province were enrolled. We conducted a two-stage randomization: First, sub-districts were randomized to either a community video screening and house-to-house visits or standard of care educational pamphlets. Second, within each sub-district, participants were randomized to receive either enhanced individual level post-test counseling and group support sessions or standard of care HIV testing and counseling. This resulted in four arms: 1) standard of care; 2) community level intervention; 3) individual level intervention; and 4) community plus individual intervention. Follow-up was conducted at 6, 12, 18, and 24 months. Primary outcomes were self-reported HIV injecting and sexual risk behaviors. Secondary outcomes included HIV incidence among HIV negative network members. Results Fewer participants reported sharing injecting equipment and unprotected sex from baseline to 24 months in all arms (77% to 4% and 24% to 5% respectively). There were no significant differences at the 24-month visit among the 4 arms (Wald = 3.40 (3 df); p = 0.33; Wald = 6.73 (3 df); p = 0.08). There were a total of 4 HIV seroconversions over 24 months with no significant difference between intervention and control arms. Discussion Understanding the mechanisms through which all arms, particularly the control arm, demonstrated both low risk behaviors and low HIV incidence has important implications for policy and prevention programming. Trial Registration ClinicalTrials.gov NCT01689545 PMID:26011427

  15. The effect of coadministration of duloxetine on steady-state serum concentration of risperidone and aripiprazole: a study based on therapeutic drug monitoring data.

    Science.gov (United States)

    Hendset, Magnhild; Molden, Espen; Enoksen, Torill Bakko; Refsum, Helge; Hermann, Monica

    2010-12-01

    Previous studies have categorized duloxetine as a moderate inhibitor of CYP2D6. The aim of the present study was to investigate the potential interactions between duloxetine and the two CYP2D6 substrates risperidone and aripiprazole in psychiatric patients. Serum concentration data from patients treated with risperidone (n = 8) or aripiprazole (n = 7) in combination with duloxetine were retrieved from therapeutic drug monitoring files at the Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway. The degree of interaction was assessed by comparing the data with a control group of CYP2D6-genotyped patients (homozygous "extensive metabolizers") using oral risperidone or aripiprazole without duloxetine. Coadministration of duloxetine did not significantly increase the concentration of the parent drug or the parent drug/metabolite ratio of either risperidone or aripiprazole. The present study therefore indicates that duloxetine may safely be used concomitantly with risperidone or aripiprazole. PMID:21068650

  16. A 6-year open-label study of the efficacy and safety of olanzapine long-acting injection in patients with schizophrenia: a post hoc analysis based on the European label recommendation

    Directory of Open Access Journals (Sweden)

    An

    2015-05-01

    Full Text Available Ernie Anand,1 Lovisa Berggren,2 Claudia Deix,3 Ágoston Tóth,4 David P McDonnell5 1Neuroscience Medical Affairs – EU, Eli Lilly, Windlesham, United Kingdom; 2Global Statistical Sciences, Lilly Deutschland GmbH, Bad Homburg, Germany; 3Neuroscience, Eli Lilly Regional Operations GmbH, Vienna, Austria; 4Lilly Hungary, Budapest, Hungary; 5Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA Purpose: To assess the long-term efficacy and safety of olanzapine long-acting injection (LAI in the treatment of schizophrenia, focusing on clinical trial data consistent with the approved indication and dosing recommendations in the European label and which forms the basis for treatment decisions made by clinicians in daily clinical practice.Patients and methods: This was a post hoc analysis of a 6-year open-label study of olanzapine LAI in patients (male or female, 18–75 years old with schizophrenia entering this study following feeder studies of olanzapine LAI. Patients were flexibly dosed (45–405 mg, 2- to 4-week intervals, but those receiving oral olanzapine supplementation whose total olanzapine dose was >20 mg/day equivalent were excluded from this post hoc analysis.Results: Data from 669 patients were analyzed (44.5% completed. Positive and Negative Syndrome Scale total scores did not change significantly from baseline to endpoint; Clinical Global Impression-Severity scores improved significantly. Mean weight change was +2.19 kg (P<0.001, with 40.8% of patients experiencing ?7% weight gain. There were 24 occurrences of post-injection delirium/sedation syndrome (PDSS.Conclusion: Olanzapine LAI appeared to be effective in the long-term maintenance of schizophrenia, and the safety profile was consistent with that of oral olanzapine, except for injection-related events and PDSS events. Keywords: antipsychotic, depot, long-acting injection, olanzapine, pamoate, schizophrenia

  17. 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

    Scientific Electronic Library Online (English)

    Nadia Ajub, Moysés; Nilson Lopes da, Fonseca Júnior; José Ricardo Carvalho Lima, Rehder.

    2011-04-01

    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.

  18. Risperidone in the management of violent, treatment-resistant schizophrenics hospitalized in a maximum security forensic facility.

    Science.gov (United States)

    Beck, N C; Greenfield, S R; Gotham, H; Menditto, A A; Stuve, P; Hemme, C A

    1997-01-01

    This study examines the effectiveness of risperidone compared with traditional neuroleptic medications in the areas of clinical functioning and aggressive behaviors in a sample of inpatients diagnosed with chronic schizophrenia. Similar to the methodology of Menditto et al. (Psychiatr Serv 47:46-51, 1996), two groups of 10 patients were selected from those being treated in a comprehensive psychosocial rehabilitation program. Group 1 subjects were placed on risperidone at various times during their treatment. Group 2 subjects, who were matched with Group 1 subjects on pre-study levels of clinical functioning as measured by the Time-Sample Behavioral Checklist (TSBC), remained on traditional neuroleptics throughout the study period. For each subject, scores on six TSBC subscales were examined at four time points; data were analyzed with repeated-measures multivariate analyses of variance and univariate analyses of variance. Frequency counts of aggressive behaviors (threats and assaults) were compiled into two six-month time periods and analyzed with nonparametric techniques. The risperidone group did not differ from the traditional neuroleptic group on measures of clinical functioning and aggressiveness measured over time. Both groups evidenced improvements in bizarre motor behaviors over the study period. The risperidone group evidenced some deterioration in measures of appropriate interpersonal interaction over time. No differences in aggressive behaviors were noted for either group. The study concludes that for forensic patients with chronic schizophrenia, risperidone failed to produce therapeutic effects in overall clinical functioning and aggressive behaviors that were significantly different from traditional neuroleptics. Descriptive comparisons are made between the receptor-binding profiles and clinical effectiveness of risperidone and clozapine in an attempt to explain these findings. PMID:9460034

  19. Risperidone regulates Dopamine D2-like receptors expression in rat brain in a time-dependent manner

    Scientific Electronic Library Online (English)

    Ni, Peiyan; Liang, Linhui; Wang, Yingcheng; Wei, Jinxue; Gu, Xiaochu; Zhao, liansheng; Ma, Xiaohong; Li, Tao.

    2015-03-01

    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.

  20. Comparison of efficacy of intralesional injection of meglumine anti-moniate once-weekly with twice-weekly in the treatment of anthroponotic cutaneous leishmaniasis in Mashhad: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Alireza Firooz

    2011-03-01

    Full Text Available Background and Aim: Cutaneous leishmaniasis (CL is endemic in Iran, where it is one of the most important health problems. Both anthroponotic CL (ACL caused by L. tropica and zoonotic CL (ZCL caused by L. major are reported. Antimoniate derivatives as the standard therapy for CL need multiple injections and are not easy to tolerate for the patients. This study was conducted in Mashhad to compare the efficacy of weekly versus twice a week intralesional injections of meglumine antimoniate (MA in the treatment of ACL."n"nMethods: This randomised controlled trial was performed during 2006 to 2008 in Mashhad, Iran. Using computerized sequence of random numbers, participants were randomly allocated in the two arms of the study: one receiving weekly and the other receiving twice-a-week intralesional injections of MA. The lesion size, induration and healing rate were assessed, recorded and compared. Healing was defined as complete re-epithelialisation and disappearance of induration."n"nResults: A total of 252 suspected CL patients with 372 lesions were screened. 82 parasitologically proven cases with 121 lesions caused by L. tropica were included and 74 patients with 113 lesions completed the study. At 12th week after initiation of treatment, complete healing was observed in 38 out of 44 lesions (86.4% in the group which received weekly intralesional MA injection. The median time-to-heal in this group was 36 days (95% confidence interval [CI]: 32.0-39.9. Complete healing was recorded in 60 out of 69 lesions (86.9% in the group which received twice a week intralesional injections of MA with a median time-to-heal of 25 days (95% CI: 20.9-29.1. While no significant difference was observed between the two groups in terms of complete healing rate (P=0.999, time-to-heal was significantly different between the 2 groups (P=0.003."n"nConclusion: It seems that the effectiveness of twice-weekly intralesional injections of MA is similar to once-weekly regimen while the former regimen causes more rapid healing of lesions.

  1. Determination of the role of injection site on the efficacy of intra-CSF enzyme replacement therapy in MPS IIIA mice.

    Science.gov (United States)

    Beard, Helen; Luck, Amanda J; Hassiotis, Sofia; King, Barbara; Trim, Paul J; Snel, Marten F; Hopwood, John J; Hemsley, Kim M

    2015-05-01

    MPS IIIA is an inherited neurodegenerative lysosomal storage disorder characterized by cognitive impairment, sleep-wake cycle disturbance, speech difficulties, eventual mental regression and early death. Neuropathological changes include accumulation of heparan sulfate and glycolipids, neuroinflammation and degeneration. Pre-clinical animal studies indicate that replacement of the deficient enzyme, sulfamidase, via intra-cerebrospinal fluid (CSF) injection is a clinically-relevant treatment approach, reducing neuropathological changes and improving symptoms. Given that there are several routes of administration of enzyme into the CSF (intrathecal lumbar, cisternal and ventricular), determining the effectiveness of each injection strategy is crucial in order to provide the best outcome for patients. We delivered recombinant human sulfamidase (rhSGSH) to a congenic mouse model of MPS IIIA via each of the three routes. Mice were euthanized 24h or one-week post-injection; the distribution of enzyme within the brain and spinal cord parenchyma was investigated, and the impact on primary substrate levels and other pathological lesions determined. Both ventricular and cisternal injection of rhSGSH enable enzyme delivery to brain and spinal cord regions, with the former mediating large, statistically significant decreases in substrate levels and reducing microglial activation. The single lumbar CSF infusion permitted more restricted enzyme delivery, with no reduction in substrate levels and little change in other disease-related lesions in brain tissue. While the ventricular route is the most invasive of the three methods, this strategy may enable the widest distribution of enzyme within the brain, and thus requires further exploration. PMID:25795516

  2. Low perceived benefits and self-efficacy are associated with hepatitis C virus (HCV) infection-related risk among injection drug users

    OpenAIRE

    Cox, Joseph; De, Prithwish; MORISSETTE, CAROLE; Tremblay, Claude; Stephenson, Randolph; Allard, Robert; GRAVES, LISA; ROY, ÉLISE

    2007-01-01

    Hepatitis C prevention counselling and education are intended to increase knowledge of disease, clarify perceptions about vulnerability to infection, and increase personal capacity for undertaking safer behaviours. This study examined the association of drug equipment sharing with psychosocial constructs of the AIDS Risk Reduction Model, specifically, knowledge and perceptions related to hepatitis C virus (HCV) among injection drug users (IDUs). Active IDUs were recruited between April 2004 a...

  3. Autistic traits and factors related to a clinical decision to use risperidone in children with attention deficit hyperactivity disorder.

    Directory of Open Access Journals (Sweden)

    aysegul selcen guler

    2014-01-01

    Conclusion: In this clinical sample, parent-rated social problems and thought problems were associated with the clinician's decision to use risperidone in the treatment of ADHD cases (alone or in combination with stimulants. ADHD children with AT had more severe symptoms of ADHD and displayed more learning disability. However, AT profile as a category was not significantly associated with the use of risperidone. The better characterization of non-ADHD symptoms of ADHD children (social and emotional symptoms may help to develop more individualized clinical interventions, such as nonpharmacological interventions for social development, which may result in a reduction in the use of medications targeting these symptoms in this group of children.

  4. Trabecular bone loss after administration of the second-generation antipsychotic risperidone is independent of weight gain

    OpenAIRE

    Motyl, Katherine J.; Dick-de-paula, Ingrid; Maloney, Ann E.; Lotinun, Sutada; Bornstein, Sheila; Paula, Francisco J. A.; Baron, Roland; Houseknecht, Karen L.; Rosen, Clifford J.

    2011-01-01

    Second generation antipsychotics (SGAs) have been linked to metabolic and bone disorders in clinical studies, but the mechanisms of these side effects remain unclear. Additionally, no studies have examined whether SGAs cause bone loss in mice. Using in vivo and in vitro modeling we examined the effects of risperidone, the most commonly prescribed SGA, on bone in C57BL6/J (B6) mice. Mice were treated with risperidone orally by food supplementation at a dose of 1.25 mg/kg daily for 5 and 8 week...

  5. Gabapentin adjunctive to risperidone or olanzapine in partially responsive schizophrenia: an open-label pilot study

    Directory of Open Access Journals (Sweden)

    Adel Gabriel

    2010-10-01

    Full Text Available Adel GabrielDepartments of Psychiatry and Community Health Sciences, University of Calgary, Alberta, CanadaBackground: There is a great need in the treatment of schizophrenia for a drug, or drug ­combinations, to improve clinical response with fewer serious side effects. The objective of this study was to explore the therapeutic effects and tolerability of the anticonvulsant gabapentin as an adjunctive in the treatment of patients with partially responsive schizophrenia.Methods: Ten consenting patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision diagnosis of schizophrenia were identified. All patients failed at least one 12-week treatment trial with risperidone or olanzapine. Gabapentin was added to ongoing antipsychotic treatment with olanzapine or risperidone for eight weeks. The primary outcome measure was the Positive and Negative Syndrome Scale (PANSS. Other scales included the Calgary Depression Scale (CDSS and the Abnormal Involuntary Movement Scale (AIMS. Repeated-measures multivariate analysis of variance was utilized to examine changes in outcome measures over time with adjunctive treatment with gabapentin.Results: There was a significant drop in the PANSS and CDSS scores at endpoint (week 8. There were no significant differences between the two treatment groups with regard to changes in all outcome measures or in AIMS score. The adjunctive treatments were well tolerated and side effects were transient.Conclusion: Gabapentin could be used successfully as an adjunct to novel antipsychotics in partially responsive schizophrenia. However, large controlled studies are needed to examine the effectiveness of gabapentin in psychotic disorders.Keywords: schizophrenia, refractory, adjunctive treatment, gabapentin, risperidone, olanzapine

  6. Beneficial effect of risperidone on sleep disturbance and psychosis following traumatic brain injury.

    Science.gov (United States)

    Schreiber, S; Klag, E; Gross, Y; Segman, R H; Pick, C G

    1998-11-01

    Severe disturbances of sleep architecture and circadian rhythms are common in traumatic brain injured patients; however, complete absence of the rapid eye movement sleep stage is very rare. We describe a brain injured patient with cognitive disturbances who developed severe alterations of sleep architecture, accompanied by paranoid and jealousy delusions. Following several trials with conventional antipsychotics his psychotic state stabilized but he continued to complain of insomnia and daytime fatigue. When treated with risperidone 2 mg/day, both his sleep and the delusional thoughts improved markedly and his daytime alertness increased. Severe deterioration of his support system brought about discontinuation of treatment with re-emergence of all symptoms. PMID:9861578

  7. Bioequivalence study of a generic Risperidone (Iperdal® in healthy Thai male volunteers

    Directory of Open Access Journals (Sweden)

    Werawath Mahatthanatrakul

    2008-05-01

    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.

  8. PHARMACOKINETIC STUDY OF RISPERIDONE: APPLICATION OF A HPLC METHOD WITH SOLID PHASE EXTRACTION

    OpenAIRE

    Pablo Torres, V.; Jacqueline Sepu?lveda, M. C.; Carlos Von Plessing, R.

    2011-01-01

    A new, simplified solid phase extraction procedure for the determination of risperidone and 9-hydroxyrisperidone in human plasma has been developed. This method involves the use of an optimized extraction protocol developed in Waters OASIS® HLB 30mg 1cc extraction columns using 1 mL of human serum. Separation was performed by HPLC using a Waters XTerra RP-18 (5 µm, 150x4,6 mm) column with a mobile phase consisting in acetonitrile - potassium dihydrogen phosphate 50 mM pH 3.4 (27/73). UV det...

  9. Schizophrenia relapse and the clinical usefulness of once-monthly aripiprazole depot injection.

    Science.gov (United States)

    Wang, Sheng-Min; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A; Masand, Prakash S; Pae, Chi-Un

    2014-01-01

    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 (PALAI. 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

  10. A 6-year open-label study of the efficacy and safety of olanzapine long-acting injection in patients with schizophrenia: a post hoc analysis based on the European label recommendation

    Science.gov (United States)

    Anand, Ernie; Berggren, Lovisa; Deix, Claudia; Tóth, Ágoston; McDonnell, David P

    2015-01-01

    Purpose To assess the long-term efficacy and safety of olanzapine long-acting injection (LAI) in the treatment of schizophrenia, focusing on clinical trial data consistent with the approved indication and dosing recommendations in the European label and which forms the basis for treatment decisions made by clinicians in daily clinical practice. Patients and methods This was a post hoc analysis of a 6-year open-label study of olanzapine LAI in patients (male or female, 18–75 years old) with schizophrenia entering this study following feeder studies of olanzapine LAI. Patients were flexibly dosed (45–405 mg, 2- to 4-week intervals), but those receiving oral olanzapine supplementation whose total olanzapine dose was >20 mg/day equivalent were excluded from this post hoc analysis. Results Data from 669 patients were analyzed (44.5% completed). Positive and Negative Syndrome Scale total scores did not change significantly from baseline to endpoint; Clinical Global Impression-Severity scores improved significantly. Mean weight change was +2.19 kg (Pschizophrenia, and the safety profile was consistent with that of oral olanzapine, except for injection-related events and PDSS events.

  11. 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

    Directory of Open Access Journals (Sweden)

    Paula Barros Bandeira de Mello Monteiro

    2012-12-01

    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.

  12. PHARMACOKINETIC STUDY OF RISPERIDONE: APPLICATION OF A HPLC METHOD WITH SOLID PHASE EXTRACTION

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    PABLO TORRES V

    2011-01-01

    Full Text Available A new, simplified solid phase extraction procedure for the determination of risperidone and 9-hydroxyrisperidone in human plasma has been developed. This method involves the use of an optimized extraction protocol developed in Waters OASIS® HLB 30mg 1cc extraction columns using 1 mL of human serum. Separation was performed by HPLC using a Waters XTerra RP-18 (5 µm, 150x4,6 mm column with a mobile phase consisting in acetonitrile - potassium dihydrogen phosphate 50 mM pH 3.4 (27/73. UV detection at 278 nm was used to quantify analytes, encountering good linearity (r² > 0.999 in the 2-100 ng/mL concentration range. The mean recovery was 92.4 % and 92.8 % for risperidone and 9-hydroxyrisperidone respectively, with an intraday - interday precision below 7%, and accuracy below 115 %. The method has been successfully applied in pharmacokinetic studies that require a large sample number.

  13. An open-label trial of risperidone and fluoxetine in children with autistic disorder

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    Desousa Avinash

    2010-01-01

    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.

  14. PHARMACOKINETIC STUDY OF RISPERIDONE: APPLICATION OF A HPLC METHOD WITH SOLID PHASE EXTRACTION

    Scientific Electronic Library Online (English)

    PABLO, TORRES V; M. JACQUELINE, SEPÚLVEDA C; CARLOS, VON PLESSING R.

    Full Text Available A new, simplified solid phase extraction procedure for the determination of risperidone and 9-hydroxyrisperidone in human plasma has been developed. This method involves the use of an optimized extraction protocol developed in Waters OASIS® HLB 30mg 1cc extraction columns using 1 mL of human serum. [...] Separation was performed by HPLC using a Waters XTerra RP-18 (5 µm, 150x4,6 mm) column with a mobile phase consisting in acetonitrile - potassium dihydrogen phosphate 50 mM pH 3.4 (27/73). UV detection at 278 nm was used to quantify analytes, encountering good linearity (r² > 0.999) in the 2-100 ng/mL concentration range. The mean recovery was 92.4 % and 92.8 % for risperidone and 9-hydroxyrisperidone respectively, with an intraday - interday precision below 7%, and accuracy below 115 %. The method has been successfully applied in pharmacokinetic studies that require a large sample number.

  15. Selective acquired long QT syndrome (saLQTS upon risperidone treatment

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    Lazarczyk Maciej

    2012-12-01

    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.

  16. A Double-Blind Placebo Controlled Trial of "Ginkgo Biloba" Added to Risperidone in Patients with Autistic Disorders

    Science.gov (United States)

    Hasanzadeh, Elmira; Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Rezazadeh, Shams-Ali; Tabrizi, Mina; Rezaei, Farzin; Akhondzadeh, Shahin

    2012-01-01

    "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…

  17. Lack of effect of risperidone or olanzapine dose reduction on subjective experiences in stable patients with schizophrenia.

    Science.gov (United States)

    Takeuchi, Hiroyoshi; Suzuki, Takefumi; Remington, Gary; Watanabe, Koichiro; Mimura, Masaru; Uchida, Hiroyuki

    2014-08-15

    Sixty-one patients with schizophrenia stably treated with risperidone or olanzapine were randomly assigned to dose-reduction-by-half group or dose maintenance group. Subjective experiences were assessed at baseline and 28 weeks using three different self-rating scales. No significant differences in changes of subjective experiences were observed between the two groups. PMID:24768247

  18. Near infrared spectroscopic (NIRS) analysis of drug-loading rate and particle size of risperidone microspheres by improved chemometric model.

    Science.gov (United States)

    Song, Jia; Xie, Jing; Li, Chenliang; Lu, Jia-Hui; Meng, Qing-Fan; Yang, Zhaogang; Lee, Robert J; Wang, Di; Teng, Le-Sheng

    2014-09-10

    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

  19. A Comparative Study of the Effects of Clozapine and Risperidone Monotherapy on Lipid Profile in Nigerian Patients with Schizophrenia

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    O.I. Iribhogbe

    2012-01-01

    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.

  20. Review of the safety, efficacy, costs and patient acceptability of recombinant follicle-stimulating hormone for injection in assisting ovulation induction in infertile women

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    Marleen Nahuis

    2009-11-01

    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

  1. Effects of risperidone and olanzapine on remnant-like lipoprotein particle cholesterol (RLP-C in schizophrenic patients

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    Takahiko Nagamine

    2008-04-01

    Full Text Available Takahiko NagamineDivision of Psychiatric Internal Medicine, Seiwakai-Kitsunan Hospital, Suzenji, JapanAbstract: Second generation antipsychotics are associated with the risk of metabolic disorders such as diabetes mellitus and hyperlipidemia. Remnant-like lipoprotein particles cholesterol (RLP-C are a known risk factor for cardiovascular events. The present study was performed to determine possible differences in fasting blood RLP-C levels between schizophrenic patients treated with risperidone as compared to olanzapine. Patients on olanzapine had significantly higher RLP-C levels than those on risperidone (p < 0.01. In olanzapine-treated patients there was no abnormality in fasting blood glucose levels, but fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR were elevated. RLP-C levels were significantly correlated with plasma triglyceride concentrations in both the olanzapine- (p < 0.01 and risperidone-treated patients (p < 0.01. The regression line slope was greater for the olanzapine group, suggesting a greater influence of olanzapine on RLP-C. There was a significant correlation between RLP-C and HOMA-IR in the risperidone group (p < 0.01 but not in the olanzapine group (p = 0.80. These results suggest that blood glucose monitoring may not be sufficient to detect metabolic disorder and that measurement of RLP-C might be helpful for the screening for metabolic disorders associated with olanzapine therapy.Keywords: remnant-like lipoprotein particles cholesterol (RLP-C, schizophrenia, insulin resistance, risperidone, olanzapine

  2. No change of dopamine transporter density in basal ganglia after risperidone treatment in drug-naive children with Tourette's disorder

    International Nuclear Information System (INIS)

    Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the DAT densities between drug-naive children with TD and normal children investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using lodine-123 labelled N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane(I-123 IPT) single photon emission computed tomography (SPECT). I-123 IPT SPECT imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in eight drug-naive children with TD. Eight normal children also underwent SPECT imaging 2 hours after an intravenous administration of I-123 IPT and carried out both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of the specific/non-specific DAT binding ratio in the basal ganglia. The drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal gangliific DAT binding ratio of the basal ganglia before and after treatment with riperidone in children with TD was not found, although tic symptoms were significantly improved with risperidone. These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system

  3. 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

    Scientific Electronic Library Online (English)

    Paula Barros Bandeira de Mello, Monteiro; Nilson Lopes da, Fonseca Júnior; José Ricardo Carvalho Lima, Rehder.

    2012-12-01

    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

  4. Safety and efficacy of botox injection in alleviating post-operative pain and improving quality of life in lower extremity limb lengthening and deformity correction

    Directory of Open Access Journals (Sweden)

    Finley Allen

    2007-09-01

    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 5–21 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

  5. Eficacia y seguridad de la inyección intravítrea de bevacizumab en el tratamiento del glaucoma neovascular: revisión sistemática Efficacy and safety of intravitreal injection of bevacizumab in the treatment of neovascular glaucoma: systematic review

    Directory of Open Access Journals (Sweden)

    P.A. Martínez-Carpio

    2008-10-01

    Full Text Available Propósito: Revisión sistemática sobre la eficacia y seguridad de la inyección intravítrea de bevacizumab (IVB en el tratamiento del glaucoma neovascular (GNV. Se incluyen todos los trabajos originales publicados en Medline hasta agosto de 2008. Métodos: Búsqueda y selección de la información en Internet y Medline, validadas mediante el Índice Kappa (K. Estudio estadístico y clínico de los resultados en los trabajos seleccionados, uno a uno. Resultados: Se encuentran 26 artículos originales que analizan la eficacia y seguridad del procedimiento en casos únicos y en series cortas de casos. 24 de ellos se analizan conjuntamente, con un total de 127 ojos intervenidos. La eficacia calculada para casos difíciles es del 68,7%. Las recidivas en un seguimiento de 4,2 meses son del 18,6%. Todos los trabajos son posteriores a 2006 y ninguno cumple criterios de ensayo clínico aleatorizado. Las complicaciones de la IVB son inferiores al 0,78% y no se observan complicaciones sistémicas. Conclusiones: El bevacizumab demuestra que las inyecciones intravítreas pueden ser muy eficaces y seguras para la manipulación terapéutica de los factores de crecimiento en el segmento anterior. La IVB se perfila como un tratamiento de primera línea en casos de GNV dificiles. Se necesitan ensayos clínicos controlados que confirmen estos resultados y autorizen el uso.Purpose: Systematic review on efficacy and safety of intravitreal bevacizumab (IVB in the treatment of neovascular glaucoma (NVG. All original papers published in Medline (prior to August 2008 were included. Methods: Search and selection of information on the internet and in Medline, validated by Kappa Index (K. Statistical and clinical study of the results in the selected articles on a one by one basis. Results: 26 original papers analyzed the efficacy and safety of the procedure in case reports and short series of cases (127 eyes. The efficacy calculated in the sample was 68.7% and the recurrence rate was 18.6% in 4.2 months of follow-up. All studies were after 2006 and none of them was a clinical randomized controlled assay. Ophthalmic complications were under 0.78% and no systemic complications were found. Conclusions: The use of bevacizumab demonstrates that intravitreal injections may be effective and useful to manipulate growth factors in the anterior chamber. IVB could serve as a first line treatment for NVG. Clinical trials are needed to confirm these results before its use is authorized.

  6. Eficacia y seguridad de la inyección intravítrea de bevacizumab en el tratamiento del glaucoma neovascular: revisión sistemática / Efficacy and safety of intravitreal injection of bevacizumab in the treatment of neovascular glaucoma: systematic review

    Scientific Electronic Library Online (English)

    P.A., Martínez-Carpio; E., Bonafonte-Márquez; C.D., Heredia-García; S., Bonafonte-Royo.

    2008-10-01

    Full Text Available Propósito: Revisión sistemática sobre la eficacia y seguridad de la inyección intravítrea de bevacizumab (IVB) en el tratamiento del glaucoma neovascular (GNV). Se incluyen todos los trabajos originales publicados en Medline hasta agosto de 2008. Métodos: Búsqueda y selección de la información en In [...] ternet y Medline, validadas mediante el Índice Kappa (K). Estudio estadístico y clínico de los resultados en los trabajos seleccionados, uno a uno. Resultados: Se encuentran 26 artículos originales que analizan la eficacia y seguridad del procedimiento en casos únicos y en series cortas de casos. 24 de ellos se analizan conjuntamente, con un total de 127 ojos intervenidos. La eficacia calculada para casos difíciles es del 68,7%. Las recidivas en un seguimiento de 4,2 meses son del 18,6%. Todos los trabajos son posteriores a 2006 y ninguno cumple criterios de ensayo clínico aleatorizado. Las complicaciones de la IVB son inferiores al 0,78% y no se observan complicaciones sistémicas. Conclusiones: El bevacizumab demuestra que las inyecciones intravítreas pueden ser muy eficaces y seguras para la manipulación terapéutica de los factores de crecimiento en el segmento anterior. La IVB se perfila como un tratamiento de primera línea en casos de GNV dificiles. Se necesitan ensayos clínicos controlados que confirmen estos resultados y autorizen el uso. Abstract in english Purpose: Systematic review on efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of neovascular glaucoma (NVG). All original papers published in Medline (prior to August 2008) were included. Methods: Search and selection of information on the internet and in Medline, validated by [...] Kappa Index (K). Statistical and clinical study of the results in the selected articles on a one by one basis. Results: 26 original papers analyzed the efficacy and safety of the procedure in case reports and short series of cases (127 eyes). The efficacy calculated in the sample was 68.7% and the recurrence rate was 18.6% in 4.2 months of follow-up. All studies were after 2006 and none of them was a clinical randomized controlled assay. Ophthalmic complications were under 0.78% and no systemic complications were found. Conclusions: The use of bevacizumab demonstrates that intravitreal injections may be effective and useful to manipulate growth factors in the anterior chamber. IVB could serve as a first line treatment for NVG. Clinical trials are needed to confirm these results before its use is authorized.

  7. Ciprofloxacin Injection

    Science.gov (United States)

    Ciprofloxacin injection is used to treat certain infections caused by bacteria. Ciprofloxacin injection is also used to prevent or treat ... been exposed to anthrax germs in the air. Ciprofloxacin injection is in a class of antibiotics called ...

  8. Dystonia in an adolescent on risperidone following the discontinuation of methylphenidate: a case report.

    Science.gov (United States)

    Guler, Gulen; Yildirim, Veli; Kutuk, Meryem Ozlem; Toros, Fevziye

    2015-04-30

    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

  9. Differential effects of olanzapine and risperidone on cognition in schizophrenia? A saccadic eye movement study.

    Science.gov (United States)

    Broerse, A; Crawford, T J; den Boer, J A

    2002-01-01

    Recent studies suggest that novel antipsychotics have positive effects on certain cognitive functions in schizophrenia. The present study investigated this claim by means of saccadic paradigms, which provide a selective index of cognitive function. Thirty-three first-episode schizophrenic patients were randomly assigned to either olanzapine or risperidone treatment and compared with healthy control subjects for three saccadic paradigms. The influence of symptom profile, extrapyramidal symptoms, age, education, gender, hospitalization, and medication dose on cognitive performance was also investigated. Although the two patient groups did not differ from each other in task performance, both patient groups showed substantial problems in inhibitory control of saccades. A high level of education appeared to be protective for this impairment. PMID:12426415

  10. Drug Induced Parkinsonism Caused by the Concurrent Use of Donepezil and Risperidone in a Patient With Traumatic Brain Injuries

    OpenAIRE

    Kang, Si Hyun; Kim, Don-kyu

    2013-01-01

    A 69-year-old male patient with previous history of traumatic brain injury 5 months ago was admitted to the Department of Neuropsychiatry because of aggressive behavior and delusional features. After starting on 2 mg of risperidone per day, his delusion, anxiety, and aggressive behavior gradually improved. Two weeks later, he was given 10 mg of donepezil per day for his mild cognitive impairment. After 6 weeks of admission in the Department of Neuropsychiatry, he showed parkinsonian features ...

  11. Role of Long-Acting Injectable Second-Generation Antipsychotics in the Treatment of First-Episode Schizophrenia: A Clinical Perspective

    OpenAIRE

    Ikryl, Radovan P. Amp X.; Erov Amp Xe, Hana P. Amp X. Ikrylov Amp Xe Ku Amp X. D.; Michaela Vrzalová; Kov Amp Xe, Eva Amp X. C. E. Amp X.

    2012-01-01

    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...

  12. Eficacia y seguridad de la risperidona en el tratamiento agudo de las conductas disruptivas en pacientes pediátricos epilépticos / Risperidone in the treatment of acute disruptive behavior in pediatrics patients with epilepsy

    Scientific Electronic Library Online (English)

    Eduardo, Barragán-Pérez; Arturo, Garza-Peña; Oscar, Benavides-Guerrero; Juan, Hernández-Aguilar.

    2005-12-01

    Full Text Available Introducción. Las conductas disruptivas son frecuentes en más de la mitad de los pacientes pediátricos con epilepsia, impactan sobre su funcionamiento psicosocial global y provocan el rechazo de la sociedad. El presente estudio plantea la posibilidad de coadyuvar en el tratamiento integral de los ni [...] ños con epilepsia mediante el empleo de risperidona. Material y métodos. Se seleccionaron pacientes pediátricos epilépticos (con epilepsia parcial o generalizada) que presentaban conductas disruptivas asociadas, hombres y mujeres con edades comprendidas entre los 5 y 14 años, captados en la consulta externa de Neurología del Hospital Infantil de México Federico Gómez. Se realizó un estudio clínico abierto, prospectivo, con seguimiento durante 4 semanas. Se les administró risperidona, cuya eficacia se evaluó mediante las escalas de mejoría clínica global, la de Peers y la de ADHD-RS. Se midieron el número de crisis y los efectos secundarios con la escala de Yale. Resultados. Se estudiaron 23 pacientes, 7 femeninos y 16 masculinos con una relación M:F de 1.5:1 ,todos con diagnóstico de epilepsia (parcial 19 y generalizada 4). La dosis promedio de risperidona fue de 0.75 mg/día, se hizo un seguimiento de 4 semanas, con respuesta favorable al final del mes en 91% de los pacientes. Los efectos indeseables observados fueron: incremento ponderal en 12 niños, además de síntomas extrapiramidales (discinesias de cabeza y cuello), sialorrea, sed y somnolencia. Conclusión. En el manejo agudo de conductas disruptivas en pacientes pediátricos con epilepsia, la risperidona mostró ser efectiva y segura. Abstract in english Introduction. Disruptive behavior (DB) is frequent in pediatric patients with epilepsy.This conducts impacts on the functioning of the children, and often leads to their social rejection. The objectives of this study were to observe the efficacy and safety of risperidone in the treatment of acute di [...] sruptive behavior in pediatric patients with epilepsy. Material and methods. A clinical open label, prospective study with a month follow up was carried out. Pediatric patients with epilepsy (partial or generalized) and disruptive behavior, both gender, between 5 and 14 years of age seen in the neurology department, Hospital Infantil de Mexico, were enrolled.The efficacy was evaluated with CGI, Peers scale and ADHD RS. Number of seizures and secondary effects was evaluated with the same methods. Results. A total of 23 patients, 7 females and 16 males enter the study with a relation M:F of 1.5:1. All the patients had epilepsy, either partial or generalized.The average doses of risperidone was 0.75 mg/kg/d, with and efficacy of 91 % at the final of the 4 weeks follow up.The more frequent side effects were increase in weight in 12 patients, extrapiramidal symptoms (head and neck discinesias) sialorrhea, thirst and somnolence. Conclusions. With these results, we support in this clinic open label study, the efficacy and safety of the use of risperidone in the management of acute disruptive behaviors in pediatric patients with epilepsy.

  13. Handwriting Movement Analyses for Monitoring Drug-Induced Motor Side Effects in Schizophrenia Patients Treated with Risperidone

    Science.gov (United States)

    Caligiuri, Michael P.; Teulings, Hans-Leo; Dean, Charles E.; Niculescu, Alexander B.; Lohr, James

    2009-01-01

    Epidemiologic studies indicate that nearly 60% of schizophrenia (SZ) patients treated with conventional antipsychotic drugs develop extrapyramidal side effects (EPS) such as parkinsonism and tardive dyskinesia. Although the prevalence of EPS has decreased due to the newer antipsychotics, EPS continue to limit the effectiveness of these medicines. Ongoing monitoring of EPS is likely to improve treatment outcome or compliance and reduce the frequency of re-hospitalization. A quantitative analysis of handwriting kinematics was used to evaluate effects of antipsychotic medication type and dose in schizophrenia patients. Twenty-seven schizophrenia patients treated with risperidone, six schizophrenia patients who received no antipsychotic medication and 46 healthy comparison participants were enrolled. Participants performed a 20-minute handwriting task consisting of loops of various sizes and a sentence. Data were captured and analyzed using MovAlyzeR software. Results indicated that risperidone-treated participants exhibited significantly more dysfluent handwriting movements than either healthy or untreated SZ participants. Risperidone-treated participants exhibited lower movement velocities during production of simple loops compared to unmedicated patients. Handwriting dysfluency during sentence writing increased with dose. A 3-factor model consisting of kinematic variables derived from sentence writing accounted for 83% (r = .91) of the variability in medication dose. In contrast, we found no association between observer-based EPS severity ratings and medication dose. These findings support the importance of handwriting-based measures to monitor EPS in medicated schizophrenia patients. PMID:19692133

  14. Curative effect and influence on glucose and lipid metabolism of risperidone with SHU Mian capsules in patients with chronic

    Directory of Open Access Journals (Sweden)

    Ming-jie HAN

    2014-04-01

    Full Text Available Objective: To explore the curative effect and influence on glucose and lipid metabolism of risperidone with Shu Mian capsules in patients with schizophrenia .Methods: 128patients with chronic schizophrenia were randomly divided into the combined group (crisperidone combined with shu mian capsules group and the single group (risperidone group , each group was assessed the positive and negative syndrome scale (PANSS,the body mass index (BMI was measured and the blood glucose and blood lipid were detected before treatment and after 2,4,8 weekends respectively. After 4,8 weeks ,both the two groups were assessed by Wesconsin card sorting test ( WCST curative effect and their cognitive function was evaluated .Results: The reacting time in the two groups were of no significantly difference , but compared with condition before treatment, cognitive function of the patients with schizophrenia was improved and their level of total cholesterol was significantly increased (P < 0.05 in the combined group. BMI, blood glucose and blood lipid were significantly increased in single group after 8weeks’ treatment (P < 0.05 or P < 0.01. Conclusion: Shu Mian capsules can lower negative symptoms and improve cognitive function of schizophrenia ,and the dverse reactions is mild. With therapeutic dose range, risperidone in combined group or single group can make equal reacting time, curative effect and affecting blood lipid metabolism in patients with schizophrenia. Single group shows more obvious influence on blood sugat and blood fat metabolismcan.

  15. Combined therapeutic efficacy of (188)Re-liposomes and sorafenib in an experimental colorectal cancer liver metastasis model by intrasplenic injection of C26-luc murine colon cancer cells.

    Science.gov (United States)

    Chang, Ya-Jen; Hsu, Wei-Hsin; Chang, Chih-Hsien; Lan, Keng-Li; Ting, Gann; Lee, Te-Wei

    2014-05-01

    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

  16. Combined therapeutic efficacy of 188Re-liposomes and sorafenib in an experimental colorectal cancer liver metastasis model by intrasplenic injection of C26-luc murine colon cancer cells

    Science.gov (United States)

    CHANG, YA-JEN; HSU, WEI-HSIN; CHANG, CHIH-HSIEN; LAN, KENG-LI; TING, GANN; LEE, TE-WEI

    2014-01-01

    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

  17. Divergent long-term consequences of chronic treatment with haloperidol, risperidone, and bromocriptine on traumatic brain injury-induced cognitive deficits.

    Science.gov (United States)

    Phelps, Thomas I; Bondi, Corina O; Ahmed, Rashid H; Olugbade, Yewande T; Kline, Anthony E

    2015-04-15

    Antipsychotic drugs (APDs) are provided in the clinic to manage traumatic brain injury (TBI)-induced agitation and aggression. Experimental TBI studies consistently show that daily administration of the APDs, haloperidol (HAL) and risperidone (RISP), hinder recovery. However, it is unknown how long the adverse effects remain after cessation of treatment. To elucidate this clinically relevant issue, anesthetized male rats were randomly assigned to four TBI (controlled cortical impact) and four sham groups administered HAL (0.5?mg/kg), RISP (0.45?mg/kg), bromocriptine (BRO; 5.0?mg/kg, included as a control for D2 receptor action), or vehicle (VEH; 1?mL/kg) 24?h after surgery and once-daily for 19 days. Motor and cognitive recovery was assessed on days 1-5 and 14-19, respectively, and again at 1 and 3 months after drug withdrawal. No overall group differences were observed for motor function among the TBI groups, although the HAL group showed a greater beam-walk deficit on day 5 versus the VEH and BRO groups. Cognitive recovery was significantly impaired in the HAL and RISP groups during the treatment phase versus VEH and BRO. Further, BRO was superior to VEH (p=0.0042). At 1 month, both groups that received APDs continued to exhibit significant cognitive impairment versus VEH and BRO; at 3 months, only the HAL group was impaired. Moreover, the HAL, RISP, and VEH groups continued to be cognitively deficient versus BRO, which also reduced cortical damage. These data replicate previous reports that HAL and RISP impede cognitive recovery after TBI and expand the literature by revealing that the deleterious effects persist for 3 months after drug discontinuation. BRO conferred cognitive benefits when administered concomitantly with behavioral testing, thus replicating previous findings, and also after cessation demonstrating enduring efficacy. PMID:25275833

  18. Assessment of strategies for switching patients from olanzapine to risperidone: A randomized, open-label, rater-blinded study

    Directory of Open Access Journals (Sweden)

    Berry Sally A

    2008-06-01

    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 0.61–0.99 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

  19. Quantification of risperidone and 9-hydroxyrisperidone in plasma and saliva from adult and pediatric patients by liquid chromatography-mass spectrometry.

    Science.gov (United States)

    Flarakos, J; Luo, W; Aman, M; Svinarov, D; Gerber, N; Vouros, P

    2004-02-13

    A robust and validated LC-MS-MS quantitative method, using column switching and mutiple reaction monitoring was developed for the analysis of risperidone (RIS) and 9-hydroxyrisperidone in human plasma and saliva. The analytical range was 1-100 ng/ml. The method used 25 microl of sample precipitated with 75 microl of acetonitrile containing internal standard (R068808). Analyses were conducted on a PE Sciex API-III + triple quadrupole mass spectrometer fitted with a Turbo IonSpray source. The method was validated for human plasma using EDTA as the anticoagulant and cross-validated to heparinized human plasma and saliva. The recoveries of risperidone and 9-hydroxyrisperidone were 90-93 and 89-93%, respectively. The validated method was applied to clinical samples to study risperidone and 9-hydroxyrisperidone concentrations in plasma and saliva. Risperidone and 9-hydroxyrisperidone appear in the saliva of patients treated with risperidone. Their detection/quantification in saliva provides evidence for recent adherence with therapy. PMID:14763744

  20. Plerixafor Injection

    Science.gov (United States)

    Plerixafor injection is used along with a granulocyte-colony stimulating factor (G-CSF) medication such as filgrastim ( ... a type of cancer of the bone marrow). Plerixafor injection is in a class of medications called ...

  1. Docetaxel Injection

    Science.gov (United States)

    Docetaxel injection is used alone or in combination with other medications to treat certain types of breast, lung, prostate, stomach, and head and neck cancers. Docetaxel injection is in a class of medications called ...

  2. Cyanocobalamin Injection

    Science.gov (United States)

    ... of vitamin B12 absorbed from food; or a vegan diet (strict vegetarian diet that does not allow ... injections even if you feel well. If you stop receiving cyanocobalamin injections, your anemia may return and ...

  3. Methotrexate Injection

    Science.gov (United States)

    Methotrexate injection is used alone or in combination with other medications to treat gestational trophoblastic tumors (a ... in bones) after surgery to remove the tumor. Methotrexate injection is also used to treat severe psoriasis ( ...

  4. Tacrolimus Injection

    Science.gov (United States)

    ... inserts, or injections); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); lansoprazole (Prevacid); ... there is a risk that you will develop diabetes during your treatment with tacrolimus injection. African American ...

  5. Hydromorphone Injection

    Science.gov (United States)

    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 ...

  6. Paclitaxel Injection

    Science.gov (United States)

    Abraxane® ... Paclitaxel injection manufactured with human albumin is used to treat breast cancer that has not improved or that has come back after treatment with other medications. Paclitaxel injection manufactured with polyoxyethylated castor oil is used to ...

  7. Levofloxacin Injection

    Science.gov (United States)

    Levofloxacin injection is also sometimes used to treat endocarditis (infection of the heart lining and valves), tuberculosis ( ... with bones, joints, and tissues around joints in children. Levofloxacin injection should not normally be given to ...

  8. Fondaparinux Injection

    Science.gov (United States)

    Fondaparinux injection is used to prevent deep vein thrombosis (DVT; a blood clot, usually in the leg), ... warfarin (Coumadin, Jantoven) to treat DVT or PE. Fondaparinux injection is in a class of medications called ...

  9. Cabazitaxel Injection

    Science.gov (United States)

    ... injection is usually used in men with prostate cancer. If used by pregnant women, cabazitaxel injection can cause harm to the fetus. Women who are or may become pregnant or are breast-feeding should not receive cabazitaxel injection. If you ...

  10. Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

    Directory of Open Access Journals (Sweden)

    Psarros Constantin

    2006-09-01

    Full Text Available Abstract Background The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. Case presentation A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg. Conclusion The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient.

  11. Preparation, release and pharmacokinetics of a risperidone elementary osmotic pump system.

    Science.gov (United States)

    Gong, Wei; Liu, Yan; Mei, Dan-Yu; Yang, Meiyan; Mei, Xing-Guo

    2015-03-01

    Preparation and in vitro/in vivo evaluation of risperidone elementary osmotic pump (RIS-EOP) formulations were investigated. A method for the preparation of RIS-EOP tablets was developed by modulating RIS solubility with citric acid. The influence of osmotic agents and the compositions of semipermeable membrane on drug release profiles was evaluated. The formulation of RIS-EOP was optimized by orthogonal design. The in vitro release profile of the optimum formulation achieved to deliver RIS at an approximate zero-order up to 12?h. The pharmacokinetic profiles of RIS-EOP were evaluated compared with immediate release tablets in beagle dogs. The mean tmax and mean residence time of RIS-EOP for RIS and its active metabolite, 9-hydroxyrisperidone, were remarkably longer, compared with immediate release tablets. These results corroborated prolonged release of RIS from EOP formulations. Moreover, drug plasma levels with lower fluctuations could be achieved with RIS-EOP tablets. These results suggested that increasing drug solubility by adding or reacting with alkali/acid might be used for the preparation of EOP tablets of certain poorly water-soluble drugs. PMID:24400982

  12. Dopamine transporter density assessed with [{sup 123}]IPT SPECT before and after risperidone treatment in children with tourette's disorder

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Young Hoon; Kim, Tae Hoon; Ryu, Won Gee [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)] [and others

    2004-02-01

    Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled N-(3-iodopropen-2-yl)-2{beta}-carbomethoxy-3beta-(4-chlorophenyl)tropane ([{sup 123}I]IPT) single photon emission computed tomography (SPECT). [{sup 123I}]IPT SPECT imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of [{sup 123}I]IPT. Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

  13. Forum for Injection Techniques, India: The First Indian Recommendations for Best Practice in Insulin Injection Technique

    OpenAIRE

    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.

    2012-01-01

    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 guide...

  14. Validated method for the determination of risperidone and 9-hydroxyrisperidone in human plasma by liquid chromatography-tandem mass spectrometry.

    Science.gov (United States)

    Remmerie, B M M; Sips, L L A; de Vries, R; de Jong, J; Schothuis, A M; Hooijschuur, E W J; van de Merbel, N C

    2003-01-15

    Since the first entry of risperidone on to the market in the early 1990s, investigation of the pharmacokinetic behaviour of the compound for which the availability of a bioanalytical method was a condition sine qua non, has received considerable attention. Most of the published methods, however, did not reach the level of sensitivity and selectivity which can be obtained today since the evolution of liquid chromatography-tandem mass spectrometry (LC-MS-MS) towards a routine technique in the bioanalytical laboratory. Therefore, we developed and validated a new LC-MS-MS method for the determination of risperidone and its active metabolite 9-hydroxyrisperidone in human plasma. This paper describes in detail the bioanalytical procedure and summarizes the validation results obtained. In addition, it focuses on the pitfalls one might encounter when developing similar assays. Despite the particular physicochemical characteristics of risperidone and 9-hydroxyrisperidone, the LC-MS-MS method enabled the quantification of both compounds down to 0.1 ng/ml. The method uses a sample preparation step by solid-phase extraction at pH 6 using a mixed-mode phase. In a short chromatographic run, separation of 9-hydroxyrisperidone from the minor metabolite 7-hydroxyrisperidone is achieved. Detection takes place by (turbo)ionspray tandem mass spectrometry in the positive ion mode. The validated concentration range is from 0.100 to 250 ng/ml, using 500 microliter of sample, with accuracy (bias) and precision (coefficient of variation) being below 15%. Although new developments in equipment will allow us to further improve and speed up the method, the assay reported can be used as a routine method to support a wide range of pharmacokinetic studies. PMID:12482489

  15. Combination of Risperidone and Paroxetine for Inappropriate Sexual Behaviors in an Adolescent with Autism and Mental Retardation

    Directory of Open Access Journals (Sweden)

    Sabri HERGÜNER

    2012-12-01

    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

  16. Schizophrenia relapse and the clinical usefulness of once-monthly aripiprazole depot injection

    Directory of Open Access Journals (Sweden)

    Wang SM

    2014-08-01

    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 Mary’s 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 Mary’s 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 (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 (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 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. Keywords: aripiprazole, schizophrenia, depot, long-acting injectable, relapse, treatment

  17. Injection Sclerotherapy

    OpenAIRE

    Worthington-Kirsch, Robert L.

    2005-01-01

    Injection sclerotherapy is an important primary and adjunctive therapy in the spectrum of care for superficial venous insufficiency. This article briefly reviews the history of the procedure, agents used, technique, and outcomes. The place of injection sclerotherapy in the treatment of superficial venous disease is discussed.

  18. Alginate gel-coated oil-entrapped alginate-tamarind gum-magnesium stearate buoyant beads of risperidone.

    Science.gov (United States)

    Bera, Hriday; Boddupalli, Shashank; Nandikonda, Sridhar; Kumar, Sanoj; Nayak, Amit Kumar

    2015-07-01

    A novel alginate gel-coated oil-entrapped calcium-alginate-tamarind gum (TG)-magnesium stearate (MS) composite floating beads was developed for intragastric risperidone delivery with a view to improving its oral bioavailability. The TG-blended alginate core beads containing olive oil and MS as low-density materials were accomplished by ionotropic gelation technique. Effects of polymer-blend ratio (sodium alginate:TG) and crosslinker (CaCl2) concentration on drug entrapment efficiency (DEE, %) and cumulative drug release after 8h (Q8h, %) were studied to optimize the core beads by a 3(2) factorial design. The optimized beads (F-O) exhibited DEE of 75.19±0.75% and Q8h of 78.04±0.38% with minimum errors in prediction. The alginate gel-coated optimized beads displayed superior buoyancy and sustained drug release property. The drug release profiles of the drug-loaded uncoated and coated beads were best fitted in Higuchi kinetic model with Fickian and anomalous diffusion driven mechanisms, respectively. The optimized beads yielded a notable sustained drug release profile as compared to marketed immediate release preparation. The uncoated and coated Ca-alginate-TG-MS beads were also characterized by SEM, FTIR and P-XRD analyses. Thus, the newly developed alginate-gel coated oil-entrapped alginate-TG-MS composite beads are suitable for intragastric delivery of risperidone over a prolonged period of time. PMID:25861741

  19. Conspicuous by Their Absence: Studies Comparing and Combining Risperidone and Applied Behavior Analysis to Reduce Challenging Behavior in Children with Autism

    Science.gov (United States)

    Weeden, Marc; Ehrhardt, Kristal; Poling, Alan

    2009-01-01

    Both risperidone, an atypical antipsychotic drug, and function-based behavior-analytic interventions are popular and empirically validated treatments for reducing challenging behavior in children with autism. The kind of research that supports their effectiveness differs, however, and no published study has directly compared their effects or…

  20. The Comparison of the Effectiveness of Thiothixene and Risperidone as a Combination with Lithium for the Treatment of Patients with Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Nooshin Parvaresh

    2014-08-01

    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.

  1. Risperidone Attenuates Modified Stress-Re-stress Paradigm-Induced Mitochondrial Dysfunction and Apoptosis in Rats Exhibiting Post-traumatic Stress Disorder-Like Symptoms.

    Science.gov (United States)

    Garabadu, Debapriya; Ahmad, Ausaf; Krishnamurthy, Sairam

    2015-06-01

    Mitochondria play a significant role in the pathophysiology of post-traumatic stress disorder (PTSD). Risperidone and paroxetine were evaluated for their effect on mitochondrial dysfunction and mitochondria-dependent apoptosis in discrete brain regions in modified stress re-stress (SRS) animal model of PTSD. Male rats were subjected to stress protocol of 2 h restraint and 20 min forced swim followed by halothane anesthesia on day 2 (D-2). Thereafter, rats were exposed to re-stress (forced swim) on D-8 and at 6-day intervals on D-14, D-20, D-26, and D-32. The rats were treated with risperidone (0.01, 0.1, and 1.0 mg/kg p.o.) and paroxetine (10.0 mg/kg p.o.) from D-8 to D-32. Risperidone at median dose and paroxetine ameliorated modified SRS-induced depressive-like symptom (increase in immobility period) in forced swim, anxiety-like behavior (decrease in percentage of open arm entries and time spent) in elevated plus maze and cognitive deficits (loss in spatial recognition memory) in Y-maze tests on D-32. Risperidone, but not paroxetine, attenuated modified SRS-induced decreases in plasma corticosterone levels. Risperidone ameliorated increase in the activity of mitochondrial respiratory complex (I, II, IV, and V), decreases in the levels of mitochondrial membrane potential, cytochrome-C and caspase-9 in the hippocampus, hypothalamus, pre-frontal cortex, and amygdala. However, both drugs attenuated modified SRS-induced increase in the number of apoptotic cells and caspase-3 levels in all the brain regions indicating anti-apoptotic activity of these drugs. Hence, these results suggest that anti-apoptotic activity could be a common mechanism for anti-PTSD-like effect irrespective of the pathways of apoptosis in the modified SRS model. PMID:25750029

  2. No change of dopamine transporter density in basal ganglia after risperidone treatment in drug-naive children with Tourette's disorder

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, W. K.; Ryu, Y. H.; Yoon, M. J.; Chun, K. A.; Lee, J. D. [College of Medicine, Univ. of Yonsei, Seoul (Korea, Republic of); Zee, D. Y. [Univ. of Inhwa, Incheon (Korea, Republic of); Choi, T. H. [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2003-07-01

    Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the DAT densities between drug-naive children with TD and normal children investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using lodine-123 labelled N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane(I-123 IPT) single photon emission computed tomography (SPECT). I-123 IPT SPECT imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in eight drug-naive children with TD. Eight normal children also underwent SPECT imaging 2 hours after an intravenous administration of I-123 IPT and carried out both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of the specific/non-specific DAT binding ratio in the basal ganglia. The drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with riperidone in children with TD was not found, although tic symptoms were significantly improved with risperidone. These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

  3. Effects of two atypical neuroleptics, olanzapine and risperidone, on the function of the urinary bladder and the external urethral sphincter in anesthetized rats

    Directory of Open Access Journals (Sweden)

    Vera Pedro L

    2001-08-01

    Full Text Available Abstract Background A previous report showed that the atypical neuroleptic clozapine resulted in marked changes in urodynamic parameters and greatly inhibited the activity of the external urethral sphincter in anesthetized rats. Such findings may help explain the high incidence of urinary disturbances reported during clozapine therapy. In an effort to extend our observations to other atypical neuroleptic agents, the present study investigated the effects of two newer atypical antipsychotics, olanzapine and risperidone, on the bladder and external urethral sphincter during cystometry in anesthetized rats. Results At a dose of 0.1 mg/kg (i.v., olanzapine decreased the micturition volume and increased the residual volume. In addition, olanzapine decreased the expulsion time and the amplitude of the high frequency oscillations observed during the expulsion phase. Larger doses (1 mg/kg had a greater effect. Olanzapine also reduced the activity recorded from the external urethral sphincter, and the bursting observed during the expulsion phase was abolished by 1.0 mg/kg. Risperidone had similar effects although the maximal effects were smaller than those observed with olanzapine. The amplitude of bladder contractions elicited by electrical stimulation of the pelvic nerve was reduced by olanzapine but not risperidone suggesting a possible anti-muscarinic peripheral effect of olanzapine. Conclusions Olanzapine and risperidone significantly altered several voiding parameters and decreased the activity of the external urethral sphincter in the anesthetized rat. We propose that these effects are due to the central action of these drugs and not to peripheral effects. These findings may explain some of the clinical reports of urinary incontinence with risperidone and may predict similar occurrences with olanzapine therapy.

  4. Low dose intradetrusor injections of onabotulinumtoxinA in women with overactive bladder symptoms or the painful bladder syndrome: unfavorable balance between clinical efficacy and the need for catheterization

    OpenAIRE

    Dohle, Gert R.; Marchand, Wouter J. C.; Blok, Bertil F. M.; Jan Groen

    2012-01-01

    Background: We evaluated our results with low dose intradetrusor injections of onabotulinumtoxinA in women with overactive bladder symptoms and the painful bladder syndrome in terms of clinically successful outcomes and the need for clean intermittent self-catheterisation (CISC) and in relation to urodynamic aspects. Materials and Methods: The files of patients treated with 100 U of onabotulinumtoxinA injected at 20 sites with sparing of the trigone were retrospectively analysed. Nearly all p...

  5. Fludarabine Injection

    Science.gov (United States)

    ... treated with fludarabine.you should know that fludarabine injection may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume ...

  6. Fluconazole Injection

    Science.gov (United States)

    Fluconazole injection is used to treat fungal infections, including yeast infections of the mouth, throat, esophagus (tube ... chest and waist), lungs, blood, and other organs. Fluconazole is also used to treat meningitis (infection of ...

  7. Moxifloxacin Injection

    Science.gov (United States)

    ... also sometimes used to treat tuberculosis (TB) and endocarditis (infection of the heart lining and valves) when ... with bones, joints, and tissues around joints in children. Moxifloxacin injection should not be given to children ...

  8. Epinephrine Injection

    Science.gov (United States)

    Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by ... or stings, foods, medications, latex, and other causes. Epinephrine is in a class of medications called alpha- ...

  9. Intravitreal injection

    Science.gov (United States)

    ... 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, ...

  10. Enfuvirtide Injection

    Science.gov (United States)

    ... a class of medications called HIV entry and fusion inhibitors. It works by decreasing the amount of ... mole, a burn site, or has had a reaction to a previous injection of enfuvirtide.Never reuse ...

  11. Liraglutide Injection

    Science.gov (United States)

    ... ketoacidosis (a serious condition that may develop if high blood sugar is not treated). Liraglutide injection (Saxenda) is used along with a reduced calorie diet and exercise plan to help people who are ...

  12. Relapse in patients with schizophrenia: a comparison between risperidone and haloperidol / Recaída em pacientes com esquizofrenia: uma comparação entre risperidona e haloperidol

    Scientific Electronic Library Online (English)

    Eduardo Pondé de, Sena; Rogério, Santos-Jesus; Ângela, Miranda-Scippa; Lucas de Castro, Quarantini; Irismar Reis de, Oliveira.

    2003-10-01

    Full Text Available OBJETIVOS: Comparar taxas de re-hospitalização e o tempo para a recaída entre pacientes esquizofrênicos tratados com risperidona ou haloperidol após alta hospitalar. MÉTODOS: Ensaio controlado, randomizado, comparando risperidona e haloperidol em relação à recaída em pacientes com esquizofrenia trat [...] ados com doses flexíveis, com duração de um ano. RESULTADOS: Vinte pacientes foram alocados para a risperidona e 13 para o haloperidol. Um paciente em cada grupo retirou o consentimento e um tomando risperidona foi perdido para o seguimento. Seis (30,0%) do grupo da risperidona e três (23,1%) do grupo do haloperidol recaíram (p=1.00). Contudo, o tempo até a re-hospitalização foi mais curto com o haloperidol (logrank =4,2; p=0,04). Quando re-hospitalizados, os pacientes no grupo da risperidona permaneceram 34,5 dias no hospital (mediana) quando comparados com o grupo do haloperidol (mediana =61 dias) (p=0,61). CONCLUSÃO: A proporção de pacientes esquizofrênicos que recaíram foi similar em ambos os grupos. Contudo, o tempo para a recaída foi mais curto nos pacientes tratados com haloperidol. Abstract in english OBJECTIVES: To compare rates of rehospitalization and time to relapse in risperidone vs. haloperidol-treated schizophrenic patients discharged from the hospital. METHODS: Randomized controlled trial comparing risperidone and haloperidol regarding relapse in patients with schizophrenia treated with f [...] lexible doses during one year. RESULTS: Twenty patients were assigned to risperidone and 13 to haloperidol. One patient from each group withdrew consent and one patient in the risperidone group was lost for follow-up. Six (30.0%) patients in the risperidone group and 3 (23.1%) in the haloperidol group relapsed (p=1.00). However, time to relapse was shorter in the later (logrank =4.2; p=.04). When rehospitalized, patients in the risperidone group stayed 34.5 days (median) at hospital as compared to the haloperidol group (median of 61 days) (p=.61). CONCLUSION: The proportion of schizophrenic patients who relapsed was similar in both groups; However, time to relapse was shorter in the haloperidol-treated patients.

  13. Estudio de estabilidad de tabletas de risperidona 3 mg Study of stability of Risperidone (3 mg tablets

    Directory of Open Access Journals (Sweden)

    Caridad Margarita García Peña

    2010-06-01

    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.

  14. Estudio de estabilidad de tabletas de risperidona 3 mg / Study of stability of Risperidone (3 mg) tablets

    Scientific Electronic Library Online (English)

    Caridad Margarita, García Peña; Antonio, Iraizoz Barrios; Vivian, Martínez Espinosa.

    2010-06-01

    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.

  15. Adverse effects associated with second-generation antipsychotic long-acting injection treatment: a comprehensive systematic review.

    Science.gov (United States)

    Gentile, Salvatore

    2013-10-01

    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

  16. Bendamustine Injection

    Science.gov (United States)

    ... used to treat chronic lymphocytic leukemia (CLL; a type of cancer of the white blood cells). Bendamustine injection is also used to treat a type of non-Hodgkins lymphoma (NHL: cancer that begins in a type of white blood cell that normally fights infection) that is slow ...

  17. Omalizumab Injection

    Science.gov (United States)

    ... call your doctor immediately or get emergency medical treatment: fever, muscle aches, rash, and swollen glands within 1 to 5 days after receiving a dose of omalizumab injection shortness of breath coughing up blood skin sores severe pain, numbness and tingling in your hands ...

  18. Linezolid Injection

    Science.gov (United States)

    ... and other signs of infection changes in color vision, blurred vision, or other changes in vision seizures Linezolid injection may cause other side effects. Call your doctor if you have any unusual problems ... [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

  19. Verteporfin Injection

    Science.gov (United States)

    ... a solution to be injected intravenously (into a vein) by a doctor. Verteporfin is usually infused over 10 minutes. Fifteen minutes after the start of the verteporfin infusion, your doctor will administer a special laser light to your eye. If both of your ...

  20. Naltrexone Injection

    Science.gov (United States)

    ... substances if you take or use them at low or normal doses at most times during your treatment. However, you may be more sensitive to the effects of these substances when it is almost time for you to receive a dose of naltrexone injection or if you miss a dose of ...

  1. Tositumomab Injection

    Science.gov (United States)

    ... injection with radioactive material. The first infusion will last about 60 minutes, and the second infusion about 30 minutes. On the same day, you will undergo an imaging scan (test that shows a picture of all or part of the inside of ...

  2. Combined therapeutic efficacy of 188Re-liposomes and sorafenib in an experimental colorectal cancer liver metastasis model by intrasplenic injection of C26-luc murine colon cancer cells

    OpenAIRE

    Chang, Ya-jen; Hsu, Wei-hsin; Chang, Chih-hsien; Lan, Keng-li; Ting, Gann; Lee, Te-wei

    2014-01-01

    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 soraf...

  3. Priapismo secundario a antipsicóticos: a propósito de un caso asociado a risperidona / Priapism associated with risperidone use: Report of one case

    Scientific Electronic Library Online (English)

    Lizardo, Cruzado; César E, Vallejos.

    2012-11-01

    Full Text Available [...] Abstract in english Background: The use of drugs with ?-adrenergic antagonistic effect is one of the most prominent etiologies of priapism. We report a 32-year-old schizophrenic male in treatment with risperidone who consulted in the emergency room for a painful priapism. A low flow priapism was diagnosed. Medical trea [...] tment was unsuccessful and the patient was subjected to a proximal corporo-spongiosal shunt (Quackels technique), with good results. The patient was discharged in good conditions.

  4. Incidence of diabetes in a general practice population: a database cohort study on the relationship with haloperidol, olanzapine, risperidone or quetiapine exposure.

    Science.gov (United States)

    Sacchetti, Emilio; Turrina, Cesare; Parrinello, Giovanni; Brignoli, Ovidio; Stefanini, Giovanni; Mazzaglia, Giampiero

    2005-01-01

    The present study aimed to estimate the incidence of diabetes in general practice patients who were treated with haloperidol, olanzapine, risperidone or quetiapine monotherapy and in subjects who were not exposed to antipsychotics. The design was a retrospective, up to 2 years, cohort study, with age-, sex- and length of observation-matching between subjects who were exposed and not exposed to antipsychotic drugs. Data were taken from the Health Search database, which contains information from 550 Italian general practitioners. Participants comprised 2,071 subjects taking haloperidol, 266 taking olanzapine, 567 taking risperidone and 109 taking quetiapine, in addition to 6,026 age- and sex-matched subjects who were not using antipsychotic drugs during the period of observation. Inclusion was limited to initially non-diabetic and antipsychotic drug-free individuals. The main outcome measure was the incidence of drug-treated diabetes. After age and sex correction by Cox regression analysis, the four groups treated with antipsychotics significantly differed from untreated subjects in hazard ratios for diabetes. The ratios for the haloperidol, olanzapine, risperidone and quetiapine groups were 12.4 (95% confidence interval 6.3-24.5), 20.4 (6.9-60.3), 18.7 (8.2-42.8) and 33.7 (9.2-123.6), respectively, with no significant differences when compared to each other. PMID:15602114

  5. 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

    Directory of Open Access Journals (Sweden)

    Leonardo E Gaete

    2003-05-01

    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 (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.

  6. 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

    Scientific Electronic Library Online (English)

    Leonardo E, Gaete; Jaime, Solís G; Pablo, Venegas F; Mitzy J, Carrillo C; Oscar, Schatloff B; Iván, Saavedra S.

    2003-05-01

    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).

  7. Efficacy and safety of sertindole in schizophrenia: a clinical review.

    Science.gov (United States)

    Zoccali, Rocco A; Bruno, Antonio; Muscatello, Maria Rosaria Anna

    2015-06-01

    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

  8. The therapeutic potential of risperidone in tourette's syndrome; A preclinical and clinical study.

    OpenAIRE

    Bruggeman, Richard

    2001-01-01

    Antipsychotic drugs are not only effective for psychosis, but also for Tourette's syndrome. Their use is limited by their extrapyramidal side-effects (EPS). An atypical antipsychotic can be defined as a compound that has a significant antipsychotic action on positive symptoms but with no or few EPS (Meltzer 2000). This definition is often expanded to include efficacy in treatment-resistant schizophrenia, amelioration of negative- and cognitive symptoms, and the lack of sustained prolactin ele...

  9. Injection laser

    International Nuclear Information System (INIS)

    A Q-switching resonant cavity injection laser comprises a monocrystalline semiconductive body including at least one p-n junction with an active lasing region having an emitter section and an ion implanted region forming a saturable absorber section. The implantation is of a type and amount to increase the resistivity of the implanted region and selected so as to provide energy levels sufficiently widely separated from the conduction and valence bands to prevent thermal excitation from transferring charge carriers to or from the bands to or from the energy levels of the implanted ion. (UK)

  10. Methodology for the Randomised Injecting Opioid Treatment Trial (RIOTT): evaluating injectable methadone and injectable heroin treatment versus optimised oral methadone treatment in the UK

    OpenAIRE

    Byford Sarah; Metrebian Nicola; Strang John; Lintzeris Nicholas; Hallam Christopher; Lee Sally; Zador Deborah

    2006-01-01

    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 treatmen...

  11. Epinephrine injection therapy versus a combination of epinephrine injection and endoscopic hemoclip in the treatment of bleeding ulcers

    OpenAIRE

    Chua, Tju-siang; Fock, Kwong-ming; Ng, Tay-meng; Teo, Eng-kiong; Tan, Jessica Yi-lyn; Ang, Tiing-leong

    2005-01-01

    AIM: To assess the efficacy of hemoclip application in combination with epinephrine injection in the treatment of bleeding peptic ulcers and to compare the clinical outcomes between patients treated with such a combination therapy and those treated with epinephrine injection alone.

  12. Management of Tennis Elbow with sodium hyaluronate periarticular injections

    OpenAIRE

    Petrella Robert J; Cogliano Anthony; Decaria Joseph; Mohamed Naem; Lee Robert

    2010-01-01

    Abstract Objectives To determine the efficacy and safety of peri-articular hyaluronic acid injections in chronic lateral epicondylosis (tennis elbow). Design Prospective randomized clinical trial in primary care sport medicine. Patients Three hundred and thirty one consecutive competitive racquette sport athletes with chronic (>3 months) lateral epicondylosis were administered 2 injections (first injection at baseline) into the subcutaneous tissue and muscle 1 cm. from the lateral epicondyle ...

  13. Cervical facet injections in the management of cervicogenic headaches.

    Science.gov (United States)

    Ng, Andrew; Wang, Dajie

    2015-05-01

    Cervicogenic headache is defined as headaches originating from cervical spine structures including cervical facet joints, cervical intervertebral discs, skeletal muscles, connective tissues, and neurovascular structures. Cervical facet injections with steroids have been used to alleviate cervicogenic headache secondary to cervical facet arthropathy. In this article, we will review the cervical spine anatomy, cervical facet injections, and the efficacy of cervical facet injections as a treatment for cervicogenic headache. PMID:25795156

  14. Self-Efficacy

    Science.gov (United States)

    Albert Bandura

    This is a comprehensive summary of the topic written by one of its pioneers. The site provides a definition of self-efficacy, characteristics of efficacious people, and a description of how self-efficacy can be developed or undermined. The author describes self-efficacy in social, family and school settings and in various stages of life. There is also a short bibliography.

  15. Hiperprolactinemia y disfunción sexual en el primer episodio psicótico tratado con risperidona / Hiperprolactinaemia and sexual disfunction in first psychotic episode treated with risperidone

    Scientific Electronic Library Online (English)

    Alvaro, Cavieres F.

    2008-06-01

    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.

  16. Hiperprolactinemia y disfunción sexual en el primer episodio psicótico tratado con risperidona Hiperprolactinaemia and sexual disfunction in first psychotic episode treated with risperidone

    Directory of Open Access Journals (Sweden)

    Alvaro Cavieres F

    2008-06-01

    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. Métodos: 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.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 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.

  17. Eficácia e segurança dos antipsicóticos atípicos nas demências: uma revisão sistemática / Efficacy and safety of atypical antipsychotics in dementia: a sistematic review

    Scientific Electronic Library Online (English)

    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.

  18. 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

    Scientific Electronic Library Online (English)

    Carla Lilian, Agostini Utescher; Silvia Lucia Paro, Vieira; Sara, Fensterseifer; Liodioneza Adriano, Ribeiro; Miguel Tanús, Jorge.

    1994-06-01

    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. Abstract in english 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 ve [...] nom 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.

  19. 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

    Directory of Open Access Journals (Sweden)

    Carla Lilian Agostini Utescher

    1994-06-01

    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.

  20. Post-injection delirium/sedation syndrome in patients treated with olanzapine pamoate: mechanism, incidence, and management.

    Science.gov (United States)

    Luedecke, Daniel; Schöttle, Daniel; Karow, Anne; Lambert, Martin; Naber, Dieter

    2015-01-01

    Second-generation antipsychotics (SGAs) are a mainstay in the treatment of patients with schizophrenia. However, continuity in intake of the prescribed medication has been one of the greatest challenges in these patients. One option to improve medication adherence is to prescribe depot or long-acting injectable formulations (LAIs) of antipsychotics. Following risperidone, several other SGAs have been introduced as LAIs. Olanzapine pamoate, paliperidone palmitate, and aripiprazole are the new-generation LAIs, which are available for 2- to 4-week intervals of application in many countries. The literature shows a clear advantage of these drugs over placebo regarding symptom reduction and relapse prevention. LAIs show a similar safety profile to oral formulations of the relevant drug, with the exception of olanzapine pamoate, which can lead to rare cases of post-injection delirium/sedation syndrome (PDSS). PDSS is characterized by heavy sedation (possibly including coma) and/or delirium after injection. During PDSS events, patients show higher plasma concentrations of olanzapine, leading to the assumption that unintended partial intravascular injection or blood vessel injury during the injection is causative of PDSS. Therefore, a risk-management plan proposing an observation period of 3 h was introduced. In August 2013, a new proposal by the European Medicines Agency terminated the requirement to accompany these patients to their next destination, although this requirement remains in place according to US FDA recommendations. PMID:25424243

  1. Treating delayed endoscopic sphincterotomy-induced bleeding: Epinephrine injection with or without thermotherapy

    OpenAIRE

    Yung-kuan Tsou, Cheng-hui Lin

    2009-01-01

    AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed post-endoscopic sphincterotomy (ES) bleeding.METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements wer...

  2. Concurrent Oral Antipsychotic Drug Use Among Schizophrenia Patients Initiated on Long-Acting Injectable Antipsychotics Post-Hospital Discharge.

    Science.gov (United States)

    Doshi, Jalpa A; Pettit, Amy R; Stoddard, Jeffrey J; Zummo, Jacqueline; Marcus, Steven C

    2015-08-01

    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

  3. Treatment of lipoma by injection lipolysis.

    Science.gov (United States)

    Nanda, Soni

    2011-05-01

    Injection lipolysis or lipodissolve is the practice of injecting phosphatidyl choline/ sodium deoxycholate (PDC/DC) compounds in the subcutaneous fat. Though this practice is being used extensively for nonsurgical contouring of body and dissolving localized collections of excess fat, it's use as a treatment modality for lipomas needs further evaluation. We present a case where this technique was used for treating a lipoma, with no recurrence after 9 months of follow up. Injection lipolysis as a treatment modality for lipomas needs to be evaluated for safety and efficacy in trials on larger population. This could prove to be a very valuable adjunct to the current practice of excision, if done by a trained person in a properly selected patient. Also the side effects and the controversies regarding this procedure have been discussed in detail in the present paper. PMID:21976907

  4. Antigen injection (image)

    Science.gov (United States)

    Leprosy is caused by the organism Mycobacterium leprae . The leprosy test involves injection of an antigen just under ... if your body has a current or recent leprosy infection. The injection site is labeled and examined ...

  5. Treatment of posttraumatic stress disorder - related nightmares and other sleep disturbances with risperidone in combat veterans and victims of domestic and childhood abuse

    Directory of Open Access Journals (Sweden)

    Nina Khachiyants

    2010-08-01

    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.

  6. Treatment of posttraumatic stress disorder - related nightmares and other sleep disturbances with risperidone in combat veterans and victims of domestic and childhood abuse

    Directory of Open Access Journals (Sweden)

    Nina Khachiyants

    2010-09-01

    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.

  7. Botulinum toxin injections for the treatment of frontal tension headache

    OpenAIRE

    Kokoska, Mimi S.; Glaser, Dee A.; Burch, Christine M.; Hollenbeak, Christopher S.

    2004-01-01

    We performed a randomized, double-blind, placebo-controlled trial to determine the efficacy of botulinum toxin type A (BOTOX; Allergan) in treating frontal tension-type headache (TTH). A total of 40 patients attending a headache treatment center were randomized to receive 50 U botulinum toxin type A or saline, injected at 10 sites of the forehead. Frequency and severity of headaches before and after injection were compared. The intensity of headaches in the botulinum toxin type A group, but n...

  8. NEEDLE FREE INJECTION SYSTEMS

    OpenAIRE

    Rapolu Bharath Kumar and Zuheb Ur Rahman

    2013-01-01

    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...

  9. Adjunctive aripiprazole in the treatment of risperidone-induced hyperprolactinemia: A randomized, double-blind, placebo-controlled, dose-response study.

    Science.gov (United States)

    Chen, Jing-Xu; Su, Yun-Ai; Bian, Qing-Tao; Wei, Li-He; Zhang, Rong-Zhen; Liu, Yan-Hong; Correll, Christoph; Soares, Jair C; Yang, Fu-De; Wang, Shao-Li; Zhang, Xiang-Yang

    2015-08-01

    Hyperprolactinemia is an unwanted adverse effect associated with several antipsychotics. The addition of partial dopamine receptor agonist aripiprazole may attenuate antipsychotic-induced hyperprolactinemia effectively. However, the ideal dosing regimen for this purpose is unknown. We aimed to evaluate the dose effects of adjunctive treatment with aripiprazole on prolactin levels and hyperprolactinemia in schizophrenia patients. Stable subjects 18-45 years old with schizophrenia and hyperprolactinemia (i.e., >24ng/ml for females and >20ng/ml for males) were randomly assigned to receive 8 weeks of placebo (n=30) or oral aripiprazole 5mg/day (n=30), 10mg/day (n=29), or 20mg/day (n=30) added on to fixed dose risperidone treatment. Serum prolactin levels were measured at baseline and after 2, 4 and 8 weeks; clinical symptoms and side effects were assessed at baseline and week 8 using the Positive and Negative Syndrome Scale, Clinical Global Impressions Severity scale, Barnes Akathisia Scale, Simpson-Angus Scale and UKU Side Effects Rating Scale. Of 119 randomized patients, 107 (89.9%) completed the 8-week study. At study end, all three aripiprazole doses resulted in significantly lower prolactin levels (beginning at week 2), higher response rates (?30% prolactin reduction) and higher prolactin normalization rates than placebo. Effects were significantly greater in the 10 and 20mg/day groups than the 5mg/day group. No significant changes were observed in any treatment groups regarding psychopathology and adverse effect ratings. Adjunctive aripiprazole treatment was effective and safe for resolving risperidone-induced hyperprolactinemia, producing significant and almost maximal improvements by week 2 without significant effects on psychopathology and side effects. PMID:25981348

  10. Estimating vaccine efficacy using animal efficacy data.

    Science.gov (United States)

    Yellowlees, Ann; Perry, Richard H J

    2015-07-15

    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

  11. Long-acting injectable aripiprazole: how might it fit in our tool box?

    Science.gov (United States)

    Gopalakrishna, Ganesh; Aggarwal, Arpit; Lauriello, John

    2013-01-01

    Schizophrenia is a severe mental illness with a lifetime prevalence of approximately one percent worldwide. Maintenance antipsychotic treatment has been effective in preventing relapses in long-term follow-up studies. Logically it can be proposed that long-acting injectable antipsychotics (LAI) might reduce both unintentional and intentional nonadherence. Long-acting injectable aripiprazole was approved for the treatment of schizophrenia by the U.S. FDA on 28th February 2013 and will be marketed under the name Abilify Maintena. Aripiprazole LAI (ALAI) is a lyophilized powder that needs to be reconstituted with sterile water to form an injectable suspension without affecting the original molecule. The monthly injection interval is very attractive since patients prefer fewer injections. From a tolerability perspective, ALAI appears to be both weight neutral and lacking metabolic side effects. This can confer an advantage over the other currently available second-generation antipsychotic LAIs. Simple constitution with sterile water and no requirement to refrigerate make storage and administration easier. Like all medications, there are always potential disadvantages to ALAI. There is a period of oral coverage, while not as long as for long-acting risperidone microspheres (RLAI), that is required. Care must be taken to review concomitant medications for the presence of metabolic inducers and inhibitors. One would also expect some patients to be sensitive to extrapyramidal symptoms, especially akathisia which is well documented in the oral preparation. All things considered, we welcome our new tool, ALAI, to our work-place and predict both clinical practice and post marketing analysis and studies will discover its true value. PMID:23644169

  12. In thrombin stimulated human platelets Citalopram, Promethazine, Risperidone, and Ziprasidone, but not Diazepam, may exert their pharmacological effects also through intercalation in membrane phospholipids in a receptor-independent manner

    OpenAIRE

    Oruch, Ramadhan; Hodneland, Erlend; Pryme, Ian F.; Holmsen, Holm

    2009-01-01

    Intercalation of drugs in the platelet membrane affects phospholipid-requiring enzymatic processes according to the drugs’ intercalation capability. We investigated effects of Promethazine, Citalopram, Ziprasidone, Risperidone, and Diazepam on phospholipase A2 (PLA2) and polyphosphoinositide (PPI) metabolism in thrombin-stimulated human platelets. We also examined effects of the drugs on monolayers of glycerophospholipids using the Langmuir technique. Diazepam did not influence PLA2 activit...

  13. Atypical antipsychotics olanzapine, quetiapine, and risperidone and risk of acute major cardiovascular events in young and middle-aged adults : a nationwide register-based cohort study in Denmark

    DEFF Research Database (Denmark)

    Pasternak, Björn; Svanström, Henrik

    2014-01-01

    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 atypical antipsychotics in young and middle-aged adults. METHODS: We conducted a nationwide register-based cohort study in Denmark, 1997-2011, including adults aged 18-64 years, who started treatment with oral or intramuscular olanzapine (n = 15,774), oral quetiapine (n = 18,717), and oral or intramuscular 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 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 cardiovascular event was not significantly different in olanzapine users (HR 0.90, 95 % confidence interval [CI] 0.53-1.52) and quetiapine users (HR 0.79, 95 % CI 0.45-1.39). The absolute risk difference per 1,000 person-years on treatment was -0.5 (95 % CI -2.4 to 2.7) events for olanzapine and -1.1 (95 % CI -2.9 to 2.0) events for quetiapine. CONCLUSIONS: Among young and middle-aged outpatients, the risk of acute major cardiovascular events was similar with use of olanzapine, quetiapine, and risperidone. Although moderate relative differences cannot be ruled out, any differences are small in absolute terms.

  14. Autologus Blood Injection for Recurrent Lateral Epicondylitis

    Directory of Open Access Journals (Sweden)

    M. Dehghani, M.D.

    2007-09-01

    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.

  15. DEVELOPMENTS IN LIMB (LIMESTONE INJECTION MULTISTAGE BURNER) TECHNOLOGY

    Science.gov (United States)

    The paper describes the most recent results from the Limestone Injection Multistage Burner (LIMB) program, results from the wall-fired demonstration. Tests were conducted to determine the efficacy of commercial calcium hydroxide--Ca(OH)2--supplied by Marblehead Lime Co. and of ca...

  16. Theory of spin injection

    OpenAIRE

    Rashba, Emmanuel I.

    2002-01-01

    Diffusive theory of spin injection is reviewed and a number of new results is presented for the dc and ac regimes. They were derived by means of the "gamma-technique" allowing to simplify the calculations by choosing the spin injection coefficients through different interfaces as the basic variables. The prospects for increasing spin injection by using resistive spin-selective contacts are emphasized and spin non-conserving contacts are introduced. Finding the basic paramete...

  17. Piezoelectric Injection Systems

    Science.gov (United States)

    Mock, R.; Lubitz, K.

    The origin of direct injection can be doubtlessly attributed to Rudolf Diesel who used air assisted injection for fuel atomisation in his first self-ignition engine. Although it became apparent already at that time that direct injection leads to reduced specific fuel consumption compared to other methods of fuel injection, it was not used in passenger cars for the moment because of its disadvantageous noise generation as the requirements with regard to comfort were seen as more important than a reduced specific consumption.

  18. Urinary incontinence - injectable implant

    Science.gov (United States)

    ... 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 ...

  19. Atypical Antipsychotics: Sleep, Sedation, and Efficacy

    OpenAIRE

    Miller, Del D.

    2004-01-01

    Patients with schizophrenia often suffer from sleep disturbances such as excessive sleeping and insomnia. Common medications for schizophrenia can have a sedative effect on patients. Not all antipsychotic medications have the same sedative effect, which is related to dosage and affinity for histamine H1 receptors. Studies have shown that, compared with conventional antipsychotics, atypical antipsychotics such as risperidone, olanzapine, quetiapine, and ziprasidone generally cause less sedatio...

  20. 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

    Directory of Open Access Journals (Sweden)

    Hong Jihyung

    2012-12-01

    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.

  1. Efeitos cardiotóxicos resultantes da interação da risperidona com diuréticos tiazídicos / Cardiotoxic effects resulting from the interaction between risperidone and thiazide diuretics

    Scientific Electronic Library Online (English)

    Aline Costa, Barcelos; Andreia Mota, Trein; Gustavo Santos, Sousa; Luciano, Fleury Neto; Leonardo, Baldaçara.

    2014-12-01

    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.

  2. The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome

    OpenAIRE

    Deniz, Orhan; AYGÜL, Recep; KOTAN, Dilcan; Özdemir, Gökhan; Odaba?, Faruk Ömer; KAYA, M. Dursun; Ulvi, H?z?r

    2011-01-01

    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 ...

  3. Efficacy of different steam distribution systems against five soil-borne pathogens under controlled laboratory conditions

    OpenAIRE

    Garibaldi, Angelo; Gullino, Maria Lodovica; Gilardi, Giovanna; Ricauda Aimonino, Davide

    2010-01-01

    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...

  4. Ferric Carboxymaltose Injection

    Science.gov (United States)

    Ferric carboxymaltose injection is used to treat iron-deficiency anemia (a lower than normal number of red blood cells due to too little iron) in ... stop working) who are not on dialysis. Ferric carboxymaltose injection is in a ... called iron replacement products. It works by replenishing iron stores ...

  5. Efficacy markers in depression.

    OpenAIRE

    Harmer, CJ; Cowen, PJ; Goodwin, GM

    2011-01-01

    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...

  6. Cost effectiveness of epidural steroid injections to manage chronic lower back pain

    OpenAIRE

    Whynes David K; McCahon Robert A; Ravenscroft Andrew; Hardman Jonathan

    2012-01-01

    Abstract Background The efficacy of epidural steroid injections in the management of chronic low back pain is disputed, yet the technique remains popular amongst physicians and patients alike. This study assesses the cost effectiveness of injections administered in a routine outpatient setting in England. Methods Patients attending the Nottingham University Hospitals’ Pain Clinic received two injections of methylprednisolone plus levobupivacaine at different dosages, separated by at least 1...

  7. Treatment of sialorrhoea with ultrasound guided botulinum toxin type A injection in patients with neurological disorders

    OpenAIRE

    Porta, M; Gamba, M.; Bertacchi, G; Vaj, P

    2001-01-01

    OBJECTIVES—To 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.?METHODS—The 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 inte...

  8. Topiramate versus Valproate Sodium as Adjunctive Therapies to a Combination of Lithium and Risperidone for Adolescents with Bipolar I Disorder: Effects on Weight and Serum Lipid Profiles

    Science.gov (United States)

    Mahmoudi-Gharaei, Javad; Shahrivar, Zahra; Mohammadi, Mohammad Reza; Tehrani-Doost, Mehdi; Alaghband-Rad, Javad; Ghaeli, Padideh

    2012-01-01

    Objective To compare the effects of topiramate versus valproate sodium as an add-on therapy to a combination of lithium and risperidone (Li+Ris) on body weight and serum lipid profile in children and adolescents with bipolar disorder. Methods In a single-blind randomized clinical trial, thirty children and adolescents with bipolar disorder type I in the manic or mixed phase, treated with the combination of Li+Ris at therapeutic doses for at least 4 weeks who had the indication of add-on therapy due to a recurrent episode; a partial response or non response in the current episode or relapse were included. Participants were randomly assigned to receive either topiramate or sodium valproate as the third drug add-on therapy for a total of 6 weeks. Weight, height and serum lipid profiles were determined at baseline and at the end of week 6. Results Differences in the mean levels of lipid profiles at baseline and after week 6 evaluation were not significant in both treatment groups. BMI z-score increased in both treatment groups, being significant only in the Li+Ris/Valproate group, increasing from (mean±SD) 0.38±0.55 to 0.72±1.23 (p<0.05). Between group changes in BMI z-score was not significant.Among the BMI percentile categories, participants in the normal weight subgroup showed a significant increase in BMI z-score during the 6 week trial, compared to overweight/obese subgroup, in both Li+Ris/Valproate and Li+Ris/Topiramate treatment groups. Elevated mean serum level of triglyceride and a high proportion of participants with elevated total cholesterol (? 170 mg/dl), triglyceride (? 110 mg/dl), and BMI percentile 85-<95 at baseline (before randomization) and at the end of 6 week study were noted. Conclusion When topiramate and valproate sodium are used for six weeks as adjunctive treatment to a combination of Li+Ris, they act alike on lipid milieu of children and adolescents with bipolar disorder. Both Li+Ris/Valproate and Li+Ris/Topiramate therapies can lead to an increase in BMI z-score. This increase is statistically significant with Li+Ris/Valproate therapy. This suggests that topiramate could attenuate the ongoing weight gain from lithium and risperidone. In this study, the majority of participants who gained weight were those with BMI less than 85th percentile. This suggests that normal weight patients may have greater weight gain potential than overweight/obese patients.High proportion of metabolic abnormalities among the patients at baseline, which remained elevated throughout the trial, warrants cardiometabolic monitoring in this population. PMID:23056111

  9. Intravitreal injections and complications

    Directory of Open Access Journals (Sweden)

    Mehmet Demir

    2015-01-01

    The name and ratio's of intravitreal agents were as follows; bevacizumab (57, ranibizumab (17, triamcinolone acetonide (16 and bevacizumab + triamcinolone acetonide (10. Conclusion: The most common indication for intravitreal injections was diabetic macular edema and the most common drug that injected intravitreally was bevacizumab. The most serious complication that occurred in 2 cases was endophthalmitis. Endophthalmitis rate was 0.046. A spontaneously cleared vitreous hemorrhage occurred in one eye. Pseudoendophtalmitis was occurred in one case after triamcinolone injection. Retinal detachment was not recorded.

  10. Theory of spin injection

    CERN Document Server

    Rashba, E I

    2002-01-01

    Diffusive theory of spin injection is reviewed and a number of new results is presented for the dc and ac regimes. They were derived by means of the "gamma-technique" allowing to simplify the calculations by choosing the spin injection coefficients through different interfaces as the basic variables. The prospects for increasing spin injection by using resistive spin-selective contacts are emphasized and spin non-conserving contacts are introduced. Finding the basic parameters of a junction from the ac data is discussed.

  11. LDAP Injection Techniques

    Directory of Open Access Journals (Sweden)

    Jose Maria ALONSO

    2009-11-01

    Full Text Available 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 presented. Furthermore, a clear distinction between classic and blind injection techniques is made.

  12. Intramuscular injections into the buttocks: Are they truly intramuscular?

    International Nuclear Information System (INIS)

    Aim: To radiologically determine if intramuscular (IM) injections into the buttocks are truly intramuscular. Materials and methods: This was a prospective study conducted during a 6 month period beginning in October 2004. Fifty inpatients were recruited from a single tertiary referral hospital. Approval was obtained from the hospital research ethics committee and informed written consent was acquired from all participants. Prior to computerised tomography (CT), each patient received an IM injection of their prescribed medication along with 1 mL of air into the upper outer quadrant of the buttocks. CT images were subsequently analyzed by two radiologists to determine the position of the injected air bubble and to assess whether it was intramuscular or subcutaneous in position. Body mass index (BMI), distance to injection site, subcutaneous fat and muscle thickness were also measured. Results: Overall, only 32% (n = 16/50) of patients had intramuscular injections, with the majority of injections (68%, n = 34/50) being subcutaneous. When analysed by gender, 56% (n = 14/25) of males had intramuscular injections while in females, the efficacy rate was significantly lower at 8% (n = 2/25). Conclusion: The majority of assumed intramuscular injections are actually subcutaneous

  13. Vincristine Lipid Complex Injection

    Science.gov (United States)

    ... to change your dose of vincristine lipid complex injection.you should know that vincristine may interfere with the normal menstrual cycle (period) in women and may temporarily or permanently stop sperm production in men. Tell your doctor if you ...

  14. Storage ring injection

    International Nuclear Information System (INIS)

    Some basic issues involved in injecting the beam into storage rings with the principal parameters of those studied at the workshop have been considered. The main conclusion is that straightforward adjustments of the storage ring parameters makes injection easy. The largest number of injected turns is fourteen, and the phase space dilution allowance seems adequate to ensure very small beam loss during injection. The adjustments also result in lower bending magnet fields, and high field superconducting magnets (e.g., 5 Tesla) are not necessary. Finally, the impact of the parameters on cost is noted, and a system is considered that cuts the length of the linac in half by using doubly charged ions

  15. Collagenase Clostridium Histolyticum Injection

    Science.gov (United States)

    ... disease (a thickening of tissue [plaque] inside the penis that causes the penis to curve). Collagenase Clostridium histolyticum injection is in ... the plaque of thickened tissue and allows the penis to be straightened.

  16. Injection moulding antireflective nanostructures

    DEFF Research Database (Denmark)

    Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik

    2014-01-01

    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.

  17. Other Injectable Medications

    Science.gov (United States)

    ... Donation Planned Giving Options Do-It-Yourself Fundraising & Local Events Donate Your ... are other injectable drugs used to treat diabetes. Exenatide Exenatide (brand name Byetta) enhances insulin secretion when blood glucose ...

  18. Hydration Solution for Injection

    Science.gov (United States)

    Your doctor has ordered an intravenous hydration solution for injection. Hydration solution is used for patients who cannot or should not get fluids through drinking and eating. The hydration solution will ...

  19. Joint Injection/Aspiration

    Science.gov (United States)

    ... bursa or tendon sheath to treat bursitis and tendonitis, respectively. What benefit is derived from a joint ... conditions, such as rheumatoid arthritis, psoriatic arthritis, gout, tendonitis, bursitis and, occasionally, osteoarthritis. What usually is injected ...

  20. Mouse bladder wall injection.

    Science.gov (United States)

    Fu, Chi-Ling; Apelo, Charity A; Torres, Baldemar; Thai, Kim H; Hsieh, Michael H

    2011-01-01

    Mouse bladder wall injection is a useful technique to orthotopically study bladder phenomena, including stem cell, smooth muscle, and cancer biology. Before starting injections, the surgical area must be cleaned with soap and water and antiseptic solution. Surgical equipment must be sterilized before use and between each animal. Each mouse is placed under inhaled isoflurane anesthesia (2-5% for induction, 1-3% for maintenance) and its bladder exposed by making a midline abdominal incision with scissors. If the bladder is full, it is partially decompressed by gentle squeezing between two fingers. The cell suspension of interest is intramurally injected into the wall of the bladder dome using a 29 or 30 gauge needle and 1 cc or smaller syringe. The wound is then closed using wound clips and the mouse allowed to recover on a warming pad. Bladder wall injection is a delicate microsurgical technique that can be mastered with practice. PMID:21775962

  1. NEEDLE FREE INJECTION SYSTEMS

    Directory of Open Access Journals (Sweden)

    Rapolu Bharath Kumar and Zuheb Ur Rahman

    2013-01-01

    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.

  2. Injection and Dump Systems

    CERN Document Server

    Bracco, C; Barnes, M J; Carlier, E; Drosdal, L N; Goddard, B; Kain, V; Meddahi, M; Mertens, V; Uythoven, J

    2012-01-01

    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.

  3. Mouse Bladder Wall Injection

    OpenAIRE

    Fu, Chi-Ling; Apelo, Charity A.; Torres, Baldemar; Thai, Kim H.; Hsieh, Michael H.

    2011-01-01

    Mouse bladder wall injection is a useful technique to orthotopically study bladder phenomena, including stem cell, smooth muscle, and cancer biology. Before starting injections, the surgical area must be cleaned with soap and water and antiseptic solution. Surgical equipment must be sterilized before use and between each animal. Each mouse is placed under inhaled isoflurane anesthesia (2-5% for induction, 1-3% for maintenance) and its bladder exposed by making a midline abdominal incision wit...

  4. Injection therapy for impotence.

    Science.gov (United States)

    Kursh, E D; Bodner, D R; Resnick, M I; Althof, S E; Turner, L; Risen, C; Levine, S B

    1988-11-01

    Injection of vasoactive drugs is an effective form of treatment for selected patients with impotence from virtually all causes. The two most commonly employed drugs in the United States are either papaverine alone or various combinations of papaverine and phentolamine. Patients with organic and mixed impotence are best suited for injection treatment, but selected patients with psychogenic impotence also benefit from therapy. After the patient is selected for injection therapy, he undergoes a series of trial injections in the physician's office. The incidence of priapism will be minimized if the initially administered doses are low and the patient is titrated to an appropriate dose level. Uncontrolled trials have revealed that injection treatment produces a satisfactory erection in 65 to 100 per cent of patients for a follow-up period of as long as 2 years with minimal side effects, but the dropout rate is high. If priapism does occur, it almost always responds readily to treatment with aspiration, low doses of an alpha-adrenergic agent, or both. The other common side effects are bruising or ecchymosis and nodule formation at the injection site. This latter complication has not been noted to cause significant abnormal penile curavature necessitating cessation of the program. PMID:3055615

  5. The perspectives of injection drug users regarding safer injecting education delivered through a supervised injecting facility

    OpenAIRE

    Wood Evan; Small Will; Fast Danya; Kerr Thomas

    2008-01-01

    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...

  6. Dimethyl Ether Injection Studies

    DEFF Research Database (Denmark)

    Sorenson, Spencer C.; Glensvig, Michael

    1998-01-01

    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 injection equipment. It was shown that the penetration of the DME spray can be predicted with the methods developed for diesel fuel by Hiroyasu and co-workers. Some anomalies in spray shape, such as rapid lateral spreading at the base of the spray and spray bifurcation have been observed.The compressibility effects of DME in high pressure injection have also been observed. DME has a higher compressibility than diesel fuel, resulting in larger pressure oscillations in the injection system during the injection process. The oscillations with DME also have a slower delay rate than those of diesel fuel in the 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 with the model. This spray model was then adapted to a combustion model similar to that of Hiroyasu and co-workers. In the DME model, the chemical reactions were assumed to be much faster than the mixing related processes. Combustion rates calculated on the basis of the spray correlations were found to agree well with the experimentally observed combustion rates during the mixing controlled portions of the combustion in a naturally aspirated direct injection diesel engine.

  7. Storage ring injection

    International Nuclear Information System (INIS)

    Some basic issues involved in injecting the beam into storage rings with the principal parameters of those studied at the workshop have been considered. The main conclusion is that straightforward adjustments of the storage ring parameters makes injection easy. The largest number of injected turns is fourteen, and the phase space dilution allowance seems adequate to ensure very small beam loss during injection. The adjustments also result in lower bending magnet fields, and high field superconducting magnets (e.g., 5 Tesla) are not necessary. The design changes do not necessarily affect the Keil-Schnell criterion for stability of the longitudinal microwave instability, although that criterion appears to be irrelevant. Because the beams are expected to be unstable, but with slow growth rates, the vacuum chamber impedances required to give equal risetimes for the various designs are compared for systems posing various degrees of difficulty for injection. Finally, the impact of the parameters on cost is noted, and a system is considered that cuts the length of the linac in half by using doubly charged ions

  8. Normalisation of refractive error after steroid injection for adnexal haemangiomas.

    OpenAIRE

    Morrell, A. J.; Willshaw, H E

    1991-01-01

    A longitudinal study of 27 patients with infantile haemangiomas is reported. It confirmed the efficacy of local steroid injection as a method of treatment; 81.5% of patients showed a marked improvement, with the lesion reducing to 25% or less of its original size. Involution was most marked in the first two weeks but continued for up to four months after injection. Amblyopia was present in 43% of children and was usually the result of induced refractive error rather than obstruction of the vi...

  9. 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

    Scientific Electronic Library Online (English)

    Ana Paula Werneck de, Castro; Helio, Elkis.

    2007-09-01

    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.

  10. Efficacy of different DTPA treatment schedules for removal of 234Th from simulated wounds in rats

    International Nuclear Information System (INIS)

    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)

  11. Clinical evaluation of gadodiamide injection in paediatric MR imaging.

    Science.gov (United States)

    Hanquinet, S; Christophe, C; Greef, D D; Gordon, P; Perlmutter, N

    1996-11-01

    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. PMID:8929382

  12. Clinical evaluation of gadodiamide injection in paediatric MR imaging

    International Nuclear Information System (INIS)

    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

  13. Ocular inflammatory effects of intravitreally injected interleukin-2.

    Science.gov (United States)

    Samples, J R; Boney, R S; Rosenbaum, J T

    1993-07-01

    The primary, known physiologic effect of interleukin-2 (IL-2) is to act as a T lymphocyte growth factor. We investigated the potential contribution of IL-2 to intraocular inflammation by studying the inflammation resulting from the intravitreal injection of recombinant, human IL-2 in New Zealand white rabbits. Serial slit lamp observations indicated that 40 microgram of intravitreally injected IL-2 induced an anterior uveitis which was maximal 5 days after the injection. Inflammation was less marked but still significant with amounts of IL-2 as low as 400 ng. Direct examination of aqueous humor confirmed elevations of protein, prostaglandin E2, and mononuclear cells which correlated with the clinical observations. The kinetics of the response to intravitreal IL-2 distinguished it from the responses to other intravitreally injected cytokines such as interleukins 1, 6, or 8 as well as tumor necrosis factor. Intramuscular injection of cyclosporine A significantly reduced the protein extravasation associated with IL-2 injection, but cyclosporine had no effect on inflammation secondary to an intravitreal injection of interleukin-1. These observations implicate IL-2 as a potential contributor to uveitis. In addition, the studies with cyclosporine indicate the heterogeneity of inflammation such that pharmacologic agents which affect one cause of uveitis are not necessarily efficacious in another model. PMID:8222724

  14. Topiramate Versus Valproate Sodium as Adjunctive Therapies to a Combination of Lithium and Risperidone for Adolescents with Bipolar I Disorder: Effects on Weight and Serum Lipid Profiles

    Directory of Open Access Journals (Sweden)

    Javad Alaghband-Rad

    2012-04-01

    Full Text Available Objective: To compare the effects of topiramate versus valproate sodium as an add-on therapy to a combination of lithium and risperidone (Li+Ris on body weight and serum lipid profile in children and adolescents with bipolar disorder. Methods: In a single-blind randomized clinical trial, thirty children and adolescents with bipolar disorder type I in the manic or mixed phase ,treated with the combination of Li+Ris at therapeutic doses for at least 4 weeks who had the indication of add-on therapy due to a recurrent episode; a partial response or non response in the current episode or relapse were included. Participants were randomly assigned to receive either topiramate or sodium valproate as the third drug add-on therapy for a total of 6 weeks. Weight, height and serum lipid profiles were determined at baseline and at the end of week 6. Results: Differences in the mean levels of lipid profiles at baseline and after week 6 evaluation were not significant in both treatment groups. BMI z-score increased in both treatment groups, being significant only in the Li+Ris/Valproate group, increasing from (mean ±SD 0.38 ±0.55 to 0.72 ±1.23 (p<0.05. Between group changes in BMI z-score was not significant.Among the BMI percentile categories, participants in the normal weight subgroup showed a significant increase in BMI z-score during the 6 week trial, compared to overweight/obese subgroup, in both Li+Ris/Valproate and Li+Ris/Topiramate treatment groups. Elevated mean serum level of triglyceride and a high proportion of participants with elevated total cholesterol (? 170 mg/dl, triglyceride (? 110 mg/dl, and BMI percentile 85-<95 at baseline (before randomization and at the end of 6 week study were noted. Conclusion: When topiramate and valproate sodium are used for six weeks as adjunctive treatment to a combination of Li+Ris, they act alike on lipid milieu of children and adolescents with bipolar disorder. Both Li+Ris/Valproate and Li+Ris/Topiramate therapies can lead to an increase in BMI z-score. This increase is statistically significant with Li+Ris/Valproate therapy. This suggests that topiramate could attenuate the ongoing weight gain from lithium and risperidone .In this study, the majority of participants who gained weight were those with BMI less than 85th percentile. This suggests that normal weight patients may have greater weight gain potential than overweight/obese patients.High proportion of metabolic abnormalities among the patients at baseline, which remained elevated throughout the trial, warrants cardiometabolic monitoring in this population.

  15. Effect of photodynamic therapy (PDT), posterior subtenon injection of triamcinolone acetonide with PDT, and intravitreal injection of ranibizumab with PDT for retinal angiomatous proliferation

    OpenAIRE

    Negi A; Kita M; Oh H.; Honda S; Nakano S

    2012-01-01

    Saya Nakano1, Shigeru Honda1, Hideyasu Oh2, Mihori Kita2, Akira Negi11Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, 2Department of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, JapanBackground: The purpose of this work was to compare the efficacy of photodynamic therapy (PDT) with or without posterior subtenon injections of triamcinolone acetonide (STA) or intravitreal injections of ranibizumab (IVR) for retinal angiomat...

  16. Water Injected Turbomachinery

    Science.gov (United States)

    Hendricks, R. C.; Shouse, D. T.; Roquemore, W. M.

    2005-01-01

    From antiquity, water has been a source of cooling, lubrication, and power for energy transfer devices. More recent applications in gas turbines demonstrate an added facet, emissions control. Fogging gas turbine inlets or direct injection of water into gas turbine combustors, decreases NOx and increases power. Herein we demonstrate that injection of water into the air upstream of the combustor reduces NOx by factors up to three in a natural gas fueled Trapped Vortex Combustor (TVC) and up to two in a liquid JP-8 fueled (TVC) for a range in water/fuel and fuel/air ratios.

  17. Marble-burying is enhanced in 3xTg-AD mice, can be reversed by risperidone and it is modulable by handling.

    Science.gov (United States)

    Torres-Lista, Virginia; López-Pousa, Secundino; Giménez-Llort, Lydia

    2015-07-01

    Translational research on behavioural and psychological symptoms of dementia (BPSD) is relevant to the study the neuropsychiatric symptoms that strongly affect the quality of life of the human Alzheimer's disease (AD) patient and caregivers, frequently leading to early institutionalization. Among the ethological behavioural tests for rodents, marble burying is considered to model the spectrum of anxiety, psychotic and obsessive-compulsive like symptoms. The present work was aimed to study the behavioural interactions of 12 month-old male 3xTg-AD mice with small objects using the marble-burying test, as compared to the response elicited in age-matched non-transgenic (NTg) mice. The distinction of the classical 'number of buried marbles' but also those left 'intact' and those 'changed' of position of marbles or partially buried (the transitional level of interaction) provided new insights into the modelling of BPSD-like alterations in this AD model. The analysis revealed genotype differences in the behavioural patterns and predominant behaviors. In the NTg mice, predominance was shown in the 'changed or partially buried', while interactions with marble were enhanced in 3xTg-AD mice resulting in an increase of marble burying. Besides, genotype-dependent meaningful correlations were found, with the marble test pattern of 3xTg-AD mice being directly related to neophobia in the corner tests. In both genotypes, the increase of burying was reversed by chronic treatment with risperidone (1mg/kg, s.c.). In 3xTg-AD mice, the repetitive handling of animals during the treatment also exerted modulatory effects. These distinct patterns further characterize the modelling of BPSD-like symptoms in the 3xTg-AD mice, and provide another behavioural tool to assess the benefits of preventive and/or therapeutic strategies, as well as the potential action of risk factors for AD, in this animal model. PMID:25957954

  18. Il trattamento dei disturbi psicotici con olanzapina, risperidone e neurolettici tipici: una valutazione comparativa di costo/efficacia in una realtà psichiatrica locale

    Directory of Open Access Journals (Sweden)

    Egidio Filippelli

    2005-09-01

    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 didn’t 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.

  19. Efficacy of Enrofloxacin in a Mouse Model of Sepsis

    OpenAIRE

    Slate, Andrea R.; Bandyopadhyay, Sheila; Francis, Kevin P.; Papich, Mark G.; Karolewski, Brian; Hod, Eldad A.; Prestia, Kevin A.

    2014-01-01

    We examined the efficacy of enrofloxacin administered by 2 different routes in a mouse model of sepsis. Male CD1 mice were infected with a bioluminescent strain of enteropathogenic Escherichia coli and treated with enrofloxacin either by injection or in drinking water. Peak serum levels were evaluated by using HPLC. Mice were monitored for signs of clinical disease, and infections were monitored by using bioluminescence imaging. Serum levels of enrofloxacin and the active metabolite ciproflox...

  20. Efficacy of a nucleic acid free herpetic subunit vaccine

    International Nuclear Information System (INIS)

    The efficacy of immunization with an herpes simplex subunit vaccine, free of nucleic acid was evaluated in mice, rabbits and monkeys. One injection of 3?g per kg of body weight elicited both humoral and cell-mediated immunity in all the animals studied. Furthermore, the immunization reduced significantly the mortality to a subsequent challenge with live herpes simplex virus in mice and rabbits (p<0.01). (author)

  1. Methodology for the Randomised Injecting Opioid Treatment Trial (RIOTT: evaluating injectable methadone and injectable heroin treatment versus optimised oral methadone treatment in the UK

    Directory of Open Access Journals (Sweden)

    Byford Sarah

    2006-09-01

    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.

  2. INTERATHECAL INJECTION OF NEOSTIGMINE FOR POSTOPERATIVE PAIN REDUCTION

    OpenAIRE

    Abasi, H. R.; Hosseni, H.

    2000-01-01

    Background. Nowadays, important aim of surgical and anesthetic teams is removing of postoperative pain. One way for decreasing of postoperative pain is usage of interathecal injection of neostigmine. Neostigmine is an anticholinesterase drug to reverse the muscle relaxant effects. The main purpose of this study was evaluation the postoperative pain analgesic efficacy and safety of intrathecal neostigmine in patient undergoing below knee surgery with spinal anesthesia. Methods. In a clini...

  3. Evaluation of antimicrobial efficacy

    Directory of Open Access Journals (Sweden)

    Vijay.R

    2010-10-01

    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.

  4. Pellet injection in WVIIA

    International Nuclear Information System (INIS)

    The results of pellet injection experiments in the Wendelstein VII A stellarator are presented. The injector was a single shot pneumatic gun using deuterium pellets. Experiments were carried out in both ECRH and NI plasmas. Data is shown for plasma density, energy confinement, penetration depth and pellet ablation. Results are compared to a neutral gas shielding model

  5. Cefazolin Sodium Injection

    Science.gov (United States)

    Your doctor has ordered cefazolin, an antibiotic, to help treat your infection. The drug will be either injected into a large muscle (such as your ... 30 minutes, two to four times a day.Cefazolin eliminates bacteria that cause many kinds of infections, ...

  6. Cold water injection nozzles

    International Nuclear Information System (INIS)

    Purpose: To inject cold water in a reactor without applying heat cycles to a reactor container and to the inner wall of a feedwater nozzle by securing a perforated plate at the outlet of the cold water injection nozzle. Constitution: A disc-like cap is secured to the final end of a return nozzle of a control rod drive. The cap prevents the flow of a high temperature water flowing downward in the reactor from entering into the nozzle. The cap is perforated with a plurality of bore holes for injecting cold water into the reactor. The cap is made to about 100 mm in thickness so that the cold water passing through the bore holes is heated by the heat conduction in the cap. Accordingly, the flow of high temperature water flowing downwardly in the reactor is inhibited by the cap from backward flowing into the nozzle. Moreover, the flow of the cold water in the nozzle is controlled and rectified when passed through the bore holes in the cap and then injected into the reactor. (Yoshino, Y.)

  7. Split Injection Gas Chromatography

    Science.gov (United States)

    This animation site deals specifically with split injection in gas chromatography. The animations are short (one to two minutes each) and can easily be shown in class as part of a lecture. They are extremely helpful in illustrating key components and concepts of chromatographic systems. Users are encouraged to explore the site and the other brief animations as well.

  8. Radiotracer injections through microfilters

    International Nuclear Information System (INIS)

    Full text: Problems with the injection of radiotracers (99mTc-HAMS, 99mTc-DPD) to infants when administered through polar-filter-protected venous pathways caused us to get a closer look of what happens to a tracer in such a system. We simulated injections of the tracers mainly used at our institution in an in-vitro array and measured full and empty tracer syringes, filters (0.2 ?m micropores) and the post-filter receptacle of the radioactivity. We calculated the percentage of filter-trapped activity and of activity in the receptacle. For several tracers we repeated this process with a neutral filter of the same pore size to get a comparison between the behavior in polarized and electrically inert filters. In general injection of a soluble radiotracer through a polar filter system means a dose loss in the filter of about 10 %, up to the tracer molecule size of IgG-antibodies. Suspended tracers, which consist of comparatively large particles, like RES- or pulmonary perfusion markers, are blocked by the filter, as can be foreseen with a particle size of >> 0.2 ?m. DMSA and DPD (a biphosphonate), although both being soluble and rather small molecules, were blocked by the polar filter to a high extent, and by the neutral filter to a much lower, almost neglectable degree. The conclusions are: if possible avoid any use of a filter in your tracer injection pathway. Never use a filter with bone scan or DMSA applications. When doing uptake calculations you have to add the filter counts to the empty syringe value in the formula. If you cannot avoid to inject the radiotracer through a filter you have to replace the filter afterwards and treat the used filter as radioactive waste. The polarity of the filter material might severely affect retention of radiotracer in the filter. (author)

  9. Ultrasound-guided sacroiliac joint injection technique.

    LENUS (Irish Health Repository)

    Harmon, Dominic

    2008-07-01

    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.

  10. Effectiveness of long-acting injectable antipsychotics in delusional disorders with nonprominent hallucinations and without hallucinations.

    Science.gov (United States)

    González-Rodríguez, Alexandre; Molina-Andreu, Oriol; Penadés, Rafael; Bernardo, Miquel; Catalán, Rosa

    2014-05-01

    The presence of nonprominent hallucinations in delusional disorder (DD) has been accepted by the current Diagnostic and Statistical Manual of Mental Disorders, 5th ed. A recent meta-analysis revealed that patients with schizophrenia treated with long-acting atypical antipsychotics showed a significant improvement in psychotic symptoms. However, little research has been conducted on DD. Our goal was to investigate demographic and clinical differences between two subgroups of DD patients, those with nonprominent hallucinations and those without hallucinations, and to determine treatment effectiveness of long-acting antipsychotics in these patients. We conducted a longitudinal observational study with a 6-month follow-up period in a clinical group of 45 DD outpatients. Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale, and Hamilton Rating Scale for Depression-17 (HRSD-17) were used for assessment. Age at onset of DD, scores in baseline assessment scales, and drug compliance were included in the analysis as potential confounders. When uncorrected for influencing factors, patients treated with long-acting antipsychotics showed lower scores in PANSS positive and negative subscales. There were no statistically significant clinical subgroup×treatment group interactions for any of the scores in assessment scales at 6 months. After adjustment, patients treated with long-acting antipsychotics showed lower scores in the PANSS negative subscale and a tendency toward improvement in scores in the PANSS positive subscale. Our study suggests that risperidone long-acting injection and paliperidone palmitate long-acting injection may be useful in the treatment of DD patients, specifically those with nonprominent hallucinations. PMID:24681811

  11. Injection of Deuterium Pellets

    DEFF Research Database (Denmark)

    SØrensen, H.; Andersen, P.

    1984-01-01

    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.

  12. SPS injection kicker magnet

    CERN Multimedia

    1975-01-01

    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.

  13. Ceramic injection molding

    International Nuclear Information System (INIS)

    Interest in making complex net-shape ceramic parts with good surface finishing and sharp tolerances without machining is a driving force for studying the injection molding technique. This method consists of softhening the ceramic material by means of adding some plastic and heating in order to inject the mixture under pressure into a relatively cold mold where solidification takes place. Essentially, it is the same process used in thermoplastic industry but, in the present case, the ceramic powder load ranges between 80 to 90 wt.%. This work shows results obtained from the fabrication of pieces of different ceramic materials (alumina, barium titanate ferrites, etc.) in a small scale, using equipments developed and constructed in the laboratory. (Author)

  14. Intravitreal injection of perfluoropropane for the treatment of vitreomacular traction

    Directory of Open Access Journals (Sweden)

    Xiao-Ping Wan

    2013-07-01

    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.

  15. Spin injection into superconductors

    International Nuclear Information System (INIS)

    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)

  16. Epidural injections for back pain

    Science.gov (United States)

    ESI; Spinal injection for back pain; Back pain injection ... JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary ...

  17. Injection Therapies in Temporomandibular Region

    Directory of Open Access Journals (Sweden)

    Demirhan D?raço?lu

    2010-04-01

    Full Text Available The indications for injection therapies in temporomandibular joint (TMJ are myofascial pain syndrome, osteoarthritis of TMJ, non-reducing disc displacements, TMJ involvement of inflammatory diseases, bruxism, masseter hypertrophy, orofacial dystonia and trigeminal neuralgia. Intra-articular injections, local trigger point injections, dry needling, botulinum toxin injections, and ganglion blocks are frequently used in this region. The general complications of the injections are bleeding, infections, syncope, local or severe allergic reactions and anaphylaxis. In the TMJ region, similar with the other parts of the body, success of the injection therapies depends on correct patient sellection, attention to application rules, using the right and adequate injection technique, and regular follow-up of the patients together with exercise program in post-injection period.Turk J Phys Med Rehab 2010; 56 Suppl 1: 1-6.

  18. Flow Injection Analysis

    DEFF Research Database (Denmark)

    Hansen, Elo Harald

    2004-01-01

    This chapter provides an introduction to automated chemical analysis, which essentially can be divided into two groups: batch assays, where the solution is stationary while the container is moved through a number of stations where various unit operations performed; and continuous-flow procedures, 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 permits thr execution of novel and unique analytical procedures which are difficult or even impossible by conventional means. The performance and applicability of FIA, SI and LOV are illustrated by a series of practical examples.

  19. A randomised controlled comparison of injection, thermal, and mechanical endoscopic methods of haemostasis on mesenteric vessels

    OpenAIRE

    Hepworth, C; Kadirkamanathan, S; Gong, F; SWAIN, C

    1998-01-01

    Background and aims—A randomised controlled comparison of haemostatic efficacy of mechanical, injection, and thermal methods of haemostasis was undertaken using canine mesenteric vessels to test the hypothesis that mechanical methods of haemostasis are more effective in controlling haemorrhage than injection or thermal methods. The diameter of arteries in human bleeding ulcers measures up to 3.45 mm; mesenteric vessels up to 5 mm were therefore studied. ?Methods—Mesenteri...

  20. Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

    Directory of Open Access Journals (Sweden)

    Abiola Jesuloba

    2009-10-01

    Full Text Available Abstract Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale, length of response and duration of complications (breathiness, cough, dysphagia and total voice loss. Injections were performed under electromyography (EMG guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.

  1. Study on effects of an atypical antipsychotic, risperidone on regional cerebral blood flow with 99mTc-HMPAO SPECT in drug-naive and unmedicated schizophrenic patients

    International Nuclear Information System (INIS)

    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 su 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)

  2. Método analítico para la cuantificación y ensayo de disolución de risperidona tabletas 3 mg / Analytical method for quantification and dissolution essay of 3 mg tablets of Risperidone

    Scientific Electronic Library Online (English)

    Caridad Margarita, García Peña; Lissette, Martínez Miranda; Antonio, Iraizoz Barrios; Vivian, Martínez Espinosa; Matilde, Torres García; Gissel María, León Guerrero.

    2009-12-01

    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.

  3. Increasing the Efficacy of Oncolytic Adenovirus Vectors

    Directory of Open Access Journals (Sweden)

    William S. M. Wold

    2010-08-01

    Full Text Available Oncolytic adenovirus (Ad vectors present a new modality to treat cancer. These vectors attack tumors via replicating in and killing cancer cells. Upon completion of the vector replication cycle, the infected tumor cell lyses and releases progeny virions that are capable of infecting neighboring tumor cells. Repeated cycles of vector replication and cell lysis can destroy the tumor. Numerous Ad vectors have been generated and tested, some of them reaching human clinical trials. In 2005, the first oncolytic Ad was approved for the treatment of head-and-neck cancer by the Chinese FDA. Oncolytic Ads have been proven to be safe, with no serious adverse effects reported even when high doses of the vector were injected intravenously. The vectors demonstrated modest anti-tumor effect when applied as a single agent; their efficacy improved when they were combined with another modality. The efficacy of oncolytic Ads can be improved using various approaches, including vector design, delivery techniques, and ancillary treatment, which will be discussed in this review.

  4. Evidence based knee injections for the management of arthritis

    Science.gov (United States)

    Cheng, Olivia T.; Souzdalnitski, Dmitri; Vrooman, Bruce; Cheng, Jianguo

    2012-01-01

    Objective Arthritis of the knee affects 46 million Americans. We aimed to determine the level of evidence of intraarticular knee injections in the management of arthritic knee pain. Methods We systematically searched PUBMED/MEDLINE and the Cochrane databases for articles published on knee injections and evaluated their level of evidence and recommendations according to established criteria. Results The evidence supports the use of intraarticular corticosteroid injections for rheumatoid arthritis (1A+ level), osteoarthritis (1A+ level), and juvenile idiopathic arthritis (2C+ level). Pain relief and functional improvement are significant for months up to one year after the injection. Triamcinolone hexacetonide offers an advantage over triamcinolone acetonide and should be the intraarticular steroid of choice (2B+ level). Intraarticular injection of hyaluronate may provide longer pain relief than steroid injection in osteoarthritis (2B+ level). It can also be effective for rheumatoid arthritis knee pain (1A+ level). However, it is only recommended for patients with significant surgical risk factors and for patients with mild radiographic disease in whom conservative treatment has failed (2B± level). Botulinum toxin Type A injection is effective in reducing arthritic knee pain (2B+ level) and so is tropisetron (2B+ level) and tanezumab (2B+ level). The new agents, such as rAAV2-TNFR:Fc, SB-210396/CE 9.1, and various radioisotopes have provided various degrees of success, but their long-term safety and efficacy remains to be determined. Conclusions We conclude that strong evidence supports the use of intraarticular knee injection as a valuable intervention in the continuum of management of arthritis between conservative treatment and knee surgeries. PMID:22621287

  5. Efficient Spin Injection into Semiconductor

    International Nuclear Information System (INIS)

    Spintronic research has made tremendous progress nowadays for making future devices obtain extra advantages of low power, and faster and higher scalability compared to present electronic devices. A spintronic device is based on the transport of an electron's spin instead of charge. Efficient spin injection is one of the very important requirements for future spintronic devices. However, the effective spin injection is an exceedingly difficult task. In this paper, the importance of spin injection, basics of spin current and the essential requirements of spin injection are illustrated. The experimental technique of electrical spin injection into semiconductor is also discussed based on the experimental experience. The electrical spin injection can easily be implemented for spin injection into any semiconductor. (author)

  6. MKI UFOs at Injection

    CERN Document Server

    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

    2011-01-01

    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.

  7. Water injection dredging:

    OpenAIRE

    Verhagen , H.J.

    2000-01-01

    Some twenty years ago WIS-dredging has been developed in the Netherlands. By injecting water into the mud layer, the water content of the mud becomes higher, it becomes fluid mud and will start to flow. The advantages of this system are that there is no need of transporting the mud in a hopper, and no need for a pipeline. Also from an energetic point of view the solution is attractive. The system requires however a different way of payment. Most efficient is a maintenance contract with a dred...

  8. SQL Injection Defenses

    CERN Document Server

    Nystrom, Martin

    2007-01-01

    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

  9. Efficacy of radioiodine urinalysis

    International Nuclear Information System (INIS)

    Little exists in the literature to support the efficacy of urinalysis for demonstrating thyroid uptake of radioiodine. A review was made of a variety of kinetic models. Computer analysis and graphics were used to assess the variables in the two models chosen for this study. The applicability of each model was tested by using data obtained from a group of euthyroid subjects. The results indicate that using an integral urine-sampling method and a three-component model yields minimum detectable thyroid uptakes which fall well below required reporting limits. Furthermore, the results show that integral urine samples obtained in the first few hours post exposure may be used to predict major thyroid uptakes in time for effective thyroid blocking

  10. EVALUATION OF AEROSOL SPRAY AND INTRAMUSCULAR INJECTION OF BACTERIOPHAGE TO TREAT AN ESCHERICHIA COLI RESPIRATORY INFECTION

    Science.gov (United States)

    Bacteriophage are viruses that can be used to prevent and treat bacterial diseases, and reduce human foodborne pathogens on agricultural products. Two studies were conducted to determine the efficacy of either aerosol or intramuscular (im) injection of bacteriophage to treat an E. coli respiratory ...

  11. ENHANCED CONTACT OF COSOLVENT AND DNAPL IN POROUS MEDIA BY CONCURRENT INJECTION OF COSOLVENT AND AIR

    Science.gov (United States)

    Remediation of sites contaminated by dense nonaqueous phase liquids (DNAPLS) is a major environmental problem and cosolvent flooding is proposed as a remedial alternative. The efficacy of cosolvent flooding is a function of the degree of mixing between the injected remed...

  12. Transverse Injection Experiment

    International Nuclear Information System (INIS)

    The motion of a plasma stream injected transverse to a magnetic field has been discussed by several authors. In early experiments with the injection of a fast (50 to 70 cm/?sec) dense (1014 ion/cm3) plasma transverse to a magnetic field, a self polarization electric field was observed and the stream crossed the magnetic field with an E x B drift. The magnetic field was only slightly disturbed by the stream (| ?B/B | <0.1) while the drift across magnetic fields up to 5 kG was at approximately the velocity of the injected stream. The height of the stream in the direction of V x B is compressed as it drifts into high magnetic field regions. At the same time, electron density measurements using interferometry techniques with the He-Ne laser show that the transverse field up to 7 kG causes no appreciable spreading of the stream to take place in the direction of B. Of interest is the action of the stream as it crosses a region where magnetic field lines reverse direction about a field null line. As the stream proceeds across the separatrix between the two field line directions, the electric field must change direction if the stream drift is to continue. The stream halts in the region of the separatrix while large currents are measured along magnetic field lines connecting the front of the stream with the following portions. Insulators placed to interrupt the current allow the stream to proceed into the reversed field region. By making use of the inductance associated with the depolarization current when magnetic field lines are tied at some distance to the side of the stream, a separation of fast and slow stream components can be made. The cutoff of the slow stream component is observed with the He-Ne laser interferometry techniques. Electric field measurements at several points along the stream show some of the more complicated features of the plasma flow. (author)

  13. Effects of risperidone, clozapine and the 5-HT6 antagonist GSK-742457 on PCP-induced deficits in reversal learning in the two-lever operant task in male Sprague Dawley rats.

    Science.gov (United States)

    de Bruin, N M W J; van Drimmelen, M; Kops, M; van Elk, J; Wetering, M Middelveld-van de; Schwienbacher, I

    2013-05-01

    Reasoning and problem solving deficits have been reported in schizophrenic patients. In the present study, we have tested rats in a two-lever reversal learning task in a Skinner box to model these deficits. In other studies using the Skinner box, atypical antipsychotics fully reversed phencyclidine (PCP)-induced impairments in reversal learning which is in contrast to clinical observations where antipsychotics lack the ability to fully reverse cognitive deficits in schizophrenia. Therefore, it can be argued that the outcome of these tests may lack predictive value. In the present study, after training on a spatial discrimination between two levers, rats were exposed to a reversal of the previously learned stimulus-response contingency during 5 days. We first investigated the effects of sub-chronic treatment with the non-competitive N-methyl-d-aspartate (NMDA) antagonists dizocilpine (MK-801) and PCP on reversal learning and extinction in male Sprague Dawley rats. Subsequently, we studied the effects of different PCP treatment regimes. Then, we investigated whether the atypical antipsychotics risperidone and clozapine and the 5-hydroxytryptamine6 (5-HT6) antagonist GSK-742457 could reverse the PCP-induced deficits. All drugs were administered subcutaneously (s.c.). MK-801 did not impair reversal learning, while PCP (1.0 and 2.0 mg/kg) induced a clear deficit in reversal learning. Both compounds, however, disrupted extinction at all tested doses. Risperidone and clozapine were both ineffective in significantly ameliorating the PCP-induced deficit in reversal learning which fits well with the clinical observations. The lowest dose of clozapine (1.25 mg/kg) had an intermediate effect in ameliorating the deficit in reversal learning induced by PCP (not different from control or PCP-treated rats). The lowest dose of GSK-742457 (0.63 mg/kg) fully reversed the PCP-induced deficits while the higher dose (5.0 mg/kg) had an intermediate effect. PMID:23384714

  14. Validación del método analítico aplicable al estudio de estabilidad de risperidona solución oral 1 mg/mL / Validation of an analytical method applicable to study of 1 mg/mL oral Risperidone solution stability

    Scientific Electronic Library Online (English)

    Maikel, Abreu Álvarez; Caridad Margarita, García Peña; Lissette, Martínez Miranda; Adriana, Muñoz Cernada; Mirna, Fernández Cervera; Vivian, Martínez Espinosa.

    2010-09-01

    Full Text Available Se validó un método analítico por cromatografía líquida de alta resolución, aplicable al estudio de estabilidad de risperidona solución oral 1 mg/mL. El método analítico validado resultó lineal, preciso, específico y exacto. Se desarrolló el estudio de estabilidad de la solución oral de risperidona [...] 1 mg/mL y se determinó su fecha de vencimiento. 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 humedad y la temperatura; se realizó el análisis durante 3 meses. La formulación 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 indicaron que el producto mantiene los parámetros que determinan su calidad durante ese tiempo, y en los estudios acelerados no se observó degradación significativa (p> 0,05) del producto. Se estableció 2 años como fecha de vencimiento en las condiciones señaladas. Abstract in english 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 e [...] xpiry 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.

  15. Prime injections and quasipolarities

    OpenAIRE

    Octavio Alberto Agustín-Aquino

    2013-01-01

    Let $p$ be a prime number. Consider the injection\\[ \\iota:\\mathbb{Z}/n\\mathbb{Z}\\to\\mathbb{Z}/pn\\mathbb{Z}:x\\mapsto px, \\]and the elements $e^{u}.v:=(u,v)\\in \\mathbb{Z}/n\\mathbb{Z}\\rtimes \\mathbb{Z}/n\\mathbb{Z}^{\\times}$ and$e^{w}.r:=(w,r)\\in \\mathbb{Z}/pn \\mathbb{Z}\\rtimes \\mathbb{Z}/pn\\mathbb{Z}^{\\times}$. Suppose that $e^{u}.v\\in\\mathbb{Z}/n\\mathbb{Z}\\rtimes \\mathbb{Z}/n\\mathbb{Z}^{\\times}$ is seen as an automorphism of $\\mathbb{Z}/n\\mathbb{Z}$defined by $e^{u}.v(x)=vx+u$; then $e^{u}.v$...

  16. The perspectives of injection drug users regarding safer injecting education delivered through a supervised injecting facility

    Directory of Open Access Journals (Sweden)

    Wood Evan

    2008-10-01

    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.

  17. Nitrocobinamide, a new cyanide antidote that can be administered by intramuscular injection.

    Science.gov (United States)

    Chan, Adriano; Jiang, Jingjing; Fridman, Alla; Guo, Ling T; Shelton, G Diane; Liu, Ming-Tao; Green, Carol; Haushalter, Kristofer J; Patel, Hemal H; Lee, Jangwoen; Yoon, David; Burney, Tanya; Mukai, David; Mahon, Sari B; Brenner, Matthew; Pilz, Renate B; Boss, Gerry R

    2015-02-26

    Currently available cyanide antidotes must be given by intravenous injection over 5-10 min, making them ill-suited for treating many people in the field, as could occur in a major fire, an industrial accident, or a terrorist attack. These scenarios call for a drug that can be given quickly, e.g., by intramuscular injection. We have shown that aquohydroxocobinamide is a potent cyanide antidote in animal models of cyanide poisoning, but it is unstable in solution and poorly absorbed after intramuscular injection. Here we show that adding sodium nitrite to cobinamide yields a stable derivative (referred to as nitrocobinamide) that rescues cyanide-poisoned mice and rabbits when given by intramuscular injection. We also show that the efficacy of nitrocobinamide is markedly enhanced by coadministering sodium thiosulfate (reducing the total injected volume), and we calculate that ?1.4 mL each of nitrocobinamide and sodium thiosulfate should rescue a human from a lethal cyanide exposure. PMID:25650735

  18. Percutaneous ethanol injection therapy for neoplasms located on the surface of the liver.

    Science.gov (United States)

    Shiina, S; Tagawa, K; Unuma, T; Fujino, H; Uta, Y; Hata, Y; Niwa, Y; Shiratori, Y; Terano, A; Sugimoto, T

    1990-09-01

    There has been a reluctance to perform percutaneous ethanol injection therapy on lesions located on the surface of the liver because of the possibility of complications. We treated 16 lesions located on the surface of the liver in 14 patients by percutaneous ethanol injection and evaluated the complications and efficacy. Bleeding and seeding of malignant cells did not occur in any case. However, transient pain after injection of ethanol was more intense in these patients than in those whose lesions were not on the surface of the liver. Histopathologic examinations, imaging findings, and decrease in the serum alpha-fetoprotein levels showed that percutaneous ethanol injection was effective for tumors located on the surface of the liver. Our experience suggests that percutaneous ethanol injection can be performed safely even when lesions are located on the surface of the liver. PMID:1696779

  19. Injectable barriers for waste isolation

    International Nuclear Information System (INIS)

    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

  20. SQL Injection Attacks and Defense

    CERN Document Server

    Clarke, Justin

    2012-01-01

    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

  1. Modeling the effects of prior infection on vaccine efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Smith, D.J.; Forrest, S.; Ackley, D.H. [Univ. of New Mexico, Albuquerque, NM (United States). Dept. of Computer Science; Perelson, A.S. [Los Alamos National Lab., NM (United States)

    1997-11-01

    We performed computer simulations to study the effects of prior infection on vaccine efficacy. We injected three antigens sequentially. The first antigen, designated the prior, represented a prior infection or vaccination. The second antigen, the vaccine, represented a single component of the trivalent influenza vaccine. The third antigen, the epidemic, represented challenge by an epidemic strain. For a fixed vaccine to epidemic strain cross-reactivities to the vaccine and to the epidemic strains. We found that, for many cross-reactivities, vaccination, when it had been preceded by a prior infection, provided more protection than vaccination alone. However, at some cross-reactivities, the prior infection reduced protection by clearing the vaccine before it had the chance to produce protective memory. The cross-reactivities between the prior, vaccine and epidemic strains played a major role in determining vaccine efficacy. This work has applications to understanding vaccination against viruses such as influenza that are continually mutating.

  2. MR epidurography: distribution of injectate at caudal epidural injection

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Darra T. [Cappagh National Orthopedic Hospital, Dublin 11 (Ireland); St Paul' s Hospital, Department of Radiology, Vancouver, BC (Canada); Kavanagh, Eoin C.; Moynagh, Michael R.; Eustace, Stephen [Cappagh National Orthopedic Hospital, Dublin 11 (Ireland); Mater Misericordiae University Hospital, Dublin 7 (Ireland); Poynton, Ashley; Chan, Vikki O. [Cappagh National Orthopedic Hospital, Dublin 11 (Ireland)

    2014-08-02

    To (a) evaluate the feasibility of MR epidurography (MRE) and (b) assess the distribution of injectate using two different volumes at caudal epidural steroid injection. Twenty patients who were referred with symptomatic low back pain for caudal epidural steroid injection were assigned to have either 10 ml (9/20) or 20 ml (11/20) of injectate administered. Gadolinium was included in the injection. The patients proceeded to MRI where sagittal and coronal T1-weighted fat-saturated sequences were acquired and reviewed in the mid-sagittal and right and left parasagittal views at the level of the exit foramina. Gadolinium was observed at or above the L3/4 disc level in all 11 patients who received 20 ml (100 %), compared with only five of nine patients who received 10 ml (56 %). Injectate was seen to the L4 nerve root level in all 11 patients who received 20 ml (100 %) but only four out of nine patients who received 10 ml (44 %), not even reaching the L5 nerve root level in four further of these nine patients (44 %). Overall, there was a trend to visualize gadolinium at higher levels of the epidural space with higher volumes injected. Firstly, MR epidurography is a safe technique that allows excellent visualization of the distribution of gadolinium in the epidural space following injection via the caudal hiatus. Secondly, a volume of 10 ml is unlikely to treat L5/S1 disease in almost half of patients at caudal epidural steroid injection and at least 20 ml of injectate is likely required for any medication to reach the desired level. (orig.)

  3. MR epidurography: distribution of injectate at caudal epidural injection

    International Nuclear Information System (INIS)

    To (a) evaluate the feasibility of MR epidurography (MRE) and (b) assess the distribution of injectate using two different volumes at caudal epidural steroid injection. Twenty patients who were referred with symptomatic low back pain for caudal epidural steroid injection were assigned to have either 10 ml (9/20) or 20 ml (11/20) of injectate administered. Gadolinium was included in the injection. The patients proceeded to MRI where sagittal and coronal T1-weighted fat-saturated sequences were acquired and reviewed in the mid-sagittal and right and left parasagittal views at the level of the exit foramina. Gadolinium was observed at or above the L3/4 disc level in all 11 patients who received 20 ml (100 %), compared with only five of nine patients who received 10 ml (56 %). Injectate was seen to the L4 nerve root level in all 11 patients who received 20 ml (100 %) but only four out of nine patients who received 10 ml (44 %), not even reaching the L5 nerve root level in four further of these nine patients (44 %). Overall, there was a trend to visualize gadolinium at higher levels of the epidural space with higher volumes injected. Firstly, MR epidurography is a safe technique that allows excellent visualization of the distribution of gadolinium in the epidural space following injection via the caudal hiatus. Secondly, a volume of 10 ml is unlikely to treat L5/S1 disease in almost half of patients at caudal epidural steroid injection and at least 20 ml of injectate is likely required for any medication to reach the desired level. (orig.)

  4. 300 Area Uranium Stabilization Through Polyphosphate Injection: Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Vermeul, Vincent R.; Bjornstad, Bruce N.; Fritz, Brad G.; Fruchter, Jonathan S.; Mackley, Rob D.; Newcomer, Darrell R.; Mendoza, Donaldo P.; Rockhold, Mark L.; Wellman, Dawn M.; Williams, Mark D.

    2009-06-30

    The objective of the treatability test was to evaluate the efficacy of using polyphosphate injections to treat uranium-contaminated groundwater in situ. A test site consisting of an injection well and 15 monitoring wells was installed in the 300 Area near the process trenches that had previously received uranium-bearing effluents. This report summarizes the work on the polyphosphate injection project, including bench-scale laboratory studies, a field injection test, and the subsequent analysis and interpretation of the results. Previous laboratory tests have demonstrated that when a soluble form of polyphosphate is injected into uranium-bearing saturated porous media, immobilization of uranium occurs due to formation of an insoluble uranyl phosphate, autunite [Ca(UO2)2(PO4)2•nH2O]. These tests were conducted at conditions expected for the aquifer and used Hanford soils and groundwater containing very low concentrations of uranium (10-6 M). Because autunite sequesters uranium in the oxidized form U(VI) rather than forcing reduction to U(IV), the possibility of re-oxidation and subsequent re-mobilization is negated. Extensive testing demonstrated the very low solubility and slow dissolution kinetics of autunite. In addition to autunite, excess phosphorous may result in apatite mineral formation, which provides a long-term source of treatment capacity. Phosphate arrival response data indicate that, under site conditions, the polyphosphate amendment could be effectively distributed over a relatively large lateral extent, with wells located at a radial distance of 23 m (75 ft) reaching from between 40% and 60% of the injection concentration. Given these phosphate transport characteristics, direct treatment of uranium through the formation of uranyl-phosphate mineral phases (i.e., autunite) could likely be effectively implemented at full field scale. However, formation of calcium-phosphate mineral phases using the selected three-phase approach was problematic. Although amendment arrival response data indicate some degree of overlap between the reactive species and thus potential for the formation of calcium-phosphate mineral phases (i.e., apatite formation), the efficiency of this treatment approach was relatively poor. In general, uranium performance monitoring results support the hypothesis that limited long-term treatment capacity (i.e., apatite formation) was established during the injection test. Two separate overarching issues affect the efficacy of apatite remediation for uranium sequestration within the 300 Area: 1) the efficacy of apatite for sequestering uranium under the present geochemical and hydrodynamic conditions, and 2) the formation and emplacement of apatite via polyphosphate technology. In addition, the long-term stability of uranium sequestered via apatite is dependent on the chemical speciation of uranium, surface speciation of apatite, and the mechanism of retention, which is highly susceptible to dynamic geochemical conditions. It was expected that uranium sequestration in the presence of hydroxyapatite would occur by sorption and/or surface complexation until all surface sites have been depleted, but that the high carbonate concentrations in the 300 Area would act to inhibit the transformation of sorbed uranium to chernikovite and/or autunite. Adsorption of uranium by apatite was never considered a viable approach for in situ uranium sequestration in and of itself, because by definition, this is a reversible reaction. The efficacy of uranium sequestration by apatite assumes that the adsorbed uranium would subsequently convert to autunite, or other stable uranium phases. Because this appears to not be the case in the 300 Area aquifer, even in locations near the river, apatite may have limited efficacy for the retention and long-term immobilization of uranium at the 300 Area site..

  5. A study to evaluate the field efficacy of ivermectin, fenbendazole and pyrantel pamoate, with preliminary observations on the efficacy of doramectin, as anthelmintics in horses

    OpenAIRE

    Davies, J.A.; L.M.J. Schwalbach

    2012-01-01

    The efficacy of ivermectin, fenbendazole, pyrantel pamoate and doramectin was evaluated under field conditions at 2 sites in the Free State Province of South Africa. The study involved 25 horses at each site, divided into 5 groups of equal size. Ivermectin, fenbendazole and pyrantel pamoate were administered orally at doses of 0.2, 10 and 19 mg/kg respectively. Doramectin was administered by intramuscular injection at a dose of 0.2 mg/kg. Treatment efficacy was based on the mean faecal egg co...

  6. Towards spin injection into silicon

    Energy Technology Data Exchange (ETDEWEB)

    Dash, S.P.

    2007-08-15

    Si has been studied for the purpose of spin injection extensively in this thesis. Three different concepts for spin injection into Si have been addressed: (1) spin injection through a ferromagnet-Si Schottky contact, (2) spin injection using MgO tunnel barriers in between the ferromagnet and Si, and (3) spin injection from Mn-doped Si (DMS) as spin aligner. (1) FM-Si Schottky contact for spin injection: To be able to improve the interface qualities one needs to understand the atomic processes involved in the formation of silicide phases. In order to obtain more detailed insight into the formation of such phases the initial stages of growth of Co and Fe were studied in situ by HRBS with monolayer depth resolution.(2) MgO tunnel barrier for spin injection into Si: The fabrication and characterization of ultra-thin crystalline MgO tunnel barriers on Si (100) was presented. (3) Mn doped Si for spin injection: Si-based diluted magnetic semiconductor samples were prepared by doping Si with Mn by two different methods i) by Mn ion implantation and ii) by in-diffusion of Mn atoms (solid state growth). (orig.)

  7. ISA ''split pole'' injection magnet

    International Nuclear Information System (INIS)

    The conceptual design for a shutterless ''split pole'' vertical deflecting dipole magnet for ISA beam injection is presented. Preliminary results of field mesh calculations are given together with measured data for a simple dc model. The results warrant proceeding with the further design and construction of a fast pulsed ferrite vertical injection kicker model for the ISA

  8. Obesity and hormonal contraceptive efficacy

    OpenAIRE

    Robinson, Jennifer A.; Burke, Anne E.

    2013-01-01

    Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating alter...

  9. A Network Pharmacology Approach to Evaluating the Efficacy of Chinese Medicine Using Genome-Wide Transcriptional Expression Data

    OpenAIRE

    Leihong Wu; Yi Wang; Jing Nie; Xiaohui Fan; Yiyu Cheng

    2013-01-01

    The research of multicomponent drugs, such as in Chinese Medicine, on both mechanism dissection and drug discovery is challenging, especially the approaches to systematically evaluating the efficacy at a molecular level. Here, we presented a network pharmacology-based approach to evaluating the efficacy of multicomponent drugs by genome-wide transcriptional expression data and applied it to Shenmai injection (SHENMAI), a widely used Chinese Medicine composed of red ginseng (RG) and Radix Ophi...

  10. CT guided diagnostic foot injections

    International Nuclear Information System (INIS)

    AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy

  11. SNS Injection Foil Experience

    International Nuclear Information System (INIS)

    The Spallation Neutron Source comprises a 1 GeV, 1.4 MW linear accelerator followed by an accumulator ring and a liquid mercury target. To manage the beam loss caused by the H0 excited states created during the H charge exchange injection into the accumulator ring, the stripper foil is located inside one of the chicane dipoles. This has some interesting consequences that were not fully appreciated until the beam power reached about 840 kW. One consequence was sudden failure of the stripper foil system due to convoy electrons stripped from the incoming H beam, which circled around to strike the foil bracket and cause bracket failure. Another consequence is that convoy electrons can reflect back up from the electron catcher and strike the foil and bracket. An additional contributor to foil system failure is vacuum breakdown due to the charge developed on the foil by secondary electron emission. In this paper we will detail these and other interesting failure mechanisms, and describe the improvements we have made to mitigate them.

  12. Neutron particle injection device

    International Nuclear Information System (INIS)

    In a neutron particle injection device, neutralized cells are provided as an assembly of unit neutralized cells having the cross sectional area corresponding to the cross sectional area of unit electrode of an ion source. Further, the neutralized cells are caused to correspond to the position of the unit electrode of the ion source, to be provided as plasma neutralized cells, and a high frequency plasma excitation means is used. A plurality of aluminum alloy plates are used between the outer and the inner walls of the unit neutralized cells, a magnetic field generation means is disposed between plate members for confining plasmas, and boron water as coolants is caused to flow. Then, the cross sectional area is reduced, a gas efficiency is improved, filaments for arc discharge is no more necessary, and a maintenance period can be extended. Further, generation of induced radioactivity caused by generated neutrons is reduced, neutrons are absorbed by flowing the boron water to a coolant flow channel, then the radioactive boron water is discharged upon shut down of operation, thereby enabling to reduce remaining induced radioactivity level. (N.H.)

  13. The RHIC injection kicker

    International Nuclear Information System (INIS)

    Beam transfer from the AGS to RHIC is performed in single-bunch mode. Close spacing of the bunches in the collider requires an injection kicker with a rise time of <90 nsec, suggesting adoption of a travelling wave structure. The required vertical kick of 0.186 t·m is provided by 4 magnets, each 1.12 m long with a 48.4 x 48.4 mm aperture and operated at 1.6 kA. The kicker is constructed as a open-quotes Cclose quotes cross section magnet, in which ferrite and high-permittivity dielectric sections alternate. The dielectric blocks provide the capacity necessary for the nominally 25 ? characteristic impedance of the travelling wave structure, but impose the practical limit on the peak voltage, and thus current, achievable. Computer studies to minimize local electric field enhancements resulted in a configuration capable of holding ? 50 kV, with adequate safety margin over the nominal 40 kV. Equivalent circuit analysis indicated the possibility of lowering the nominal voltage by operating mismatched into 20 ? terminations without degrading the pulse shape. In this paper, the experience gained in the fabrication of the production units and the results from various single-unit tests and operation of four kickers with beam in the open-quotes Sextant Testclose quotes are reported

  14. Injection, injectivity and injectability in geothermal operations: problems and possible solutions. Phase I. Definition of the problems

    Energy Technology Data Exchange (ETDEWEB)

    Vetter, O.J.; Crichlow, H.B.

    1979-02-14

    The following topics are covered: thermodynamic instability of brine, injectivity loss during regular production and injection operations, injectivity loss caused by measures other than regular operations, heat mining and associated reservoir problems in reinjection, pressure maintenance through imported make-up water, suggested solutions to injection problems, and suggested solutions to injection problems: remedial and stimulation measures. (MHR)

  15. Assessment of self-injection experience in patients with rheumatoid arthritis: psychometric validation of the Self-Injection Assessment Questionnaire (SIAQ

    Directory of Open Access Journals (Sweden)

    Keininger Dorothy

    2011-01-01

    Full Text Available Abstract Background Subcutaneous self-injection of medication has benefits for the patient and healthcare system, but there are barriers such as dexterity problems and injection anxiety that can prevent self-injection being used effectively. An accurate method of evaluating patients' experiences with self-injection would enable assessment of their success in giving self-injections and the likelihood of them adhering to a self-injection regimen. The aim of this study was to develop a questionnaire to measure overall patient experience with subcutaneous self-injection (the Self-Injection Assessment Questionnaire [SIAQ], and to investigate its psychometric properties. Methods The construct validity and reliability of the SIAQ were tested in patients with rheumatoid arthritis who volunteered to inject certolizumab pegol using a standard syringe during an open-label multinational extension trial of the long-term safety and efficacy of this drug. The SIAQ PRE module was self-completed before the first self-injection, and the POST module was self-completed following each of three fortnightly self-injections. Results Ninety-seven patients completed the SIAQ. All items correlated well with their respective domains in confirmatory factor analysis. As predicted, compared with other participants, patients with very low scores (less than 3 out of 10 in PRE causal domains (Feelings about injections and Self-confidence were significantly less satisfied with their first self-injection, as were patients with a very low score in any POST causal domain (Self-confidence, Feelings about injections, Injection-site reactions and Ease of use, demonstrating known-groups validity. Causal domain scores generally correlated most strongly with the Satisfaction with self-injection domain, supporting convergent validity. The SIAQ demonstrated internal consistency and reproducibility; Cronbach's ? and the test-retest coefficient were > 0.70 for all domains. Sensitivity and responsiveness were also shown, where measurable. Each language version showed structural validity. Conclusion The SIAQ was demonstrated to be a valid, reliable tool in patients with rheumatoid arthritis.

  16. Optimization of injection law for direct injection diesel engine

    International Nuclear Information System (INIS)

    This paper describes how different timing and shape of the injection law can influence pollutant emission of a direct injection diesel engine. The study was carried out making use of a multizone thermodynamic model as regards the closed valve phase, and a filling-emptying one as regards the open valve phase. After being calibrated by comparison with experimental data, the abovementioned model was used for injection law optimization as regards minimum pollutant concentration (NOx and soot) in the exhaust gases with the smallest engine performance reduction possible

  17. Relief of palatal injection pain by liposome-encapsulated 2% lignocaine prepared by ultrasonic dental scaler.

    Science.gov (United States)

    Paphangkorakit, Jarin; Sangsirinakagul, Chaichan; Priprem, Aroonsri

    2012-12-01

    Injections into the palate are common in dental treatment and are unpleasant for the patient. A liposomal encapsulation technique was developed to improve the efficacy of 2% lignocaine dental injection so that it could be used as a topical anaesthetic. Liposome-encapsulated 2% lignocaine was prepared as needed by sonicating 2% lignocaine hydrochloride dental injection (with 1:100,000 adrenaline) with a lipid mixture using a dental ultrasonic scaler for 1 min. The time to onset and time to take effect were calculated by a pinprick test in the palatal mucosa in 10 normal subjects. In another experiment, the preparation was tested in a further 22 subjects for its pain-relieving effect during a standard palatal injection, and compared with 18% benzocaine/2% tetracaine gel. The results showed that the mean (SD) time to onset and time to take effect of the liposome-encapsulated 2% lignocaine were 39.0 (21.4) and 157.5 (2.3)s, respectively, and the mean (SD) pain score measured on a visual analogue scale (VAS) during injection was 4.1 (2.3)cm. After the application of the gel the corresponding measurement was 4.8 (2.8)cm (p=0.045). The encapsulation of 2% lignocaine dental injection in liposomes by a dental ultrasonic scaler was effective in improving the efficacy of the anaesthetic for topical application. PMID:22277697

  18. Management of Tennis Elbow with sodium hyaluronate periarticular injections

    Directory of Open Access Journals (Sweden)

    Petrella Robert J

    2010-02-01

    Full Text Available Abstract Objectives To determine the efficacy and safety of peri-articular hyaluronic acid injections in chronic lateral epicondylosis (tennis elbow. Design Prospective randomized clinical trial in primary care sport medicine. Patients Three hundred and thirty one consecutive competitive racquette sport athletes with chronic (>3 months lateral epicondylosis were administered 2 injections (first injection at baseline into the subcutaneous tissue and muscle 1 cm. from the lateral epicondyle toward the primary point of pain using a two-dimensional fanning technique. A second injection was administered 1 week later. Outcomes measures Assessments were done at baseline, days 7, 14, 30, 90 and 356. Efficacy measures included patient's visual analogue scale (VAS of pain at rest (0-100 mm and following assessment of grip strength (0-100 mm. Grip strength was determined using a jamar hydraulic hand dynamometer. Other assessments included patients' global assessment of elbow injury (5 point categorical scale; 1 = no disability, 5 = maximal disability, patients' assessment of normal function/activity (5 point categorical scale, patients/physician satisfaction assessment (10 point categorical scale, time to return to pain-free and disability-free sport and adverse events as per WHO definition. Differences between groups were determined using an intent-to-treat ANOVA. Results Average age of the study population was 49 years (± 12 years. One hundred and sixty-five patients were randomized to the HA and 166 were randomized to the control groups. The change in VAS pain was -6.7 (± 2.0 for HA vs -1.3 (± 1.5 for control (p Conclusion Peri-articular HA treatment for tennis elbow was significantly better than control in improving pain at rest and after maximal grip testing. Further, HA treatment was highly satisfactory by patients and physicians and resulted in better return to pain free sport compared to control.

  19. HIV vaccine trial willingness among injection and non-injection drug users in two urban centres, Barcelona and San Francisco.

    Science.gov (United States)

    Etcheverry, M Florencia; Lum, Paula J; Evans, Jennifer L; Sanchez, Emilia; de Lazzari, Elisa; Mendez-Arancibia, Eva; Sierra, Ernesto; Gatell, José M; Page, Kimberly; Joseph, Joan

    2011-02-24

    Being able to recruit high-risk volunteers who are also willing to consider future participation in vaccine trials are critical features of vaccine preparedness studies. We described data from two cohorts of injection- and non-injection drug users in Barcelona, Spain [Red Cross centre] and in San Francisco, USA, [UFO-VAX study] at high risk of HIV/HCV infection to assess behaviour risk exposure and willingness to participate in future preventive HIV vaccine trials. We successfully identified drug-using populations that would be eligible for future HIV vaccine efficacy trials, based on reported levels of risk during screening and high levels of willingness to participate. In both groups, Red Cross and UFO-VAX respectively, HCV infection was highly prevalent at baseline (41% and 34%), HIV baseline seroprevalence was 4.2% and 1.5%, and high levels of willingness were seen (83% and 78%). PMID:21241735

  20. Intrapelvic obturator internus muscle injections: a novel fluoroscopic technique.

    Science.gov (United States)

    Valovska, Assia; Zaccagnino, Michael P; Weaver, Michael J; Valovski, Ivan; Kaye, Alan David; Urman, Richard D

    2015-01-01

    The obturator internus (OI) muscle is important in adult chronic noninfectious pelvic, perineal, gluteal, and retrotrochanteric pain syndromes. Evaluation and management of these patients' pain can be challenging because of the complex anatomy of this region, broad differential diagnosis, and lack of specific physical examination findings. Consequently, several clinicians have advocated the use of image guided injections to assist in the accurate diagnosis of OI-related symptoms and provide symptomatic relief to affected patients. We present 2 case series describing a novel fluoroscopically guided contrast controlled transpectineal approach to intrapelvic OI injections. Unlike prior fluoroscopically guided OI injection techniques, the approach described in the present 2 cases utilized multiple standard pelvic views, thus facilitating optimal needle positioning in three-dimensional space. This technique utilized standard fluoroscopic pelvic views to accurately measure needle depth within the pelvic cavity permitting the bulk of the OI to be injected in a controlled and safe fashion. The first patient underwent a left intrapelvic OI muscle injection with bupivacaine 0.25% and 40 mg methylprednisolone. The average pre- and postprocedural visual analog pain scale scores were 5 out of 10 and 2 out of 10, respectively, with a self-reported 75% pain reduction. The second patient underwent a right intrapelvic OI muscle injection with bupivacaine 0.25% and 40 mg methylprednisolone. The average pre- and postprocedural visual analog scale scores were 8 out of 10 and 1 out of 10, respectively, with a self-reported 90% pain reduction. Larger scale studies should be undertaken to evaluate the therapeutic efficacy and generalized accuracy of this technique. PMID:25794225

  1. Transforaminal epidural steroid injection via a preganglionic approach for lumbar spinal stenosis and lumbar discogenic pain with radiculopathy

    OpenAIRE

    Kabatas Serdar; Cansever Tufan; Yilmaz Cem; Kocyigit Ozgen; Coskun Evrim; Demircay Emre; Akar Aykan; Caner Hakan

    2010-01-01

    Background: Epidural steroid injection (ESIs) is one of the treatment modalities for chronic low back pain (CLBP) with various degrees of success. Aim: We analyzed the efficacy of fluoroscopically guided transforaminal epidural steroid injections (TFESIs) via a preganglionic approach in patients with foraminal stenosis due to lumbar spinal stenosis and lumbar discogenic pain with radiculopathy. Materials and Methods: We analyzed the data of 40 patients (February 2008 and April 2009) with...

  2. A Controlled, Evidence-Based Trial of Paliperidone Palmitate, A Long-Acting Injectable Antipsychotic, in Schizophrenia

    OpenAIRE

    Nasrallah, Henry A.; Gopal, Srihari; Gassmann-mayer, Cristiana; Quiroz, Jorge A.; Lim, Pilar; Eerdekens, Marie?lle; Yuen, Eric; Hough, David

    2010-01-01

    Paliperidone palmitate is a long-acting injectable antipsychotic agent. This 13-week, multicenter, randomized (1?:?1?:?1?:?1), double-blind, parallel-group study evaluated the efficacy, safety, and tolerability of fixed 25, 50, and 100?milligram equivalent (mg equiv.) doses of paliperidone palmitate vs placebo administered as gluteal injections on days 1 and 8, then every 4 weeks (days 36 and 64) in 518 adult patients with schizophrenia. The intent-to-treat analysis set (N=514) ...

  3. Ceramic injection molding material analysis, modeling and injection molding simulation

    Science.gov (United States)

    Drummer, D.; Messingschlager, S.

    2014-05-01

    In comparison to unfilled polymers, a ceramic feedstocks has a very high viscosity, a very high heat conductivity and a different pvT-behavior. So far standard simulation tools for plastic injection molding are capable of simulating unfilled or fiber filled compounds with their typical low viscosity and heat conductivity etc. but not for very high ceramic powder filled polymers. This article shows an approach of preparing and adding ceramic feedstocks to standard injection molding tools. Two different feedstocks are used.

  4. Injection nozzle for a turbomachine

    Science.gov (United States)

    Uhm, Jong Ho; Johnson, Thomas Edward; Kim, Kwanwoo

    2012-09-11

    A turbomachine includes a compressor, a combustor operatively connected to the compressor, an end cover mounted to the combustor, and an injection nozzle assembly operatively connected to the combustor. The injection nozzle assembly includes a first end portion that extends to a second end portion, and a plurality of tube elements provided at the second end portion. Each of the plurality of tube elements defining a fluid passage includes a body having a first end section that extends to a second end section. The second end section projects beyond the second end portion of the injection nozzle assembly.

  5. Intravitreal injection with ranibizumab combined with triamcinolone acetonide sub-Tenon injection for macular edema due to CRVO

    Directory of Open Access Journals (Sweden)

    Ting-Ting Li

    2015-01-01

    Full Text Available AIM: To evaluate the efficacy of intravitreal injection with Ranibizumab combined with sub-Tenon injection with Triamcinolone acetonide(TAfor macular edema(MEdue to central retinal venous occlusions(CRVO.METHODS:Forty-six patients(46 eyeswere diagnosed ischemic CRVO with significant macular edema by fundus fluorescence-angiography(FFAand optical coherence tomography(OCT. All the patients had panretinal photocoagulation(PRP, a week after the four times therapies. Twenty-three patients(23 eyesin group A were randomly chosen to receive intravitreal injection with ranibizumab(IVR, another 23 patients(23 eyesin group B to treat with both IVR and sub-Tenon injection with TA(PSTT. There was no significant difference on macular edema and best corrected visual activity(BCVAbetween the two groups. The changes in BCVA and central macular thickness(CMTbefore and 1wk; 1, 3, 6mo after treatments were analyzed.RESULTS: One week after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B(PPPPPP>0.05.CONCLUSION: Not only IVR can decrease ME caused by CRVO and increase the BCVA, but also IVR combined with PSTT can. But combined therapies can be more rapidly and have more positive effect on decreasing the ME and protecting the visual function.

  6. Adaptive engine injection for emissions reduction

    Science.gov (United States)

    Reitz, Rolf D. (Madison, WI): Sun, Yong (Madison, WI)

    2008-12-16

    NOx and soot emissions from internal combustion engines, and in particular compression ignition (diesel) engines, are reduced by varying fuel injection timing, fuel injection pressure, and injected fuel volume between low and greater engine loads. At low loads, fuel is injected during one or more low-pressure injections occurring at low injection pressures between the start of the intake stroke and approximately 40 degrees before top dead center during the compression stroke. At higher loads, similar injections are used early in each combustion cycle, in addition to later injections which preferably occur between about 90 degrees before top dead center during the compression stroke, and about 90 degrees after top dead center during the expansion stroke (and which most preferably begin at or closely adjacent the end of the compression stroke). These later injections have higher injection pressure, and also lower injected fuel volume, than the earlier injections.

  7. Efectividad y seguridad de la viscosuplementación con dosis única de ácido hialurónico estabilizado de origen no animal (NASHA) para el tratamiento del dolor secundario a gonartrosis / Efficacy and safety of single intra-articular injection of non-animal stabilized hyaluronic acid (NASHA) for gonarthrosis pain treatment

    Scientific Electronic Library Online (English)

    M. M., Monerris Tabasco; I., Martí Acebedo; G., Roca Amatria; R. M., Rincón Párraga; M., Hinojosa Zaguirre; Y., Jiménez Capel; D., Samper Bernal.

    2012-10-01

    Full Text Available Objetivos: valorar la efectividad y seguridad de la inyección de dosis única de ácido hialurónico estabilizado de origen no animal (NASHA) para el tratamiento del dolor secundario a gonartrosis. Material y métodos: se han incluido un total de 37 pacientes afectos de gonartrosis diagnosticada previam [...] ente por el Traumatólogo/Reumatólogo en los que ha fracasado el tratamiento conservador y/o que no son tributarios de tratamiento quirúrgico. Se les ha efectuado una infiltración en dosis única de ácido hialurónico estabilizado no animal (NASHA), Durolane®. Se han recogido datos demográficos, efectos adversos e intensidad del dolor (valorada mediante escala verbal numérica) y puntuación en los cuestionarios Western Ontario and McMaster Universities Osteoartritis Index (WOMAC) y Barthel -basal, a las 2 semanas, a los 3 meses y a los 6 meses de la infiltración-. Se ha considerado efectiva una disminución ? 30% durante más de 3 meses en las puntuaciones basales. Resultados: los pacientes son mayoritariamente mujeres (83,8%), con una edad media de 72,8 años (desviación típica -S- = 8,4) e índice de masa corporal medio (IMC) 31,9 (S = 6,9). La rodilla infiltrada es izquierda en el 51,7%, derecha en el 41,4% y bilateral en el 6,9% de los pacientes. Han presentado efectos adversos en forma de artralgias bien toleradas el 11,1% de los pacientes. En base a los resultados, la infiltración con dosis única de ácido hialurónico estabilizado de origen no animal (NASHA) por gonalgia de origen artrósico provoca una reducción estadísticamente significativa en la intensidad del dolor (escala verbal numérica y WOMAC) y de la capacidad funcional (WOMAC) en todos los intervalos valorados. Se ha producido una reducción ? 30% en la intensidad del dolor en el 54% (valor que coincide con la reducción en la puntuación WOMAC de dolor), en la rigidez en el 62,1% y en la capacidad funcional en el 48,6% de los pacientes. Conclusiones: en nuestros pacientes, la viscosuplementación intrarticular con dosis única de ácido hialurónico estabilizado de origen no animal (NASHA, Durolane®) para el tratamiento del dolor secundario a gonartrosis ha resultado efectiva y segura y supone un arma más para el manejo del dolor y la invalidez que genera la gonartrosis. Abstract in english Objective: to evaluate the effectiveness and safety of single-dose injection of stabilized hyaluronic acid of non-animal origin (NASHA) for the treatment of pain related to knee osteoarthritis. Material and methods: we included a total of 37 patients with previously diagnosed gonarthritis by the Ort [...] hopedist/Rheumatologist in which conservative treatment has failed and/or who are not candidates for surgery. They carried out a single-dose injection of non-animal stabilized hyaluronic acid (Durolane®). We collected demographic data, adverse effects and pain intensity (assessed by verbal numeric scale) and scores on the questionnaires Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Barthel -baseline, at 2 weeks, at 3 months and 6 months of infiltration-. It has been considered effective a decrease ? 30% for more than 3 months at baseline scores. Results: patients are predominantly female (83.8%) with a mean age of 72.8 years (standard deviation = -S-8.4) and mean body mass index (BMI) 31.9 (S = 6.9). The left knee is infiltrated in 51.7%, 41.4% right and bilateral in 6.9% of patients. Adverse effects have occurred as well tolerated arthralgia 11.1% of patients. Based on the results, the infiltration with single dose of stabilized hyaluronic acid of non-animal origin for osteoarthritic source gonalgia caused a statistically significant reduction in pain intensity (numerical verbal scale and WOMAC) and functional capacity (WOMAC) at all measured intervals. There has been a ? 30% reduction in pain intensity in 54% (value that matches the reduction in WOMAC pain score) in 62.1% stiffness and functional capacity in 48.6% of patients. Conclusion: in our patients, intra-articular viscosupplem

  8. Betti numbers and injectivity radii

    CERN Document Server

    Culler, Marc

    2009-01-01

    We give lower bounds on the maximal injectivity radius for a closed orientable hyperbolic 3-manifold M with first Betti number 2, under some additional topological hypotheses. A corollary of the main result is that if M has first Betti number 2 and contains no fibroid surface then its maximal injectivity radius exceeds 0.32798. For comparison, Andrew Przeworski showed, with no topological restrictions, that the maximal injectivity radius exceeds arcsinh(1/4) = 0.247..., while the authors showed that if M has first Betti number at least 3 then the maximal injectivity exceeds log(3)/2 = 0.549.... The proof combines a result due to Przeworski with techniques developed by the authors in the 1990s.

  9. Powder co-injection moulding

    OpenAIRE

    Hanson, S. M. J.

    2000-01-01

    A novel powder processing technique has been developed by combining conventional powder injection moulding with polymer co-injection moulding, to permit the in-situ surface engineering of metal or ceramic components as an integral step within the processing cycle. The new technique has been used to produce surface engineered iron based components with either corrosion resistant or wear resistant surfaces, and to produce alumina based components with toughened surfaces. Th...

  10. ITER Neutral Beam Injection System

    International Nuclear Information System (INIS)

    A Japanese design proposal of the ITER Neutral Beam Injection System (NBS) which is consistent with the ITER common design requirements is described. The injection system is required to deliver a neutral deuterium beam of 75MW at 1.3MeV to the reactor plasma and utilized not only for plasma heating but also for current drive and current profile control. The injection system is composed of 9 modules, each of which is designed so as to inject a 1.3MeV, 10MW neutral beam. The most important point in the design is that the injection system is based on the utilization of a cesium-seeded volume negative ion source which can produce an intense negative ion beam with high current density at a low source operating pressure. The design value of the source is based on the experimental values achieved at JAERI. The utilization of the cesium-seeded volume source is essential to the design of an efficient and compact neutral beam injection system which satisfies the ITER common design requirements. The critical components to realize this design are the 1.3MeV, 17A electrostatic accelerator and the high voltage DC acceleration power supply, whose performances must be demonstrated prior to the construction of ITER NBI system. (author)

  11. Are There Enough Injective Sets?

    CERN Document Server

    Aczel, Peter; Granstroem, Johan; Schuster, Peter

    2011-01-01

    The axiom of choice ensures precisely that, in ZFC, every set is projective: that is, a projective object in the category of sets. In constructive ZF (CZF) the existence of enough projective sets has been discussed as an additional axiom taken from the interpretation of CZF in Martin-Loef's intuitionistic type theory. On the other hand, every non-empty set is injective in classical ZF, which argument fails to work in CZF. The aim of this paper is to shed some light on the problem whether there are (enough) injective sets in CZF. We show that no two element set is injective unless the law of excluded middle is admitted for negated formulas, and that the axiom of power set is required for proving that there are strongly enough injective sets. The latter notion is abstracted from the singleton embedding into the power set, which ensures enough injectives both in every topos and in IZF. We further show that it is consistent with CZF to assume that the only injective sets are the singletons. In particular, assumin...

  12. Injection and extraction for cyclotrons

    International Nuclear Information System (INIS)

    External ion sources for cyclotrons are needed for polarised and heavy ions. This calls for injection systems, either radial or axial. Radial injection is also needed when a cyclotron works as a booster after another cyclotron or a linear accelerator (usually tandem). Requirements for injection differ from separated sector cyclotrons where there is plenty of room to house inflectors and/or strippers, to superconducting cyclotrons where the space is limited by a small magnet gap, and high magnetic field puts other limitations to the inflectors. Several extraction schemes are used in cyclotrons. Stripping injection is used for H- and also for heavy ions where the q/m ratio is usually doubled. For other cases, electric and magnetic deflection has to be used. To increase the turn separation before the first deflector, both resonant and non-resonant schemes are used. In this lecture, external injection systems are surveyed and some rules to thumb for injection parameters are given. Extraction schemes are also reviewed. (orig.)

  13. The relationship between academic self-efficacy and self-efficacy levels of teacher candidates

    OpenAIRE

    Kaz?m Çelik; Erkan Tabancal?

    2013-01-01

    In this research, the relationship between academic self-efficacy beliefs and teachers' sense of efficacy were investigated for teacher candidate. The research is a descriptive study in relational screening model. Two separate instruments were used to collect data: the Academic Self-efficacy Scale to measure academic self-efficacy, and Teacher Self-efficacy Scale to measure the self-efficacy perceptions of teacher candidate. Mann Whitney U and Kruskal Wallis tests were conducted since the dat...

  14. Where do injectable stem cell treatments apply in treatment of muscle, tendon, and ligament injuries?

    Science.gov (United States)

    Mautner, Kenneth; Blazuk, Joseph

    2015-04-01

    Treatment options for muscle, tendon, and ligament injuries span a constantly evolving spectrum. For years, treatments focused on symptomatic relief. Closer scrutiny of symptomatic treatment suggests that the provision of transient relief of symptoms may have caused more harm than good. Cortisone injections provide a trade-off of short-term relief for poorer long-term outcomes. When conventional treatment failed, patients have faced limited options including surgery, which has increased risk and limited efficacy. Regenerative injections offer a more robust option for soft tissue disease. Basic science and clinical studies show conflicting results to support the use of platelet-rich plasma injections for soft tissue disorders, and even fewer trials have focused on injectable stem cells with limited findings. Additional studies are needed to determine the potential benefits of this regenerative therapy. PMID:25864658

  15. Why do so many people drop out from auto-injection therapy for impotence?

    Science.gov (United States)

    Althof, S E; Turner, L A; Levine, S B; Risen, C; Kursh, E; Bodner, D; Resnick, M

    1989-01-01

    Although intracavernous injection of vasoactive substances has been shown to be a reasonable and reliable method of reversing impotence, studies assessing patient acceptance of this new technology are lacking. By prospectively following patients and willing partners over a 2-year period, this study sought to document patient utilization rates and the reasons why patients decline or discontinue injection therapy. The cumulative dropout rate was 46%, with patients being most at risk for leaving the program after evaluation or during the trial dose phase. Patients decline treatment because they are unable to accept the idea of injecting themselves or because of potential side effects. Patients discontinue treatment because of perceived lack of efficacy. Patient and programatic obstacles to utilization of self-injection therapy are analyzed. PMID:2769773

  16. Enhanced antitumor efficacy with combined administration of astragalus and pterostilbene for melanoma.

    Science.gov (United States)

    Huang, Xin-Yan; Zhang, Song-Zhao; Wang, Wen-Xi

    2014-01-01

    Astragalus, a commonly used traditional Chinese medicine, has exhibited antitumor actions in patients. In this study, in vitro and in vivo antitumor effects of astragalus and synergistic antitumor efficacy in combination with pterostilbene were investigated. Melanoma cells were treated with pterostilbene (Pt), graduated doses of astragalus injection (AI), or these in combination. Cell viability was measured using a MTT assay. Released nucleosomes and caspase activity were measured using enzyme-linked immunosorbent assay. Growth inhibition in vitro and in vivo was also assessed. Analysis of variance and t tests were used for statistical analysis. Significant reduction (ppterostilbene enhances antitumor efficacy. PMID:24606435

  17. A conceptual model of referee efficacy

    Directory of Open Access Journals (Sweden)

    DeborahLFeltz

    2011-02-01

    Full Text Available This paper presents a conceptual model of referee efficacy, defines the concept, proposes sources of referee specific efficacy information, and suggests consequences of having high or low referee efficacy. Referee efficacy is defined as the extent to which referees believe they have the capacity to perform successfully in their job. Referee efficacy beliefs are hypothesized to be influenced by mastery experiences, referee knowledge/education, support from significant others, physical/mental preparedness, environmental comfort, and perceived anxiety. In turn, referee efficacy beliefs are hypothesized to influence referee performance, referee stress, athlete rule violations, athlete satisfaction, and co-referee satisfaction.

  18. Percutaneous Ethanol Injection in the Treatment of Pediatric Nodular Goiter

    Directory of Open Access Journals (Sweden)

    A V Kiyaev

    2007-09-01

    Full Text Available This study was to define efficacy and safety of method percutaneous ethanol injection (PEI in the treatment of thyroid cystic nodules of 20 girls and 1 boy at the age of 12—17. In 19 cases PEI was performed with purpose of elimination of cosmetic problems, and in 2 cases among them (nodule volume 31.7 and 44.1 ml it was done also for liquidation of neck compression. 4 months later after doing the procedure, the volume of nodules in the group of children, which had been studied, decreased on an average 95.5%, and after 12.6—41.3 months of medical observation it kept the same level of volume. In one case a transient paresis n. recurrence was fixed. It retrogressed after 2 weeks spontaneously. The high efficacy PEI among children and adolescents was established, which didn’t depend on the sizes of the nodules and combination of levothyroxine suppressive therapy. It didn’t depend on the facts, which were connected with methodology of procedure either. The efficacy PEI was higher with cystic component, taking more than a half of the volume of nodule.

  19. Collagenase treatment of Dupuytren's contracture using a modified injection method.

    Science.gov (United States)

    Atroshi, Isam; Nordenskjöld, Jesper; Lauritzson, Anna; Ahlgren, Eva; Waldau, Johanna; Waldén, Markus

    2015-06-01

    Background and purpose - Treatment of Dupuytren's contracture (DC) with collagenase Clostridium histolyticum (CCH) consists of injection followed by finger manipulation. We used a modified method, injecting a higher dose than recommended on the label into several parts of the cord, which allows treatment of multiple joint contractures in 1 session and may increase efficacy. We studied the occurrence of skin tears and short-term outcome with this procedure. Patients and methods - We studied 164 consecutive hands with DC, palpable cord, and extension deficit of ? 20º in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint (mean patient age 70 years, 82% men). A hand surgeon injected all the content of 1 CCH vial (approximately 0.80 mg) into multiple spots in the cord and performed finger extension under local anesthesia after 1 or 2 days. A nurse recorded skin tears on a diagram and conducted a standard telephone follow-up within 4 weeks. A hand therapist measured joint contracture before injection and at a median of 23 (IQR: 7-34) days after finger extension. Results - A skin tear occurred in 66 hands (40%). The largest diameter of the tear was ? 5 mm in 30 hands and > 10 mm in 14 hands. Hands with skin tear had greater mean pretreatment MCP extension deficit than those without tear: 59º (SD 26) as opposed to 32º (SD 23). Skin tear occurred in 21 of 24 hands with MCP contracture of ? 75º. All tears healed with open-wound treatment. No infections occurred. Mean improvement in total (MCP + PIP) extension deficit was 55º (SD 28). Interpretation - Skin tears occurred in 40% of hands treated with collagenase injections, but only a fifth of them were larger than 1 cm. Tears were more likely in hands with severe MCP joint contracture. All tears healed without complications. Short-term contracture reduction was good. PMID:25695745

  20. The use of Permacol® injections for the treatment of faecal incontinence.

    Science.gov (United States)

    Hussain, Zeiad I; Lim, Michael; Mussa, Haider; Abbas, Kazim; Stojkovic, Stevan

    2012-12-01

    The aim of this study is to assess the safety and efficacy of Permacol(®) implant for the treatment of idiopathic faecal incontinence using a novel injection technique. Patients with idiopathic passive faecal incontinence were selected for trans-submucosal injection of Permacol(®) after assessment by anorectal physiology and endoanal ultrasonography. Clinical assessment and St. Mark's Incontinence Score were used to evaluate efficacy before and at two time points (1 and 2 years) after treatment. Rockwood Score were also used to determine quality of life before and after treatment. The Friedman and Chi-square tests were used to compare continuous and categorical data, respectively. A p value of Permacol(®) injections was categorised as excellent, good, fair and poor in 12, 5, 4 and 17 patients, respectively. St. Mark's Score improved in 72 and 63 % of patients at 1 and 2 years, respectively. However, a smaller proportion of patients (39 and 27 %, respectively) achieved a 50 %, or more, improvement in Mark's Score. All four domains of Rockwood Quality of Life Score improved on first and second year follow-up, however, only two domains, coping and embarrassment, were statistically significant. Permacol(®) injection improved symptoms by >50 % in 39 and 27 % of patients on short and medium-term follow-ups, respectively. The trans-submucosal technique for injection of Permacol(®) in this study was safe with no significant adverse outcomes. PMID:22948797

  1. Efficacy and safety of ginseng.

    Science.gov (United States)

    Kitts, D; Hu, C

    2000-12-01

    Ginseng (Panax ginseng, C.A. Meyer) has been a popular herbal remedy used in eastern Asian cultures for thousands of years. In North America, the ginseng species indigenous to both Canada and the United States (Panax quinquefolium) represents an important industry for both domestic and export markets. There are numerous theories and claims describing the efficacy of ginseng, which can combat stress, enhance both the central and immune systems and contribute towards maintaining optimal oxidative status against certain chronic disease states and aging. Risk issues concerning the safety of ginseng at recommended dosages are less prominent and scientifically based. While some epidemiological or clinical studies have reported indications of efficacy for specific health benefits or potential toxicity, there are an equal number of studies that provide contradictory evidence. This situation has led to questionable conclusions concerning specific health benefits or risks associated with ginseng. Recent advances in the development of standardized extracts for both Panax ginseng (G-115) and Panax quinquefolius (CNT-2000) have and will continue to assist in the assessment of efficacy and safety standards for ginseng products. This paper reviews the scientific literature and evidence for ginseng efficacy and safety derived mostly from in vitro and animal studies and places emphasis on the need for more randomized, double-blinded, placebo clinical studies that can provide unequivocal conclusions. An example of the efficacy and safety of ginseng is provided with the description of biological activity of a North American ginseng extract (NAGE), which includes illustrating mechanisms for antioxidant activity without prooxidant properties. PMID:11276295

  2. Staged direct injection diesel engine

    Science.gov (United States)

    Baker, Quentin A. (San Antonio, TX)

    1985-01-01

    A diesel engine having staged injection for using lower cetane number fuels than No. 2 diesel fuel. The engine includes a main fuel injector and a pilot fuel injector. Pilot and main fuel may be the same fuel. The pilot injector injects from five to fifteen percent of the total fuel at timings from 20.degree. to 180.degree. BTDC depending upon the quantity of pilot fuel injected, the fuel cetane number and speed and load. The pilot fuel injector is directed toward the centerline of the diesel cylinder and at an angle toward the top of the piston, avoiding the walls of the cylinder. Stratification of the early injected pilot fuel is needed to reduce the fuel-air mixing rate, prevent loss of pilot fuel to quench zones, and keep the fuel-air mixture from becoming too fuel lean to become effective. In one embodiment, the pilot fuel injector includes a single hole for injection of the fuel and is directed at approximately 48.degree. below the head of the cylinder.

  3. DSA-guided percutaneous injection of hypertonic glucose or ethanol for sclerotherapy of giant hepatic cysts: a comparative study

    International Nuclear Information System (INIS)

    Objective: To compare the 3-month, 6-month and 12-month therapeutic efficacy of DSA-guided percutaneous injection of hypertonic glucose or ethanol combined with catheter directed drainage for the treatment of giant hepatic cysts. Methods: A total of seventy-three cases of single hepatic cysts with complete clinical data were retrospectively selected. Injection of hypertonic glucose was employed for sclerotherapy in 27 patients (group A), while sclerotherapy with ethanol injection was adopted in 46 patients (group B). Cyst diameters ranged from 8.3 cm to 15.8 cm. Under DSA guidance, puncturing injection of sclerotic agents and catheter directed drainage and aspiration were carried out for all lesions. The therapeutic efficacy at 3, 6 and 12 months were evaluated and the results were compared between the two groups. Results: The therapeutic procedure was successfully accomplished in all 73 cases. The puncturing success rate of the hepatic cysts was 100%. No significant difference in the 3-month, 6-month and 12-month therapeutic efficacy existed between the two groups, and the P values were 0.526, 0.713 and 0.613, respectively (P>0.05). Conclusion: In treating giant hepatic cysts with sclerotherapy, the 3-month, 6-month and 12-month therapeutic efficacy of using hypertonic glucose as sclerotic agent are not significantly different from those of using ethanol as sclerotic agent. As the use of hypertonic glucose carries less disagreeable feeling it is more suitable for the debilitated and aged patients. (authors)

  4. Evaluación comparativa de la liberación in vitro de risperidona 3 mg producida en Cuba contra Risperdal® / Comparative assessment of in vitro release of 3 mg Risperidone produced in Cuba versus Risperidal®

    Scientific Electronic Library Online (English)

    Caridad Margarita, García Peña; Antonio, Iraizoz Barrios; Vivian, Martínez Espinosa.

    2010-06-01

    Full Text Available Se compararon los perfiles de disolución de las tabletas de risperidona 3 mg medicamento genérico producido en Cuba y del Risperdal® (Laboratorios Janssen-Cilag SA), para demostrar su similitud. También se realizó la comparación en varios medios de disolución a diferentes pH para evaluar una posible [...] bioexoneración. Para la cuantificación del principio activo, se utilizó un método por cromatografía líquida de alta resolución, previamente validado. La comparación se realizó sobre la base de los factores de diferenciación y similitud. Los resultados mostraron que no existían diferencias en los perfiles de liberación para las tabletas producidas en Cuba y del producto innovador, así como para los diferentes medios de disolución a los pH utilizados. Abstract in english The 3 mg Risperidone tablets dissolution profiles, a generic drug produced in Cuba and the Risperidal® (Janssen-Cilag S.A. Labs) were compared to demonstrate its similarity. Also, we compared some dissolution means at different pH to assess a potential bio-exoneration. To quantify the active princip [...] le, a previously validated high-performance liquid chromatography was used. The comparison was conducted on the base of differentiation and similarity factors. Results demonstrated that there weren't differences en release profiles for tablets produced in Cuba and of innovative product, as well as for the different dissolution means at pH used.

  5. Evaluación comparativa de la liberación in vitro de risperidona 3 mg producida en Cuba contra Risperdal® Comparative assessment of in vitro release of 3 mg Risperidone produced in Cuba versus Risperidal®

    Directory of Open Access Journals (Sweden)

    Caridad Margarita García Peña

    2010-06-01

    Full Text Available Se compararon los perfiles de disolución de las tabletas de risperidona 3 mg medicamento genérico producido en Cuba y del Risperdal® (Laboratorios Janssen-Cilag SA, para demostrar su similitud. También se realizó la comparación en varios medios de disolución a diferentes pH para evaluar una posible bioexoneración. Para la cuantificación del principio activo, se utilizó un método por cromatografía líquida de alta resolución, previamente validado. La comparación se realizó sobre la base de los factores de diferenciación y similitud. Los resultados mostraron que no existían diferencias en los perfiles de liberación para las tabletas producidas en Cuba y del producto innovador, así como para los diferentes medios de disolución a los pH utilizados.The 3 mg Risperidone tablets dissolution profiles, a generic drug produced in Cuba and the Risperidal® (Janssen-Cilag S.A. Labs were compared to demonstrate its similarity. Also, we compared some dissolution means at different pH to assess a potential bio-exoneration. To quantify the active principle, a previously validated high-performance liquid chromatography was used. The comparison was conducted on the base of differentiation and similarity factors. Results demonstrated that there weren't differences en release profiles for tablets produced in Cuba and of innovative product, as well as for the different dissolution means at pH used.

  6. Patient Safety: An Injectable Education

    Directory of Open Access Journals (Sweden)

    Arnold William Klein

    2013-11-01

    Full Text Available Until recently, the effects of all injectable filling agents were temporary and very rarely associated with permanent problems. In the past, the permanent injectable silicone had been used but had been so problematic that the Justice Department filed injunctions against certain physicians on behalf of the FDA. After 2000 a dangerous pattern grew in the corridors of Washington DC, where politics and money changed the face of America and the field of aesthetics to the detriment of the faces of the consumers. Industry has accomplished the approval of synthetic agents that should have never reached the market. Once injected under skin, the body cannot digest these agents and the immune system walls them off with resultant formation of nodules, which at times require surgical removal.

  7. Electrical Injection Schemes for Nanolasers

    DEFF Research Database (Denmark)

    Lupi, Alexandra; Chung, Il-Sug

    2014-01-01

    Three electrical injection schemes based on recently demonstrated electrically pumped photonic crystal nanolasers have been numerically investigated: 1) a vertical p-i-n junction through a post structure; 2) a lateral p-i-n junction with a homostructure; and 3) a lateral p-i-n junction with a buried heterostructure. Self-consistent laser-diode simulations reveal that the lateral injection scheme with a buried heterostructure achieves the best lasing characteristics at a low current, whereas the vertical injection scheme performs better at a higher current for the chosen geometries. For this analysis, the properties of different schemes, i.e., electrical resistance, threshold voltage, threshold current, and internal efficiency as energy requirements for optical interconnects are compared and the physics behind the differences is discussed.

  8. Components for JET injection heating

    International Nuclear Information System (INIS)

    JET is a tokamak experimental facility which will be used for the production of a thermo-nuclear plasma. It forms part of the European nuclear fusion programme. Additional heating of the plasma will be obtained by the injection of high energy neutral hydrogen atoms. These will be generated in a neutral injection beam line which is connected with the main vacuum torus. Sulzer is to supply the calorimeters, duct scrapers and ion dumps for this injection heating, as well as the test bed ion dump (TEBID). These items are to be fabricated in accordance with the requirements applying for high vacuum technology and are to comply with the most stringent specifications under test on a special test bed. (Auth.)

  9. SNS Injection and Extraction Devices

    CERN Document Server

    Raparia, Deepak

    2005-01-01

    The Spallation Neutron Source (SNS) is a second generation pulsed neutron source (1.5 MW) and is presently in the sixth year of a seven-year construction cycle at Oak Ridge National Laboratory. The operation of the facility will begin in 2006. The most stringent requirement for the SNS accelerator complex is to allow hands-on maintenance. Operational experiences show that the most losses occur in the injection and extraction. SNS accumulator ring injection and extraction has been design with grate care to reduce uncontrolled losses. Injection systems consist of fast programmable kicker magnets and DC dump magnets to paint the beam in transverse phase space. Extraction systems consist of fast kicker magnets and a Lamberton magnet to extract beam in single turn. Paper will discuss design, construction and testing of these devices.

  10. Electrical injection simulation of SGEMP

    International Nuclear Information System (INIS)

    Increasing attention has been given to the problem of predicting the response of satellites to the system-generated electromagnetic pulse (SGEMP). Results of the first SGEMP electrical injection simulation experiments on the SKYNET satellite are presented and compared them with pretest predictions. The important advantages offered by the electrical injection techniques are reviewed in light of the experimental findings. Latest advances in the state-of-the-art of injection pulsers, wide-bandwidth current probes and voltage probes, and dielectric transmission systems (dielectric waveguides and fiber optics) are high-lighted. The significance of the results lies in the conclusion that electrical simulation techniques may provide the satellite community with a non-destructive, believable test method for satellite verification

  11. Characterization of Injection Molded Structures

    DEFF Research Database (Denmark)

    Sun, Ling; SØgaard, Emil

    Microscopy has been widely applied to understand surface structures of solid samples. According to the instrumental methodology, there are different microscopy methods: optical microscopy, electron microscopy, and scanning probe microscopy (SPM). These microscopy methods have individual advantages and limitations. Therefore, it would be difficult to characterize complex, especially hierarchical structures by using only one method. Here we present a combined optical microscopy, scanning electron microscopy (SEM), and scanning probe microscopy study on injection molded structures. These structures are used for different applications. We show how to correlate the structures of the polymer replicas with respect to their functionalities. Furthermore, we introduce how we coordinate with all partners in the “Nanoplast” project, and how we utilize the existing facilities of each method to understand structure-properties relationship of the injection molded polymer samples. These results are very important in optimizing injection molding parameters.

  12. Selective segmental sclerotherapy of the liver by transportal absolute ethanol injection: an animal experimental study

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of selective segmental sclerotherapy (SSS) of the liver by transportal absolute ethanol injection with an animal experimental study, and to discuss several technical points involved in this method. Methods: Thirty dogs received SSS of the liver by transportal absolute ethanol injection with the injection dose of 0.2-1.0 ml/kg, repeated examinations of blood ethanol level, WBC, and liver functions were done, and CT and pathological examinations of the liver were performed. Results: All dogs treated with SSS survived during the study. The maximum elevation of blood ethanol values occurred in group F. Its average value was (1.603 ± 0.083) mg/ml, which was much lower than that of death level. Transient elevations of blood WBC and ALT were seen. The average values of WBC and ALT were (46.36 ± 7.28) x 109 and (827.36 ± 147.25) U/L, respectively. CT and pathological examinations proved that the dogs given SSS by transportal absolute ethanol injection with the injection dose of 0.3-1.0 ml/kg had a complete wedge-shaped necrosis in the liver. Conclusion: Selective segmental sclerotherapy of the liver by transportal ethanol injection was quite safe and effective if the proper dose of ethanol was injected. SSS may be useful in the treatment of HCC

  13. Efficacy of Xuebijing for coagulopathy in patients with sepsis

    Science.gov (United States)

    Hou, Si-Yuan; Feng, Xing-Huo; Lin, Chang-Liang; Tan, Yong-Feng

    2015-01-01

    Objectives: To provide evidence of the clinical efficacy of Xuebijing (XBJ) on blood coagulation in patients with sepsis. Methods: We conducted this meta-analysis in The People’s Hospital of Liaoning Province, Shenyang, China between December 2013 and May 2014. We searched a number of databases for relevant randomized controlled trials (RCTs) published before December 2013 using the keywords ‘Xuebijing’, ‘coagulation’ and ‘sepsis’. Statistical analysis was performed with Review Manager 5.2 from the Cochrane Collaboration. Results: Fourteen RCTs involving 867 patients were included. Compared with placebo, XBJ injection significantly improved platelets (mean differences [MD] = 42.14, 95% confidence interval [CI]: 22.42 - 61.86, p<0.00001), shortened the activated partial thromboplastin time (MD = -4.81, 95% CI: -7.86 - [-1.76], p=0.002), shortened the prothrombin time (MD = -2.33, 95% CI: -4.15 - [-0.51], p=0.01), and shortened the thrombin time (MD = -2.05, 95% CI: -3.52 - [-0.58], p=0.006). However, no significant difference was found between the XBJ injection and the placebo group for fibrinogen (MD = 0.21, 95% CI: -0.38 - 0.81, p=0.48). Conclusion: Xuebijing injection may improve coagulopathy in patients with sepsis. High-quality and large sample clinical trials are needed for confirmation. PMID:25719579

  14. Measuring Students' Self-Efficacy for Communication

    Science.gov (United States)

    Gaffney, Amy L. Housley

    2011-01-01

    Design students are asked to regularly communicate their ideas to a diverse audience. Students' abilities may be affected by their perceived self-efficacy, the perception of abilities to perform a task. Because self-efficacy is conceived of as context-specific, it is vital to consider self-efficacy as it specifically relates to design studios and…

  15. Promoting Self-Efficacy in Youth

    Science.gov (United States)

    Reivich, Karen

    2010-01-01

    Researchers have linked self-efficacy to a wide array of outcomes including psychological adjustment, resilience, physical health, achievement, and self-regulation, among others. In this article, the author describes self-efficacy and the factors that contribute to it, highlights the positive outcomes that self-efficacy leads to, and provides…

  16. Injection of spin for electronics

    International Nuclear Information System (INIS)

    Electronic devices that exploit the spin of electrons as well as their charge are poised to overcome a major hurdle that could signal the beginning of an electronics revolution. Nearly all electronic and optoelectronic devices are made of semiconductors and rely on the exact control of electric charges. Electrons, however, possess a well defined 'spin' angular momentum, in addition to a well defined charge. Their spin is either +1/2 or -1/2: in other words an electron can rotate either clockwise or anticlockwise around its own axis with constant frequency. The two possible spin states naturally represent the '0' and '1' states in logical operations. The ability to exploit this spin in semiconductors promises new logic devices with enhanced functionality, higher speed and reduced power consumption - and might spark a revolution in the semiconductor industry. So far the problem of injecting electrons with a controlled spin direction has held up the realization of such 'spintronic' devices. Two recent experiments represent an important step towards electrical spin injection at room temperature. In the first, Klaus Ploog and co-workers at the Paul Drude Institute in Berlin have demonstrated that room-temperature spin injection is possible (H.J. Zhu et al. 2001 Phys. Rev. Lett. 87 016601). Meanwhile Vincent LaBella and co-workers at the University of Arkansas in the US have shown that the quality of semiconductor surfaces plays a vital role in spin injection (V. LaBella etital role in spin injection (V. LaBella et al. 2001 Science 292 1518). So what is the future of spintronics? Two years ago several experiments demonstrated huge progress in transporting spins over long distances and in high electric fields. This year, electrical spin injection - one of the main remaining obstacles of spintronics - is on the way to being solved. Injecting spins with an efficiency of a few per cent using planar contacts or with the tip of a scanning tunnelling microscope is useless for commercial devices. But techniques for highly efficient spin injection with planar contacts are being developed by various groups and will probably prove successful in the very near future. The next steps will be the efficient manipulation of the spin orientation and the building of spin memories and spin logic. At that stage, spintronics will face its highest hurdle and have to prove its superiority over conventional electronics. (U.K.)

  17. Pellet injection and toroidal confinement

    International Nuclear Information System (INIS)

    The proceedings of a technical committee meeting on pellet injection and toroidal confinement, held in Gut Ising, Federal Republic of Germany, 24-26 October, 1988, are given in this report. Most of the major fusion experiments are using pellet injectors; these were reported at this meeting. Studies of confinement, which is favorably affected, impurity transport, radiative energy losses, and affects on the ion temperature gradient instability were given. Studies of pellet ablation and effects on plasma profiles were presented. Finally, several papers described present and proposed injection guns. Refs, figs and tabs

  18. Injection and extraction magnets: septa

    CERN Document Server

    Barnes, M J; Goddard, B; Hourican, M

    2010-01-01

    An accelerator has limited dynamic range: a chain of accelerators is required to reach high energy. A combination of septa and kicker magnets is frequently used to inject and extract beam from each stage. The kicker magnets typically produce rectangular field pulses with fast rise- and/or fall-times, however the field strength is relatively low. To compensate for their relatively low field strength, the kicker magnets are generally combined with electromagnetic septa. The septa provide relatively strong field strength but are either DC or slow pulsed. This paper discusses injection and extraction systems with particular emphasis on the hardware required for the septa.

  19. Mastering Ninject for dependency injection

    CERN Document Server

    Baharestani, Daniel

    2013-01-01

    Mastering Ninject for Dependency Injection teaches you the most powerful concepts of Ninject in a simple and easy-to-understand format using lots of practical examples, diagrams, and illustrations.Mastering Ninject for Dependency Injection is aimed at software developers and architects who wish to create maintainable, extensible, testable, and loosely coupled applications. Since Ninject targets the .NET platform, this book is not suitable for software developers of other platforms. Being familiar with design patterns such as singleton or factory would be beneficial, but no knowledge of depende

  20. Therapeutic hip injections: Is the injection volume important?

    International Nuclear Information System (INIS)

    Aim: To assess whether an increased volume of local anaesthetic injection given with intra-articular steroids improves symptom relief in osteoarthritis of the hip. Materials and methods: One hundred and ten patients with hip osteoarthritis were randomized into two groups (A and B). All patients were given 40 mg triamcinolone and 2 ml bupivicaine, and patients from group B were also given 6 ml of sterile water for injection. Change in WOMAC (Western Ontario and McMaster University Osteoarthritis Index Version 3.1) scores from baseline to 3 months were calculated and assessed for clinical and statistical significance. The patients were assessed for pain at 2 weekly intervals using the Oxford pain chart. Results: Patients from group B showed some reduction in stiffness (7%) and improved function (3%) compared with group A, and there were more clinical responders in these two categories. However, there was no significant statistical or clinical difference in WOMAC scores between the two groups at 3 months. There was also no statistical difference in pain symptoms between the two groups during the study period, measured at 2 weekly intervals. One hundred and two patients reached the study endpoint; eight patients who had bilateral hip injections were subsequently included in the analysis, and these patients did not alter the findings significantly. Conclusions: Published total injection volumes used for treating osteoarthritis of the hip with intra-articular steroids vary he hip with intra-articular steroids vary from 3 to 12 ml. The present study has shown that there is no detriment to using a larger volume of injectate, and recommends that practitioners use total volumes between 3 and 9 ml.

  1. Therapeutic hip injections: Is the injection volume important?

    Energy Technology Data Exchange (ETDEWEB)

    Young, R., E-mail: russell.young@gwh.nhs.uk [Department of Radiology, Great Western Hospital, Swindon (United Kingdom); Harding, J. [Department of Radiology, University Hospital Coventry, Coventry (United Kingdom); Kingsly, A. [Department of Mathematics and Statistics, Bristol Institue of Technology, University of the West of England, Bristol (United Kingdom); Bradley, M. [Department of Radiology, Southmead Hospital, Bristol (United Kingdom)

    2012-01-15

    Aim: To assess whether an increased volume of local anaesthetic injection given with intra-articular steroids improves symptom relief in osteoarthritis of the hip. Materials and methods: One hundred and ten patients with hip osteoarthritis were randomized into two groups (A and B). All patients were given 40 mg triamcinolone and 2 ml bupivicaine, and patients from group B were also given 6 ml of sterile water for injection. Change in WOMAC (Western Ontario and McMaster University Osteoarthritis Index Version 3.1) scores from baseline to 3 months were calculated and assessed for clinical and statistical significance. The patients were assessed for pain at 2 weekly intervals using the Oxford pain chart. Results: Patients from group B showed some reduction in stiffness (7%) and improved function (3%) compared with group A, and there were more clinical responders in these two categories. However, there was no significant statistical or clinical difference in WOMAC scores between the two groups at 3 months. There was also no statistical difference in pain symptoms between the two groups during the study period, measured at 2 weekly intervals. One hundred and two patients reached the study endpoint; eight patients who had bilateral hip injections were subsequently included in the analysis, and these patients did not alter the findings significantly. Conclusions: Published total injection volumes used for treating osteoarthritis of the hip with intra-articular steroids vary from 3 to 12 ml. The present study has shown that there is no detriment to using a larger volume of injectate, and recommends that practitioners use total volumes between 3 and 9 ml.

  2. Prevention and control of iodine deficiency: studies on the efficacy of oral iodized oil.

    OpenAIRE

    Furnée, C.A.

    1994-01-01

    Iodized oil, either injected or given orally, is the major alternative to iodized salt for controlling iodine deficiency. Oral administration has considerable advantages despite its shorter duration of effect. Little information is available on factors which influence the effect of orally administered iodized oil. In this dissertation the efficacy of oral iodized oil is studied with regard to the type of oil used, the dosage technique, intestinal parasites, nutritional status, sex and the con...

  3. A randomised controlled trial of oral misoprostol vs injection methylergometrine for prevention of post partum hemorrhage

    OpenAIRE

    Patil, Neelamma B.; Patted, Shobhana S.

    2013-01-01

    Background: To compare the efficacy of 600mcg of oral misoprostol with 0.2mg of injection methylergometrine for the prevention of post partum hemorrhage. Methods: 200 apparently normal pregnant women were randomized to receive either 600mcg of oral misoprostol (study group) after delivery of baby or 0.2 mg of methylergometrine intravenously (control group) after delivery of placenta. Primary outcome was to know the incidence of post partum hemorrhage in both the groups. Secondary outcome meas...

  4. Corticosteroid injection for shoulder pain: single-blind randomized pilot trial in primary care.

    OpenAIRE

    Holt, TA; Mant, D; Carr, A; Gwilym, S; Beard, D.; Toms, C; Yu, LM; Rees, J.

    2013-01-01

    BACKGROUND: Shoulder pain is a very common presentation in primary care. Evidence of benefit for subacromial corticosteroid injection is inconclusive and confined largely to studies with short follow-up. We plan a large, definitive, primary-care-based trial to determine efficacy and safety in patients with rotator cuff tendinopathy, and conducted a pilot trial to explore feasibility. METHODS: Six general practitioners (GPs) from Oxfordshire, UK underwent update training in assessing painful s...

  5. Correlates of Susceptibility to Hepatitis B among People Who Inject Drugs in Sydney, Australia

    OpenAIRE

    Deacon, Rachel M.; Topp, Libby; Wand, Handan; Day, Carolyn A.; Rodgers, Craig; Haber, Paul S.; Beek, Ingrid; Maher, Lisa

    2012-01-01

    Despite a safe, effective vaccine, hepatitis B virus (HBV) vaccination coverage remains low among people who inject drugs (PWID). Characteristics of participants screened for a trial investigating the efficacy of financial incentives in increasing vaccination completion among PWID were examined to inform targeting of vaccination programs. Recruitment occurred at two health services in inner-city Sydney that target PWID. HBV status was confirmed via serological testing, and questionnaires elic...

  6. Comparison of modified percutaneous transhepatic variceal embolization and endoscopic cyanoacrylate injection for gastric variceal rebleeding

    OpenAIRE

    Jing Wang,; Xiang-Guo Tian; Yan Li; Chun-Qing Zhang; Fu-Li Liu; Yi Cui; Ji-Yong Liu

    2013-01-01

    AIM: To compare the efficacy of modified percutaneous transhepatic variceal embolization (PTVE) with 2-octyl-cyanoacrylate (2-OCA) and endoscopic variceal obturation (EVO) with an injection of 2-OCA for prophylaxis of gastric variceal rebleeding. METHODS: In this retrospective study, the medical records of liver cirrhosis patients with gastric variceal bleeding who underwent either endoscopic 2-OCA (EVO) or modified PTVE using 2-OCA at Shandong Provincial Hospital from January 2006 to Decembe...

  7. Self-Efficacy: Conditioning the Entrepreneurial Mindset

    DEFF Research Database (Denmark)

    Neergaard, Helle; Mauer, René

    2009-01-01

    Research that has sought to identify the underlying determinants of self-efficacy is sparse. This chapter seeks to identify antecedents of entrepreneurial self-efficacy and the processes that produce and reinforce self-efficacy. It seeks to broaden our understanding of the self-efficacy concept through an exploration of its origins and via a journey to its impact in the field of entrepreneurship. Finally, it suggests pedagogical initiatives needed to promote entrepreneurial self-efficacy in the different social arenas of life.

  8. Retaining Bandwidth Efficiency and Efficacy

    OpenAIRE

    Timo Meynhardt; Camillo Von Müller

    2012-01-01

    In this paper we examine how the notion of systemic relevance challenges bandwidth efficiency and efficacy of middle managers of financial service organizations and what managers can do to coop with increasingly complex environments of the firm. As the envisaged merger of The New York Stock Exchange (NYSE Euronext) with Deutsche Börse Group is revitalizing debates concerning institutional configurations of stock markets, we first ask how managers of one of the world’s leading stock exchang...

  9. Antitumor Efficacy Testing in Rodents

    OpenAIRE

    Hollingshead, Melinda G.

    2008-01-01

    The preclinical research and human clinical trials necessary for developing anticancer therapeutics are costly. One contributor to these costs is preclinical rodent efficacy studies, which, in addition to the costs associated with conducting them, often guide the selection of agents for clinical development. If inappropriate or inaccurate recommendations are made on the basis of these preclinical studies, then additional costs are incurred. In this commentary, I discuss the issues associated ...

  10. Injectivity radii of hyperbolic polyhedra

    OpenAIRE

    Masters, Joseph D.

    1998-01-01

    We define the injectivity radius of a Coxeter polyhedron in H^3 to be half the shortest translation length among hyperbolic/loxodromic elements in the orientation-preserving reflection group. We show that, for finite-volume polyhedra, this number is always less than 2.6339..., and for compact polyhedra it is always less than 2.1225... .

  11. Thermal stratification in injection lines

    International Nuclear Information System (INIS)

    This study has been conducted to evaluate the thermal hydraulic behavior of PWR safety injection lines. Injection lines are used to feed the primary circuit with cold water during accidental conditions. During nominal operating conditions, there is no mass flowrate in such piping system. However, natural convection may occur, due to the conductive heat transfer through the valve separating the injection line from the primary circuit. We have built a one to one scale model of a part of an injection line, with a two meters long horizontal pipe prolongated by a one meter long vertical pipe. We have performed velocity measurements using Laser Doppler Anemometry, temperature and local heat flux measurements with respectively thermocouples and heat fluxmeters. We show the development of a thermal stratification along the horizontal pipe, due to the propagation of a hot fluid layer in the upper part of the pipe. We have used these experimental data to validate 3D calculations performed with TRIO code. The numerical approach is able to predict the thermalhydraulic behavior in the pipe. (author)

  12. Electrical injection schemes for nanolasers

    DEFF Research Database (Denmark)

    Lupi, Alexandra; Chung, Il-Sug

    2013-01-01

    The performance of injection schemes among recently demonstrated electrically pumped photonic crystal nanolasers has been investigated numerically. The computation has been carried out at room temperature using a commercial semiconductor simulation software. For the simulations two electrical injection schemes have been compared: vertical pi- n junction through a current post structure as in1 and lateral p-i-n junction with either uniform material as in2 or with a buried heterostructure (BH) as in3. To allow a direct comparison of the three schemes the same active material composition consisting of 3 InGaAsP QWs on an InP substrate has been chosen for the modeling. In the simulations the main focus is on the electrical and optical properties of the nanolasers i.e. electrical resistance, threshold voltage, threshold current and wallplug efficiency. In the current flow evaluation the lowest threshold current has been achieved with the lateral electrical injection through the BH; while the lowest resistance has been obtained from the current post structure even though this model shows a higher current threshold because of the lack of carrier confinement. Final scope of the simulations is the analyses of advantages and disadvantages of different electrical injection schemes for the development of the optimal device design for the future generation of electrically pumped nanolasers for terabit communication.

  13. Lanreotide depot deep subcutaneous injection: a new method of delivery and its associated benefits

    Directory of Open Access Journals (Sweden)

    Carmichael JD

    2012-01-01

    Full Text Available John D CarmichaelDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: Acromegaly is a rare disease characterized by excessive growth hormone secretion, usually from a pituitary tumor. Treatment options include surgery, medical therapy, and in some cases, radiation therapy. Current medical therapy consists of treatment with somatostatin analog medications or a growth hormone receptor antagonist. There are two somatostatin analogs currently in use, octreotide and lanreotide. Both are supplied in long-acting formulations and are of comparable biochemical efficacy. Lanreotide is supplied in a prefilled syringe and is injected into deep subcutaneous tissue. Studies have been conducted to assess the efficacy of self- or partner administration, and have demonstrated that injection of lanreotide can be accomplished reliably and safely outside a physician's office. For patients who have achieved biochemical control with lanreotide, the FDA has recently approved an extended dosing interval. Selected patients may be able to receive the medication less frequently with injections of 120 mg administered every 6 or 8 weeks. This review focuses on the use of lanreotide in the treatment of acromegaly, the safety and efficacy of the drug, and the benefits afforded to patients because of unique aspects of the delivery of lanreotide.Keywords: acromegaly, treatment, lanreotide, somatostatin analog, pituitary tumor

  14. The Injectable Medicines Guide Website.

    Science.gov (United States)

    Keeling, Susan; Burfield, Robin; Proudlove, Christine; Scales, Katie

    National Patient Safety Agency Alert 20 (2007) requires that information on how to prepare and safely administer injectable medicines is available at the point of care. This article describes the development of the Injectable Medicines Guide website, which is recommended in Alert 20 as a suitable source of information. Historically, individual hospitals have produced local guidelines resulting in much duplication of effort. The website was developed by liaising with a large number of hospitals across the UK to produce standardized information on intravenous (IV) medicine administration. The website can be tailored to reflect local needs, which would include those sections that are absolutely essential for safe administration of the medicine; but access to the full monograph can still be easily obtained. In addition, organizations can link locally-produced IV medicine-related guidelines to individual monographs. For organizations that produce their own locally-prepared injectable medicines guide, it is possible to add it to the website in such a way that it can be viewed with an appropriate link in place to the Injectable Medicine Guide website monograph. The Intensive Care Society (2010) has issued a statement supporting the adoption of standard concentrations for 16 medications commonly used in critical care and the website is being updated to reflect this statement. Specialist mental health pharmacists are preparing monographs on medicines commonly administered by intramuscular (IM) injection in mental health practice. These are planned for release in the autumn of 2010. Currently, a robust source of funding is not available to underpin the production of the website. Appropriate funding would allow it to become universally available across the UK, without the need for password-protection. The website could then more easily become embedded in computerized prescribing systems. PMID:21042244

  15. Cost effectiveness of epidural steroid injections to manage chronic lower back pain

    Directory of Open Access Journals (Sweden)

    Whynes David K

    2012-09-01

    Full Text Available Abstract Background The efficacy of epidural steroid injections in the management of chronic low back pain is disputed, yet the technique remains popular amongst physicians and patients alike. This study assesses the cost effectiveness of injections administered in a routine outpatient setting in England. Methods Patients attending the Nottingham University Hospitals’ Pain Clinic received two injections of methylprednisolone plus levobupivacaine at different dosages, separated by at least 12?weeks. Prior to each injection, and every week thereafter for 12?weeks, participants completed the EQ-5D health-related quality of life instrument. For each patient for each injection, total health state utility gain relative to baseline was calculated. The cost of the procedure was modelled from observed clinical practice. Cost effectiveness was calculated as procedure cost relative to utility gain. Results 39 patients provided records. Over a 13-week period commencing with injection, mean quality adjusted life year (QALY gains per patient for the two dosages were 0.028 (SD 0.063 and 0.021 (SD 0.057. The difference in QALYs gained by dosage was insignificant (paired t-test, CIs -0.019 – 0.033. Based on modelled resource use and data from other studies, the mean cost of an injection was estimated at £219 (SD 83. The cost utility ratio of the two injections amounted to £8,975 per QALY gained (CIs 5,480 – 22,915. However, at costs equivalent to the tariff price typically paid to providers by health care purchasers, the ratio increased to £27,459 (CIs 16,779 – 70,091. Conclusions When provided in an outpatient setting, epidural steroid injections are a short term, but nevertheless cost effective, means of managing chronic low back pain. However, designation of the procedure as a day case requires the National Health Service to reimburse providers at a price which pushes the procedure to the margin of cost effectiveness. Trial registration ISRCTN 43299460

  16. Applying Manual Pressure before Benzathine Penicillin Injection for Rheumatic Fever Prophylaxis Reduces Pain in Children.

    Science.gov (United States)

    Derya, Emre-Yavuz; Ukke, Karabacak; Taner, Yavuz; Izzet, Ayhan Yusuf

    2015-06-01

    The purpose of this study was to evaluate the efficacy of applying manual pressure before benzathine penicillin injection and compare it with the standard injection technique in terms of reducing discomfort in children with rheumatic heart disease grouped by age and gender. This was a single-blind, randomized, crossover study. Fifty-one patients aged 7.1-19.9 years were recruited for this study carried out in the pediatric cardiology outpatient clinic. Twenty-nine were girls (56.9%). All subjects received an intramuscular injection of benzathine penicillin with manual pressure to one buttock or with the standard technique to the other buttock at 3-week intervals. The two techniques were used randomly. The subjects were blinded to the injection technique and a visual analogue scale was used after the procedure. Findings demonstrate that children experienced significantly less pain when they received injections with manual pressure (1.3 ± 0.9) compared with the standard injection (4.4 ± 1.6) technique. The perceived injection pain was negatively related to the age of the children in both techniques. Compared with boys, girls felt more pain, but the difference between each technique group according to gender was negligible. The application of manual pressure reduces pain in children under the stress of repeated intramuscular injections, which supports the suggestion that it should be used in routine practice. Manual pressure to the injection site is a simple, pain-reducing technique. Implementing this technique in routine practice may also promote adherence to the prophylaxis regimen, especially in children. PMID:25487006

  17. Comparative study of attenuation of the pain caused by propofol intravenous injection, by granisetron, magnesium sulfate and nitroglycerine

    Directory of Open Access Journals (Sweden)

    Singh Dhananjay

    2011-01-01

    Full Text Available Background: Propofol has the disadvantage of causing pain or discomfort on injection. The aim of the study was to assess the efficacy of pretreatment with various drugs to alleviate the propofol injection pain. Methods: One hundred American Society of Anesthesiology (ASA I and II adults, scheduled for various elective surgical procedures under general anesthesia (GA, were included in the study. They were randomly divided into four groups having 25 patients in each group. Group A received pretreatment with intravenous (i.v. magnesium sulfate, group B received i.v. granisetron, group C received i.v. nitroglycerine and group D was the control group. One-fourth of the total calculated induction dose of propofol was administered over a period of 5 seconds. The patients were asked about the pain on injection. The intensity of pain was assessed using verbal response. A score of 0-3 which corresponds to no, mild, moderate and severe pain was recorded. Results: All the three drugs reduced the incidence and intensity of pain on propofol injection but the order of efficacy in attenuation of pain on the propofol injection was granisetron > nitroglycerine > magnesium sulfate > control. Conclusion: Granisetron was the most effective followed by nitroglycerine and magnesium sulfate in attenuating pain on propofol intravenous injection.

  18. MR-guided Periarterial Ethanol Injection for Renal Sympathetic Denervation: A Feasibility Study in Pigs

    Energy Technology Data Exchange (ETDEWEB)

    Streitparth, F., E-mail: florian.streitparth@charite.de; Walter, A.; Stolzenburg, N.; Heckmann, L.; Breinl, J. [Charite, Humboldt University, Department of Radiology (Germany); Rinnenthal, J. L. [Charite, Humboldt University, Department of Neuropathology (Germany); Beck, A.; De Bucourt, M.; Schnorr, J. [Charite, Humboldt University, Department of Radiology (Germany); Bernhardt, U. [InnoRa GmbH (Germany); Gebauer, B.; Hamm, B.; Guenther, R. W. [Charite, Humboldt University, Department of Radiology (Germany)

    2013-06-15

    Purpose. To evaluate the feasibility and efficacy of image-guided periarterial ethanol injection as an alternative to transluminal radiofrequency ablation. Methods. Unilateral renal periarterial ethanol injection was performed under general anesthesia in 6 pigs with the contralateral kidney serving as control. All interventions were performed in an open 1.0 T MRI system under real-time multiplanar guidance. The injected volume was 5 ml (95 % ethanol labelled marked MR contrast medium) in 2 pigs and 10 ml in 4 pigs. Four weeks after treatment, the pigs underwent MRI including MRA and were killed. Norepinephrine (NE) concentration in the renal parenchyma served as a surrogate parameter to analyze the efficacy of sympathetic denervation. In addition, the renal artery and sympathetic nerves were examined histologically to identify evidence of vascular and neural injury. Results. In pigs treated with 10 ml ethanol, treatment resulted in neural degeneration. We found a significant reduction of NE concentration in the kidney parenchyma of 53 % (p < 0.02) compared with the untreated contralateral kidney. In pigs treated with 5 ml ethanol, no significant changes in histology or NE were observed. There was no evidence of renal arterial stenosis in MRI, macroscopy or histology in any pig. Conclusion. MR-guided periarterial ethanol injection was feasible and efficient for renal sympathetic denervation in a swine model. This technique may be a promising alternative to the catheter-based approach in the treatment of resistant arterial hypertension.

  19. MR-guided Periarterial Ethanol Injection for Renal Sympathetic Denervation: A Feasibility Study in Pigs

    International Nuclear Information System (INIS)

    Purpose. To evaluate the feasibility and efficacy of image-guided periarterial ethanol injection as an alternative to transluminal radiofrequency ablation. Methods. Unilateral renal periarterial ethanol injection was performed under general anesthesia in 6 pigs with the contralateral kidney serving as control. All interventions were performed in an open 1.0 T MRI system under real-time multiplanar guidance. The injected volume was 5 ml (95 % ethanol labelled marked MR contrast medium) in 2 pigs and 10 ml in 4 pigs. Four weeks after treatment, the pigs underwent MRI including MRA and were killed. Norepinephrine (NE) concentration in the renal parenchyma served as a surrogate parameter to analyze the efficacy of sympathetic denervation. In addition, the renal artery and sympathetic nerves were examined histologically to identify evidence of vascular and neural injury. Results. In pigs treated with 10 ml ethanol, treatment resulted in neural degeneration. We found a significant reduction of NE concentration in the kidney parenchyma of 53 % (p < 0.02) compared with the untreated contralateral kidney. In pigs treated with 5 ml ethanol, no significant changes in histology or NE were observed. There was no evidence of renal arterial stenosis in MRI, macroscopy or histology in any pig. Conclusion. MR-guided periarterial ethanol injection was feasible and efficient for renal sympathetic denervation in a swine model. This technique may be a promising alternative to the catheterbe a promising alternative to the catheter-based approach in the treatment of resistant arterial hypertension.

  20. Plasma Injection Experiment at MCX

    Science.gov (United States)

    Uzun-Kaymak, Ilker; Messer, S.

    2008-11-01

    MCX uses an axial magnetic field and a radial voltage to drive supersonic azimuthal flows. It has been observed that the high flow velocity and large radial velocity shear suppresses the higher order interchange modes. However, the MCX discharges are currently limited by the charge and current available from the capacitor bank supplying the radial voltage. The High Density Plasma Injection Experiment combines the MCX experiment with a modified coaxial plasma gun to drive rotation in the target vessel. A 32-injector prototype coaxial gun has been designed, constructed and installed at MCX midplane, top tangential port, as alternate means of momentum input. Unlike traditional coaxial plasma jets, the transport of the jet has been optimized via a combination of electrode shaping and tailored armature at HyperV Technologies Corp. in order to prevent the blow-by instability. Data will be presented for a wide range of MCX parameters and the prospects for future injection experiments will be evaluated.

  1. Injection and extraction for cyclotrons

    CERN Document Server

    Kleeven, W

    2006-01-01

    The main design goals for beam injection are explained and special problems related to a central region with internal ion source are considered. The principle of a PIG source is addressed. The issue of vertical focusing in the cyclotron centre is briefly discussed. Several examples of numerical simulations are given. Different ways of (axial) injection are briefly outlined. A proposal for a magnetostatic axial inflector is given. Different solutions for beam extraction are treated. These include the internal target, extraction by stripping, resonant extraction using a deflector and self-extraction. The different ways of creating a turn-separation are explained. The purpose of different types of extraction devices such as harmonic coils, deflectors and gradient corrector channels are outlined. Several illustrations are given in the form of photographs and drawings.

  2. [Anti-inflammatory and analgesic activity of etofenamate after intramuscular injection in laboratory animals].

    Science.gov (United States)

    Pelster, B; Dell, H D

    1990-03-01

    Antiphlogistic and Analgetic Activity of Etofenamate in Laboratory Animals after Intramuscular Administration by injection of an oily solution of 10.5; 15; 19.5 mg etofenamate/kg body weight it was possible to inhibit the development of the carrageenan edema in the rat paw. Even four days after the single i.m. injection of etofenamate (active substance of Rheumon i.m.) the swelling of the rat paw is effectively prevented. By the Randall-Selitto-analgesia test it was possible to demonstrate the fast onset. Already 1 h after the injection of 15 mg/kg the pain threshold is increased to about 60%. Even in this testsystem the prolonged efficacy of oil diluted etofenamate can be found. PMID:2346539

  3. Intravitreous injection of Lucentis combined with argon laser photocoagulation for treatment of retinal macroaneurysm

    Directory of Open Access Journals (Sweden)

    Pu Wang

    2014-05-01

    Full Text Available AIM: To evaluate the clinical efficacy of intravitreous injection of Lucentis combined with argon laser photocoagulation on retinal macroaneurysm.METHODS: A retrospective observation about intravitreous injection of Lucentis combined with argon laser photocoagulation was performed on 9 patients(9 eyeswith retinal macroaneurysms with macular edema between January 2011 and July 2013. Through the collection of clinical data in patients best-corrected visual acuity, change of the retinal macroaneurysm, optical coherence tomography and fluoresce in fundus angiography before therapy and 1 mouth,3 mouths after therapy, comparative analysis the changes in best-corrected visual acuity and central macular retinal thickness(CMTbetween before and after treatment.RESULTS: Followed for more than 3 months, all patients' best-corrected visual acuity were improved obviously, the difference was significant(PPCONCLUSION:Intravitreous injection of Lucentis combined with argon laser photocoagulation is effective and security to improving visual acuity of retinal macroaneurysms with macular edema.

  4. Treatability Test Plan for 300 Area Uranium Stabilization through Polyphosphate Injection

    Energy Technology Data Exchange (ETDEWEB)

    Vermeul, Vincent R.; Williams, Mark D.; Fritz, Brad G.; Mackley, Rob D.; Mendoza, Donaldo P.; Newcomer, Darrell R.; Rockhold, Mark L.; Williams, Bruce A.; Wellman, Dawn M.

    2007-06-01

    The U.S. Department of Energy has initiated a study into possible options for stabilizing uranium at the 300 Area using polyphosphate injection. As part of this effort, PNNL will perform bench- and field-scale treatability testing designed to evaluate the efficacy of using polyphosphate injections to reduced uranium concentrations in the groundwater to meet drinking water standards (30 ug/L) in situ. This technology works by forming phosphate minerals (autunite and apatite) in the aquifer that directly sequester the existing aqueous uranium in autunite minerals and precipitates apatite minerals for sorption and long term treatment of uranium migrating into the treatment zone, thus reducing current and future aqueous uranium concentrations. Polyphosphate injection was selected for testing based on technology screening as part of the 300-FF-5 Phase III Feasibility Study for treatment of uranium in the 300-Area.

  5. Thermosensitive methyl cellulose-based injectable hydrogels for post-operation anti-adhesion.

    Science.gov (United States)

    Zhang, Yongli; Gao, Chunjuan; Li, Xiulan; Xu, Chen; Zhang, Yang; Sun, Zhiming; Liu, Yu; Gao, Jianping

    2014-01-30

    Thermosensitive methyl cellulose (MC)-based injectable hydrogels for post-operation anti-adhesion were prepared by integrating polyethylene glycol (PEG), carboxymethyl cellulose (CMC) and chitosan sulfate (CS-SO3) with MC sols. The viscosity of the MC-based sols depended on the sol composition, especially the amount of CMC. The gelation temperature of the sols was tuned by adjusting the concentrations of K(+) and other components to obtain an MC-based sol that transformed to a gel at body temperature. The composition of the sol also affected the gel strength. Adding PEG decreased the repulsions between the CMC and CS-SO3 macromolecules and thus increased the gel strength. The efficacy of the MC-based injectable hydrogels as barriers for reducing postsurgical adhesions was evaluated using a rat cecal abrasion model. The PEG and CS-SO3 loaded MC-based injectable hydrogels were effective in reducing adhesion formation and reduced adhesiolysis difficulties. PMID:24299762

  6. Program Optimisation with Dependency Injection

    OpenAIRE

    Mcdermott, James; Carroll, Paula

    2013-01-01

    For many real-world problems, there exist non-deterministic heuristics which generate valid but possibly sub-optimal solutions. The program optimisation with dependency injection method, introduced here, allows such a heuristic to be placed under evolutionary control, allowing search for the optimum. Essentially, the heuristic is “fooled” into using a genome, supplied by a genetic algorithm, in place of the output of its random number generator. The method is demonstrated with generative ...

  7. CONTINUOUS SUBSURFACE INJECTION OF LIQUID DAIRY MANURE

    Science.gov (United States)

    The research has involved the development and evaluation of an efficient, economical, continuous subsurface injection machine. The application site was instrumented so the quality of water percolating beneath the injection zone could be measured. Wells located around the sites we...

  8. Teriparatide (rDNA origin) Injection

    Science.gov (United States)

    Teriparatide injection is used to treat osteoporosis (a condition in which the bones become thin and weak ... medication that may cause osteoporosis in some patients). Teriparatide injection contains a synthetic form of natural human ...

  9. Beef Quality Assurance Injection Sites and Techniques

    Directory of Open Access Journals (Sweden)

    Wei Li

    2012-01-01

    Full Text Available Food safety has become a very important issue in our society. Modern livestock management practices rely upon the prudent use of injectable antibiotics and vaccines for the purpose of maintain herd health and productivity. Rasmussen (1980 concluded that both the active pharmaceutical and the carrier-vehicle administered are responsible for tissue injury. Now we need to put great emphasis on improper injections which can lead to trimming and discarding of expensive cuts, and learn to use a proper injection method to cause less injection site blemishes as a costly problem for the beef industry. This paper examines the effect of needle based injections and makes a case for using needle-free injections for all but intravenous targets. Results from research on estimating the value of carcass information and potential improve­ment in pricing accuracy with injections are reviewed. Lastly, management implications are discussed for producers choosing proper injection systems to fed cattle.

  10. Pellet injection in the RFP

    International Nuclear Information System (INIS)

    Observation of pellets injected into the ZT-40M Reversed Field Pinch has allowed a new twist on the usual tokamak ablation physics modeling. The RFP provides a strong ohmic heating regime with relatively high electron drift parameter (?drift ? 0.2), in the presence of a highly sheared magnetic field geometry. In situ photos of the pellet ablation cloud using a gated-intensified CCD camera, as well as two-view integrated photos of the pellet trajectory show substantial modification of the original pellet trajectory, in both direction and speed. Depending on the launch geometry, increases in the initial 500 m/s pellet speed by 50% have been observed, and a ski jump deflector plate in the launch port has been used to counteract strong poloidal curvature. In contrast to the tokamak, the D? light signature is strongest near the edge, and weaker in the plasma center. Additional information on ion temperature response to pellet injection with 20 ?sec time resolution has been obtained using a 5-channel neutral particle analyzer (NPA). The energy confinement is transiently degraded while the beta is largely unchanged. This may be indicative of pellet injection into a high-beta plasma operating at fixed beta. (author). 10 refs, 6 figs

  11. Helicity Injected Torus Program Overview

    Science.gov (United States)

    Redd, A. J.; Jarboe, T. R.; Aboulhosn, R. Z.; Akcay, C.; Hamp, W. T.; Marklin, G.; Nelson, B. A.; O'Neill, R. G.; Raman, R.; Sieck, P. E.; Smith, R. J.; Sutphin, G. L.; Wrobel, J. S.; Mueller, D.; Roquemore, L.

    2006-10-01

    The Helicity Injected Torus with Steady Inductive Helicity Injection (HIT--SI) spheromak experiment [Sieck, Nucl. Fusion v.46, p.254 (2006)] addresses critical issues for spheromaks, including current drive, high-beta operation, confinement quality and efficient steady-state operation. HIT--SI has a ``bow-tie'' shaped axisymmetric confinement region (major radius R=0.33 m, axial extent of 0.57 m) and two half-torus helicity injectors, one mounted on each end of the flux conserver. HIT--SI has produced spheromaks with up to 30 kA of toroidal current, using less than 4 MW of applied power, demonstrating that Steady Inductive Helicity Injection can generate and sustain discharges with modest power requirements. Fast camera images of HIT--SI discharges indicate a toroidally rotating n=1 structure, driven by the helicity injectors. The direction of the toroidal current is determined by the direction of rotation of the driven n=1. Measured surface and internal magnetic fields in HIT--SI discharges are consistent with that of the true 3D Taylor state, including the injectors. Recent HIT--SI physics studies, diagnostic improvements and machine upgrades will also be summarized.

  12. Radial lean direct injection burner

    Science.gov (United States)

    Khan, Abdul Rafey; Kraemer, Gilbert Otto; Stevenson, Christian Xavier

    2012-09-04

    A burner for use in a gas turbine engine includes a burner tube having an inlet end and an outlet end; a plurality of air passages extending axially in the burner tube configured to convey air flows from the inlet end to the outlet end; a plurality of fuel passages extending axially along the burner tube and spaced around the plurality of air passage configured to convey fuel from the inlet end to the outlet end; and a radial air swirler provided at the outlet end configured to direct the air flows radially toward the outlet end and impart swirl to the air flows. The radial air swirler includes a plurality of vanes to direct and swirl the air flows and an end plate. The end plate includes a plurality of fuel injection holes to inject the fuel radially into the swirling air flows. A method of mixing air and fuel in a burner of a gas turbine is also provided. The burner includes a burner tube including an inlet end, an outlet end, a plurality of axial air passages, and a plurality of axial fuel passages. The method includes introducing an air flow into the air passages at the inlet end; introducing a fuel into fuel passages; swirling the air flow at the outlet end; and radially injecting the fuel into the swirling air flow.

  13. Onset of efficacy and tolerability following the initiation dosing of long-acting paliperidone palmitate: post-hoc analyses of a randomized, double-blind clinical trial

    OpenAIRE

    Fu Dong-Jing; Ma Yi-Wen; Sliwa Jennifer K; Bossie Cynthia A; Alphs Larry

    2011-01-01

    Abstract Background Paliperidone palmitate is a long-acting injectable atypical antipsychotic for the acute and maintenance treatment of adults with schizophrenia. The recommended initiation dosing regimen is 234 mg on Day 1 and 156 mg on Day 8 via intramuscular (deltoid) injection; followed by 39 to 234 mg once-monthly thereafter (deltoid or gluteal). These post-hoc analyses addressed two commonly encountered clinical issues regarding the initiation dosing: the time to onset of efficacy and ...

  14. The Quality and in Vitro Efficacy of Amoxicillin/Clavulanic Acid Formulations in the Central Region of Ghana

    OpenAIRE

    Henry Nettey; Grace Lovia Allotey-Babington; Philip Debrah; Ofosua Adi-Dako; Manal Shaick; Isaac Kintoh; Francis Arnansi; Makafui Nyagblordzro; Marvin Holison

    2014-01-01

    Aim: To assess the quality and in vitro efficacy of five brands of amoxicillin/clavulanic acid tablet, suspension and injectable preparations selected from pharmacies in the Central Region of Ghana. Method: Using a Stratified Representation Sampling method, forty preparations (tablets, suspensions and injectable powders) containing amoxicillin and clavulanic acid were sampled from nine different locations within the Central Region of Ghana. To determine drug quality, sever...

  15. Subacromial corticosteroid injection or acupuncture with home exercises when treating patients with subacromial impingement in primary care-a randomized clinical trial

    OpenAIRE

    Johansson, Kajsa; Bergström, Anna; Schröder, Karin; Foldevi, Mats

    2011-01-01

    bjective. To compare the efficacy of subacromial corticosteroids injected by a GP with physiotherapy combining acupuncture and home exercises as treatments for SIS. less thanbrgreater than less thanbrgreater thanMethods. A randomized clinical trial was performed in primary health care. Patients diagnosed with SIS were randomized to either subacromial corticosteroid injection (s) or 10 acupuncture treatments combined with home- exercises. The main outcomes were pain and shoulder function (Adol...

  16. Bonding strength between two injection molded Polymers

    OpenAIRE

    Stanic, Jasna Nilsson; Ploskic, Aida

    2008-01-01

    This Master Thesis project deals with the relevant factors that may effect replication and the bonding strength between two polymers injection molded by transfer injection molding. Great importance was attached to the processing parameters during injection molding of micro channels, and their influence on the replication and bonding strength quality. The finale component consists of two different polymers, several material combination was injection modled, Ultem 1000, Lexan 500...

  17. A Survey Of Sql Injection Countermeasures

    OpenAIRE

    Mahapatra, R. P.; Subi Khan

    2012-01-01

    SQL injection has become a predominant type of attacks that target web applications. It allows attackers to obtain unauthorized access to the back-end database to change the intended application-generated SQL queries. Researchers have proposed various solutions to address SQL injection problems. However, many of them have limitations and often cannot address all kinds of injection problems. What’s more, new types of SQL injection attacks have arisen over the years. To better counter these ...

  18. SQL INJECTION ATTACK DETECTION AND PREVENTION

    OpenAIRE

    Sunitha Abburu, Dr; PERUMALSAMY RAMASAMY

    2012-01-01

    Nowadays SQL injection attacks (SQLIAs) and cross scripting increased in real web applications very much, and the SQL injection attacks damages the databases through web applications. Injection queries are different type of way to attack the databases. This paper address the issue of SQLIA’s and script in an efficient way. The proposed approach detects and prevents all the Injection queries as well as the cross scripting through the Framework and Static analysis and Dynamic analysis. The co...

  19. Combined vitrectomy and intravitreal injection versus combined laser and injection for treatment of intractable diffuse diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Saeed AM

    2013-02-01

    Full Text Available Ahmed M SaeedDepartment of Ophthalmology, Benha University, Benha, EgyptBackground: The purpose of this study was to compare the safety and efficacy of combined vitrectomy, intravitreal triamcinolone acetonide (IVTA, and bevacizumab injection with that of IVTA and bevacizumab injection and subsequent macular grid laser photocoagulation for the treatment of intractable diffuse diabetic macular edema.Methods: This randomized controlled clinical trial was performed at Benha University Hospital, Benha, Egypt, and included 34 eyes from 34 diabetic patients diagnosed with intractable diffuse diabetic macular edema without vitreomacular traction. The patients were divided into two groups. In group 1, pars plana vitrectomy with removal of the posterior hyaloid was performed, and at the end of the procedure, IVTA 0.1 mL (40 mg/mL and bevacizumab 1.25 mg were injected. In group 2, macular grid laser photocoagulation was performed 2 weeks after the same intravitreal injection combination as used in group 1. The main outcome measures were best-corrected visual acuity (BCVA and central foveal thickness, which were measured using optical coherence tomography at 3, 6, and 12 months.Results: Changes in BCVA and central foveal thickness at 3, 6, and 12 months from baseline were highly statistically significant (P < 0.01. Mean BCVA was better in group 1 at 3 months, nearly equal at 6 months, and less at 12 months. Mean central foveal thickness was more improved in group 1 than in group 2 at 3 months, and was better in group 2 at subsequent measurement points. The major adverse events were development of cataract (more common in group 1 and elevation of intraocular pressure (more common in group 2.Conclusion: The combined therapy described here could represent a solution for the treatment of intractable diabetic macular edema, and could have a favorable long-term outcome. Combined treatment of IVTA and bevacizumab plus grid laser resulted in a more favorable reduction in central foveal thickness and improvement in BCVA at 12 months than vitrectomy combined with the same injections. This small study favors the safer, cheaper, and more available line of treatment.Keywords: intractable diffuse diabetic macular edema, intravitreal triamcinolone, bevacizumab injection, macular grid laser photocoagulation, central foveal thickness

  20. Helical axial injection concept for cyclotrons

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, E.D.

    1981-01-01

    A concept for an external beam injection system using a helical beam path centered on the cyclotron axis is described. This system could be used to couple two accelerator stages, with or without intermediate stripping, in cases where conventional axial injection or radial injection are not practical.

  1. The Three Generations of Flow Injection Analysis

    DEFF Research Database (Denmark)

    Hansen, Elo Harald; Wang, Jianhua

    2004-01-01

    The characteristics of the three generations of flow injection analysis, that is, FIA, sequential injection analysis (SIA), and bead injection-lab-on-valve (BI-LOV), are briefly outlined, their individual advantages and shortcomings are discussed, and selected practical applications are presented.

  2. 21 CFR 522.2005 - Propofol injection.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Propofol injection. 522.2005 Section...522.2005 Propofol injection. (a) Specifications...nonpyrogenic, oil-in-water emulsion containing...follows: As a single injection to provide general...for induction and maintenance of general...

  3. THE BUILT ENVIRONMENT AND COLLECTIVE EFFICACY

    OpenAIRE

    Cohen, Deborah A.; Inagami, Sanae; Finch, Brian

    2007-01-01

    Collective efficacy, or perception of mutual trust and willingness to help each other, is a measure of neighborhood social capital and has been associated with positive health outcomes including lower rates of assaults, homicide, premature mortality, and asthma. Collective efficacy is frequently considered a “cause”, but we hypothesized that environmental features might be the foundation for, or the etiology of personal reports of neighborhood collective efficacy. We analyzed data from th...

  4. Vaccine efficacy and control measures in pertussis.

    OpenAIRE

    Palmer, S R

    1991-01-01

    An outbreak of pertussis in primary school-children in the St David's area of Pembrokeshire provided the opportunity to estimate pertussis vaccine efficacy. The estimate of efficacy was 88% when notified cases were used, but this fell to 68% when all children with bouts of coughing for two or more weeks were included. Notified cases were significantly less likely to have been vaccinated than other cases with similar symptoms. Therefore vaccine efficacy estimates based upon notified cases are ...

  5. The short- and medium-term effectiveness of CT-guided selective cervical nerve root injection for pain and disability

    Energy Technology Data Exchange (ETDEWEB)

    Desai, Amidevi; Saha, Shouvik; Sharma, Naveen; Huckerby, Lauren; Houghton, Russell [Guy' s and St. Thomas' Hospitals, Department of Radiology, London (United Kingdom)

    2014-07-15

    CT-guided cervical nerve root injection with corticosteroid and/or local anesthetic is a recognized technique in the evaluation and treatment of cervical radiculopathy. There are few prospective studies on the efficacy of the various techniques employed in cervical nerve root injection. We present our results from a 1-year prospective series using a CT-guided anterolateral transforaminal approach for cervical nerve root injection of bupivacaine and dexamethasone. Pain using a numeric rating scale was assessed at pre-injection, 15 min post-injection, 1 month, and 3 months. Disability was assessed using the Oswestry Neck Disability Index (NDI) questionnaire at pre-injection, 1 month post-injection, and 3 months. In total, 50 patients were followed for 3 months. The mean reductions in pain were: 15 min (77 %), 1 month (39 %), and 3 months (33 %). The mean reductions in NDI were: 1 month (26 %) and 3 months (also 26 %). Results were statistically significant. CT-guided selective cervical nerve root injection in the treatment of cervical radicular pain and related disability produces statistically significant reductions in pain and disability to at least 3 months post-procedure. (orig.)

  6. The Value of Safflower Yellow Injection for the Treatment of Acute Cerebral Infarction: A Randomized Controlled Trial

    Science.gov (United States)

    Li, Le-Jun; Li, Yu-Mei; Qiao, Ben-Yu; Jiang, Shan; Li, Xin; Du, Hong-Ming; Han, Peng-Cheng; Shi, Jiong

    2015-01-01

    Background. Safflower Yellow Injection has been reported as a treatment for acute cerebral infarction in recent studies in China. However, there is a lack of availability of the evidence for the efficacy and safety of Safflower Yellow Injection for the treatment of acute ischemic stroke. So we investigated the effects of Safflower Yellow Injection for the treatment of acute cerebral infarction. Method. All subjects were randomly divided into Safflower Yellow Injection group given Safflower Yellow Injection (80?mg) and control group given placebo (0?mg) injection by intravenous drop once daily for 14 days. National Institute of Health Stroke Scale (NIHSS); hemorheological detection; coagulation function; and serum inflammatory markers, tumor necrosis factor-alpha (TNF-?), interleukin-1? (IL-1?), and interleukin-6 (IL-6), were used to investigate the effects before and 14 days after the treatment. Results. The scores of NIHSS were decreased on day 7 and day 14 after treatment. The hemorheological index of RBC deformation and RBC aggregation were significantly improved, prothrombin time (PT) increased, and fibrinogen (FIB) and TNF-?, IL-1?, and IL-6 were decreased in patients treated with Safflower Yellow injection on day 14 after treatment (P < 0.05). Conclusion. Data suggests that Safflower Yellow Injection therapy may be beneficial for acute cerebral infarction.

  7. The short- and medium-term effectiveness of CT-guided selective cervical nerve root injection for pain and disability

    International Nuclear Information System (INIS)

    CT-guided cervical nerve root injection with corticosteroid and/or local anesthetic is a recognized technique in the evaluation and treatment of cervical radiculopathy. There are few prospective studies on the efficacy of the various techniques employed in cervical nerve root injection. We present our results from a 1-year prospective series using a CT-guided anterolateral transforaminal approach for cervical nerve root injection of bupivacaine and dexamethasone. Pain using a numeric rating scale was assessed at pre-injection, 15 min post-injection, 1 month, and 3 months. Disability was assessed using the Oswestry Neck Disability Index (NDI) questionnaire at pre-injection, 1 month post-injection, and 3 months. In total, 50 patients were followed for 3 months. The mean reductions in pain were: 15 min (77 %), 1 month (39 %), and 3 months (33 %). The mean reductions in NDI were: 1 month (26 %) and 3 months (also 26 %). Results were statistically significant. CT-guided selective cervical nerve root injection in the treatment of cervical radicular pain and related disability produces statistically significant reductions in pain and disability to at least 3 months post-procedure. (orig.)

  8. Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice

    Directory of Open Access Journals (Sweden)

    Verhaar Jan AN

    2007-09-01

    Full Text Available Abstract Background Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear evidence is lacking, small observational studies suggest that this treatment is effective in the short-term follow-up. So far, there are no randomised controlled trials available evaluating the efficacy of injection therapy. This study will investigate the efficacy of local corticosteroid injections in the trochanter syndrome in the general practice, using a randomised controlled trial design. The cost effectiveness of the corticosteroid injection therapy will also be assessed. Secondly, the role of co-morbidity in relation to the efficacy of local corticosteroid injections will be investigated. Methods/Design This study is a pragmatic, open label randomised trial. A total of 150 patients (age 18–80 years visiting the general practitioner with complaints suggestive of trochanteric pain syndrome will be allocated to receive local corticosteroid injections or to receive usual care. Usual care consists of analgesics as needed. The randomisation is stratified for yes or no co-morbidity of low back pain, osteoarthritis of the hip, or both. The treatment will be evaluated by means of questionnaires at several time points within one year, with the 3 month and 1 year evaluation of pain and recovery as primary outcome. Analyses of primary and secondary outcomes will be made according to the intention-to-treat principle. Direct and indirect costs will be assessed by questionnaires. The cost effectiveness will be estimated using the following ratio: CE ratio = (cost of injection therapy minus cost of usual care/(effect of injection therapy minus effect of usual care. Discussion This study design is appropriate to estimate effectiveness and cost-effectiveness of the injection therapy. We choose to use a pragmatic study design and are thus not able to study specific effects of the injection with corticosteroids. A distinction between placebo effect of the injection and specific effects of the corticosteroids is therefore not possible. Trial Registration The trial is listed in the Dutch Trial Registry with the number ISRCTN16994576

  9. A Controlled, Evidence-Based Trial of Paliperidone Palmitate, A Long-Acting Injectable Antipsychotic, in Schizophrenia

    Science.gov (United States)

    Nasrallah, Henry A; Gopal, Srihari; Gassmann-Mayer, Cristiana; Quiroz, Jorge A; Lim, Pilar; Eerdekens, Mariëlle; Yuen, Eric; Hough, David

    2010-01-01

    Paliperidone palmitate is a long-acting injectable antipsychotic agent. This 13-week, multicenter, randomized (1?:?1?:?1?:?1), double-blind, parallel-group study evaluated the efficacy, safety, and tolerability of fixed 25, 50, and 100?milligram equivalent (mg equiv.) doses of paliperidone palmitate vs placebo administered as gluteal injections on days 1 and 8, then every 4 weeks (days 36 and 64) in 518 adult patients with schizophrenia. The intent-to-treat analysis set (N=514) was 67% men and 67% White, with a mean age of 41 years. All paliperidone palmitate dose groups showed significant improvement vs placebo in the Positive and Negative Syndrome Scale (PANSS) total score (primary efficacy measure; 25 and 50?mg equiv., p=0.02; 100?mg equiv., ppaliperidone palmitate (5–6% across doses). The mean body mass index and mean weight showed relatively small dose-related increases during paliperidone palmitate treatment. Investigator-evaluated injection-site pain, swelling, redness, and induration were similar across treatment groups; scores for patient-evaluated injection-site pain (visual analog scale) were similar across groups and diminished with time. All doses of once-monthly paliperidone palmitate were efficacious and generally tolerated, both locally and systemically. Paliperidone palmitate offers the potential to improve outcomes in adults with symptomatic schizophrenia. PMID:20555312

  10. Trait emotional intelligence and leadership self-efficacy: their relationship with collective efficacy.

    Science.gov (United States)

    Villanueva, José J; Sánchez, José C

    2007-11-01

    In this article, a leadership model is presented, with which to investigate the relationship of trait emotional intelligence (trait EI), leadership self-efficacy and leader's task self-efficacy with collective task efficacy and group performance. The sample was made up of 217 undergraduate students, randomly assigned to work teams of 1 leader and 2 followers that were requested to perform a production task. An adapted version of the Schutte Self-Report Inventory (SSRI; Schutte et al., 1998) was used to measure trait EI. Structural equation modeling was used to test the hypothesized relationships. Results indicated that task self-efficacy was a mediator between leadership self-efficacy and collective task efficacy; the latter, in turn, was the best predictor of group performance. No significant relationship was found between trait EI and collective task efficacy although, unexpectedly, trait EI was positively associated with leadership self-efficacy. Implications of the results are discussed. PMID:17992961

  11. Treatment of pilonidal sinus by phenol injection.

    OpenAIRE

    Kelly, S. B.; Graham, W. J.

    1989-01-01

    This report reviews the treatment of pilonidal sinus by phenol injection in 54 patients. Forty-four patients were treated initially by phenol injection and this was successful in 70%. The median number of injections per patient was one (range 1-5) with a median hospital stay per injection of two days (range 1-17 days). The median time to complete healing for patients treated by injection alone was two months (range 1-32 months). These results compare very favourably with more radical methods ...

  12. Operational experience during the LHC injection tests

    CERN Document Server

    Fuchsberger, K; Arduini, G; Assmann, R; Bailey, R; Bruning, O; Goddard, B; Kain, V; Lamont, M; MacPherson, A; Meddahi, M; Papotti, G; Pojer, M; Ponce, L; Redaelli, S; Solfaroli Camillocci, M; Venturini Delsolaro, W; Wenninger, J

    2010-01-01

    Following the LHC injection tests of 2008. two injection tests took place in October and November 2009 as preparation for the LHC restart on November 20, 2009. During these injection tests beam was injected through the TI 2 transfer line into sector 23 of ring 1 and through TI 8 into the sectors 78, 67 and 56 of ring 2. The beam time was dedicated to injection steering, optics measurements and debugging of all the systems involved. Because many potential problems were sorted out in advance, these tests contributed to the rapid progress after the restart. This paper describes the experiences and issues encountered during these tests as well as related measurement results.

  13. Social-Cognitive Predictors of Health Behavior : Action Self-Efficacy and Coping Self-Efficacy

    OpenAIRE

    Schwarzer, Ralf; Renner, Britta

    2000-01-01

    The effects of social-cognitive variables on preventive nutrition and behavioral intentions were studied in 580 adults at 2 points in time. The authors hypothesized optimistic self-beliefs operate in 2 phases and made a distinction between action self-efficacy (preintention) and coping self-efficacy (postintantion). Risk perceptions, outcome expectancies, and action self-efficacy were specified as predictors of the intention at Wave 1. Behavioral intention and coping serf-efficacy served as ...

  14. Principal Self-Efficacy and Work Engagement: Assessing a Norwegian Principal Self-Efficacy Scale

    Science.gov (United States)

    Federici, Roger A.; Skaalvik, Einar M.

    2011-01-01

    One purpose of the present study was to develop and test the factor structure of a multidimensional and hierarchical Norwegian Principal Self-Efficacy Scale (NPSES). Another purpose of the study was to investigate the relationship between principal self-efficacy and work engagement. Principal self-efficacy was measured by the 22-item NPSES. Work…

  15. Collective Efficacy Beliefs in Student Work Teams: Relation to Self-Efficacy, Cohesion, and Performance

    Science.gov (United States)

    Lent, Robert W.; Schmidt, Janet; Schmidt, Linda

    2006-01-01

    A measure of collective efficacy was developed and administered to undergraduates working in project teams in engineering courses. Findings in each of two samples revealed that the measure contained a single factor and was related to ratings of team cohesion and personal efficacy. Collective efficacy was also found to relate to indicators of team…

  16. STP boosts injectivity rate in Oklahoma waterflood

    Energy Technology Data Exchange (ETDEWEB)

    Holm, L.W.; Csaszar, A.K.; Bernard, G.G.

    1965-03-01

    Sodium tripolyphosphate (STP) in the amount of 20 ppm is responsible for the increased injectivity rate in Pure Oil Co.'s water-input wells in a Nowata County, Okla. waterflood. Before using STP, extensive scale formation and plugging of the injection system were experienced. Analysis of the scale showed that it contained principally iron oxide, iron sulfide, and calcium carbonate. The scale reduced water-injection rates in the flood. Also, because of the scale, water meters, valves, and sections of pipes had to be cleaned and/or replaced frequently, resulting in additional expense. Addition of small amounts of STP to a working water-injection system cleaned scale from flowlines, meters, and other surface equipment, and increased injectivity by 50%. The nominal cost of about 70 cents per 1,000 bbl of water is easily justified. Graphs illustrate how injectivity increased in the pilot area. An analysis is given of the injection water.

  17. Totally distributive categories and injective toposes

    CERN Document Server

    Lucyshyn-Wright, Rory B B

    2011-01-01

    We establish a connection between the totally distributive categories, studied by Marmolejo, Rosebrugh, and Wood, and the injective and quasi-injective Grothendieck toposes, studied by Johnstone and Joyal. We show that every quasi-injective topos is totally distributive and that every injective topos is lex totally distributive. As a partial converse, we show that every lex totally distributive category with a small dense generator is a quasi-injective topos. In view of work of Johnstone-Joyal relating injective and quasi-injective toposes to continuous categories, our results provide partial analogues of the dual equivalence between continuous dcpos and completely distributive lattices (Hoffmann, Lawson) and its restriction to continuous lattices (Banaschewski).

  18. SQL INJECTION ATTACK DETECTION AND PREVENTION

    Directory of Open Access Journals (Sweden)

    Dr. SUNITHA ABBURU

    2012-04-01

    Full Text Available Nowadays SQL injection attacks (SQLIAs and cross scripting increased in real web applications very much, and the SQL injection attacks damages the databases through web applications. Injection queries are different type of way to attack the databases. This paper address the issue of SQLIA’s and script in an efficient way. The proposed approach detects and prevents all the Injection queries as well as the cross scripting through the Framework and Static analysis and Dynamic analysis. The contribution is twofold 1. SQL Injection AttackDetection and prevention 2. SQL Injection Reports. These techniques have been implemented in ASP.Net and SQL Server and tested by conducting various experiments and prove that the web applications and database is protected from scripting and SQL injection queries.

  19. Multiple concurrent collagenase clostridium histolyticum injections to dupuytren’s cords: an exploratory study

    Directory of Open Access Journals (Sweden)

    Coleman Stephen

    2012-04-01

    Full Text Available Abstract Background Dupuytren’s contracture (DC is a progressive fibroproliferative disorder characterized by development of nodules and collagen cords within the palmar fascia of the hand. Collagenase clostridium histolyticum (CCH is currently approved in adults with DC for the nonsurgical treatment of a single palpable cord during a 30-day treatment cycle. This open-label pilot study was designed to examine the safety, efficacy, and multiple-dose pharmacokinetics of injecting two cords (affected joints with multiple doses of CCH concurrently into the same hand in subjects with DC and multiple contractures. Methods Twelve subjects with DC were enrolled, each with ?3 contractures caused by palpable cords. Efficacy assessments were taken 30?days after treatment and adverse events (AEs were recorded throughout. In the first treatment period, all subjects were injected with a single dose of CCH (0.58?mg into a single cord. The same subjects entered a second treatment period 30?days later, where two different cords (affected joints were injected concurrently on the same hand. A finger extension procedure was performed 24 hours after each administration of CCH to disrupt the enzymatically weakened cord. Results For metacarpophalangeal (MP joints, mean contracture reduction per joint treated was 29.0?±?20.7 degrees following single injection vs 30.3?±?10.9 degrees per treated joint following multiple injections. For proximal interphalangeal (PIP joints, mean reduction in contracture was 30.7?±?21.1 and 22.1?±?4.9 degrees per treated joint, respectively, for the two periods. All patients (100% were either “quite satisfied” or “very satisfied” following either treatment cycle. The most common treatment-related AEs were edema peripheral, contusion, and pain in the treated extremity; the differences in severity for local effects of the injections were minimal between treatment periods. No serious treatment-related AEs or systemic complications were reported. Conclusion These results provide preliminary evidence that two cords (affected joints can be treated concurrently with CCH with similar efficacy and safety as cords treated individually in a sequential fashion. Multiple concurrent injections would eliminate the 30-day wait between single treatments and allow for rapid and effective treatment of patients with multiple affected joints, a significant advantage for both patient and physician. Trial registration Australian New Zealand Clinical Trials Registry #ACTRN12610001045000.

  20. Border Crossing to Inject Drugs in Mexico Among Injection Drug Users in San Diego, California

    OpenAIRE

    Volkmann, Tyson; Shin, Sanghyuk S.; Garfein, Richard S; Patterson, Thomas L; Pollini, Robin A.; Wagner, Karla D; Artamanova, Irina; Strathdee , Steffanie A

    2011-01-01

    We examined correlates of ever injecting drugs in Mexico among residents of San Diego, California. From 2007 to 2010, injecting drug users (IDUs) in San Diego underwent an interviewer-administered survey. Logistic regression identified correlates of injection drug use in Mexico. Of 302 IDUs, 38% were Hispanic, 72% male and median age was 37; 27% ever injected in Mexico; 43% reported distributive syringe sharing there. Factors independently associated with ever injecting drugs in Mexico includ...