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Biomedical subjects

F Grandas

Publications and source records attributed to F Grandas.

44 records · Page 3Linked to original sources
PubMedDate not supplied

[Entacapone: is it useful as complimentary treatment with levodopa?].

Entacapone (Comtan) is a potent, selective inhibitor of peripheral catechol-O-methyltransferase (COMT) with therapeutic potential as an adjuvant to levodopa therapy in patients with Parkinson's disease. Entacapone decreases peripheral conversion of levodopa to 3-O-methyldopa increasing central extracellular levodopa and consequently striatal dopamine concentrations. At doses of 200 mg 2 to 10 times daily coadministered with levodopa/carbidopa or levodopa/benserazide entacapone may increase the duration of clinical response both after the first single dose and after repeated dosing in patients with end-of-dose fluctuations. At this dosage, it has a time to peak-plasma concentration of 1.2 hours and an elimination half life of 3.4 hours. In two multicentric, long-term (approximately 6 month), randomized and placebo-controlled studies, the duration of 'on' time was increased and the duration of 'off time' was decreased in patients who received adjunctive entacapone therapy. Moreover, patients randomized to entacapone reduced their levodopa requirements. In these and other phase III studies, entacapone was generally well tolerated, with few reported adverse events, mainly dyskinesias and gastrointestinal disorders. The dyskinesias were generally well controlled by decreasing the mean daily levodopa dose. Entacapone appears as a clinically significant and beneficial adjunct to levodopa therapy in Parkinson's disease patients with end-of-dose fluctuations.

Antiparkinson Agents↗
PubMedDate not supplied

Conversion to controlled-release levodopa/carbidopa treatment and quality of life as measured by the Nottingham Health Profile. The STAR Study Group.

BACKGROUND: Controlled-release levodopa-carbidopa (CRLC) improves some aspects of Parkinson's disease (PD) in patients previously treated with standard levodopa formulations (SL). However, little is known about the effect of this strategy on the health-related quality of life (QoL). OBJECTIVE: To assess the QoL and clinical changes due to the conversion of treatment from SL to CRLC in patients with mild to moderate PD. PATIENTS AND METHODS: Through the Nottingham Health Profile (NHP), QoL was measured in 276 non-selected PD patients included in a multicenter, open study. Guidelines for switching to CRLC and optimization of treatment were given. Assessment of patients was carried out by means of the Hoehn & Yahr, UPDRS, and Schwab & England scales, and questionnaires for dyskinesias and sleep. Examination of the NHP-Spanish Version-scaling properties by fitting data to the Rasch model, disclosed that 3 NHP scales (Emotional reactions, Pain, and Physical mobility) and the NHP distress index (NHPD) were suitable for efficacy analysis. RESULTS: Comparison of scores at baseline and at the end of the study showed significant improvement (paired Student t-test, p < 0.0001) in all these four scales associated with the change to CRLC. Responsiveness to change of the NHP was high. In the present study, changes in QoL were not contingent to baseline factors such as age, gender, stage of disease or ADL capabilities. CONCLUSION: Conversion to CRLC significantly improves the QoL of patients with mild to moderate PD.

Adult↗
PubMedDate not supplied

[Treatment with botulinum toxin in blepharospasm].

Blepharospasm is a cranial dystonia characterized by forceful spasms of the orbicularis oculi muscle which may lead to functional blindness in approximately two-thirds of patients. Botulinum toxin injection is a simple procedure, very effective and with little morbidity. It is considered as the treatment of choice for patients with disabling blepharospasm.

Blepharospasm↗
PubMedDate not supplied

[Pharmacologic, surgical and infiltration of botulin toxin treatment in blepharospasm].

The response to different therapeutic methods was evaluated in a series of 264 patients with blepharospasm. The most effective drug therapy were anticholinergic agents, which resulted in the initial improvement of symptoms in 20% of treated patients. There was improvement in isolated cases treated with levodopa, dopaminergic agonists, neuroleptics, benzodiazepines and tricyclic antidepressants. Bilateral avulsion of the facial nerve was carried out in 29 patients; 27 of these (93%) improved. Spasms relapsed in 22 cases, after a mean period of 12 months. Myectomy of the orbicular muscle was performed in 8 patients. In only 2 cases some improvement was obtained. One hundred and fifty-one patients were treated with infiltrations of botulinum toxin A in the orbicular muscle. 78% of cases improved. The mean duration of the benefit of each injection was 9.2 weeks. The most common secondary effects were local (ptosis, diplopia) and transient.

Blepharospasm↗
PubMedDate not supplied

Blink reflex recovery cycle in patients with blepharospasm unilaterally treated with botulinum toxin.

To determine whether Botulinum Toxin Type A (BTXA) has an effect on the Central Nervous System, the authors studied the excitability of the blink reflex recovery cycle in 12 patients with blepharospasm before and 3 weeks after unilateral BTXA injections. To avoid recording from severely denervated muscles, the R2 response of the blink reflex was obtained from the untreated orbicularis oculi with both ipsilateral and contralateral supraorbital nerve stimulation. Baseline recovery curves were compared with a control group (n = 11) and showed an enhanced recovery of the R2 component. There were no significant differences between the recovery curves of the R2 component of the blink reflex taken before BTXA treatment and those taken after treatment. This finding confirms that BTXA does not modify the excitability of brainstem interneurons that mediate the bilateral R2 response of the blink reflex in patients with blepharospasm.

Adult↗