PubMed Health⌕ Search

Biomedical subjects

Stefan Evers

Publications and source records attributed to Stefan Evers.

At least 19 recordsLinked to original sources
PubMed2007

Effectiveness and satisfaction with zolmitriptan 5 mg nasal spray for treatment of migraine in real-life practice: results of a postmarketing surveillance study.

OBJECTIVE: Addressing the needs of migraineurs by actively seeking patient feedback on disease-related disability and treatment satisfaction may lead to improved management and treatment outcomes. Patient feedback can be collected in postmarketing surveillance (PMS) studies. The objective of this PMS study was to evaluate the efficacy and tolerability of zolmitriptan 5 mg nasal spray in the acute treatment of migraine attacks. PATIENTS AND METHODS: Patients received zolmitriptan 5 mg nasal spray to treat migraine attacks of any severity and were followed up after a maximum of 4 months. Patients evaluated the efficacy and tolerability of zolmitriptan nasal spray, and were asked whether they wished to continue using zolmitriptan nasal spray and their preference compared with previous treatments. Physicians also assessed the efficacy and tolerability of zolmitriptan nasal spray. RESULTS: A total of 1838 patients (84.8% females) participated in the study. Within 30 minutes of administration of zolmitriptan nasal spray, 85.0% of patients reported improvements in headache pain, with 25.1% reporting an improvement within 10 minutes. At 1 hour post-dose, 57.9% of patients were pain free and 61.7% were able to resume usual daily activities. Most patients (72.9%) rated zolmitriptan nasal spray as 'better' than previous therapy. The majority (88.8%) expressed a wish to continue using zolmitriptan nasal spray. Physicians evaluated the efficacy of zolmitriptan nasal spray as 'excellent' or 'good' in 89.4% of patients. Tolerability was evaluated as 'excellent' or 'good' in 91.6% of patients. CONCLUSIONS: Zolmitriptan 5 mg nasal spray provides favourable efficacy and tolerability in the acute treatment of migraine attacks. Most patients assessed zolmitriptan nasal spray as 'better' than previous treatment, with nearly all wishing to continue using it.

Administration, Intranasal↗
PubMed2006

Effectiveness of intranasal zolmitriptan in acute cluster headache: a randomized, placebo-controlled, double-blind crossover study.

BACKGROUND: Cluster headache is a form of primary headache in which attacks are rapid in onset with very severe pain. The mainstays of acute therapy are inhaled oxygen and sumatriptan succinate injection. OBJECTIVE: To evaluate zolmitriptan nasal spray in the acute treatment of cluster headache. METHODS: Ninety-two patients, aged 40 +/- 10 years (mean +/- SD) (80 men and 12 women), with International Headache Society-defined cluster headache were randomized into a placebo-controlled, double-blind crossover study. Patients treated 3 headache attacks using placebo for 1 attack, 5 mg of zolmitriptan nasal spray (ZNS5) for 1 attack, and 10 mg of zolmitriptan nasal spray for 1 attack. The primary end point was headache relief at 30 minutes, defined as reduction from moderate, severe, or very severe pain to no or mild pain. The study was approved by the appropriate ethics committees. RESULTS: Sixty-nine patients were available for an intention-to-treat analysis. The 30-minute headache relief rates were placebo, 21%; ZNS5, 40%; and ZNS10, 62%. Modeling the response as a binary outcome, the Wald test was significant for the overall regression (chi(2)(1) = 29.4; P<.001), with both ZNS5 and ZNS10 giving significant effects against placebo. Headache relief rates for patients with episodic cluster headache were 30% for placebo, 47% for ZNS5, and 80% for ZNS10, while corresponding rates for patients with chronic cluster headache were 14%, 28%, and 36%, respectively. Zolmitriptan was also well tolerated. CONCLUSION: Five-milligram and 10-mg doses of zolmitriptan intranasal spray are effective within 30 minutes and well tolerated in the treatment of acute cluster headache. Trial Registration controlled-trials.com Identifier ISCRTN27362692.

Acute Disease↗
PubMed2006

Pregabalin-associated acute psychosis and epileptiform EEG-changes.

Pregabalin is a novel anticonvulsive and analgesic drug that has been marketed in Europe for more than a year. The typical side effects are dizziness, somnolence and weight gain. We present a patient who, after unintended rapid up-titration of pregabalin, experienced psychotic symptoms associated with rhythmic EEG-changes resolving completely after discontinuation of pregabalin and benzodiazepine administration.

Acute Disease↗
PubMed2006

Idiopathic spinal cord herniation causing progressive Brown-Séquard syndrome.

We report a 59-year-old woman with a 2.5 year history of progressive loss of temperature sensation and dysesthesia in the right and weakness in the contralateral lower limb. Magnetic resonance imaging (MRI) and computed tomography myelography of the spinal cord demonstrated transdural herniation and deformation of the spinal cord in the upper thoracic spine. The herniated part of the spinal cord was untethered and replaced, and the anterior dural defect was closed. At a clinical follow-up 3 months later, the motor and sensory functions were almost restored. MRI at this time showed disentanglement of spinal cord adherence.

Brown-Sequard Syndrome↗
PubMed2006

Treatment of cremaster synkinesias with botulinum toxin A: a video case report.

Synkinesias secondary to nerve lesions and aberrant re-innervation are well-known phenomena especially after lesions of the facial nerve. Synkinesias can successfully be treated with botulinum toxin A (BTx A). Synkinesias of the cremaster muscle have not been described or treated to date. We present the case of a 62-year-old man who developed synkinesias of both cremaster muscles after extensive laparatomy for esophageal cancer. Treatment of synkinesias with various oral medications had been unsuccessful. Electromyography-guided injections of BTx A in both cremaster muscles (15 MU on the right and 10 on the left) led to significant symptom relief for an average of 8 weeks. We present the case including pre- and posttreatment video clips.

Botulinum Toxins, Type A↗
PubMed2006

The phosphate-starvation response of Bacillus licheniformis.

The phosphate-starvation stimulon of Bacillus licheniformis was analyzed at the transcriptional and translational level. The comparison of the transcriptome and the proteome demonstrated that this specific starvation response of B. licheniformis is partially similar to that of B. subtilis. However, it is also shown that B. licheniformis has evolved its own strategies to cope with this nutrient limitation. By means of the secretome analysis the phytase was identified as the most abundant protein under phosphate-starvation conditions. Data of this study indicate that, unlike in B. subtilis, phosphate starvation in B. licheniformis does not induce the SigmaB-dependent general stress response.

6-Phytase↗
PubMed2006

Status on the use of botulinum toxin for headache disorders.

PURPOSE OF REVIEW: Reports and studies on botulinum toxin A in headache treatment are increasing. The studies available from reference systems and published congress contributions on the prophylactic treatment of idiopathic and symptomatic headache with botulinum toxin were analyzed with respect to the study design, the headache diagnosis, and the significance of results. RECENT FINDINGS: For the prophylactic treatment of tension-type headache and migraine, no sufficient positive evidence for a treatment with botulinum toxin A is obtained from randomized, double-blind, and placebo-controlled trials to date. For the treatment of chronic daily headache (including medication overuse headache), there is inconsistent positive evidence for subgroups (e.g. patients without other prophylactic treatment). SUMMARY: The majority of double-blind and placebo-controlled studies do not confirm the assumption that botulinum toxin A is efficacious in the treatment of idiopathic headache disorders. It is possible that subgroups of patients with chronic daily headache benefit from a long-term treatment with this substance. Future clinical trials should focus on these defined patient groups.

Botulinum Toxins↗
PubMed2006

Investigating prophylactic botulinum toxin type A for chronic headache disorders.

There is an increasing number of studies on botulinum toxin A in the treatment of idiopathic and symptomatic headache; however, many studies can hardly be compared with each other because of different end points and different trial designs. For the prophylactic treatment of tension-type headache, migraine and cervicogenic headache, no sufficient positive evidence for a successful treatment can be obtained from the randomised, double-blind and placebo-controlled trials performed so far. For the treatment of chronic daily headache (including medication-overuse headache), there is inconsistent positive evidence for subgroups (e.g., patients without other prophylactic treatment). This means that most of the double-blind and placebo-controlled studies do not confirm the assumption that botulinum toxin A is efficacious in the treatment of idiopathic headache disorders; however, it is possible that some subgroups of patients with chronic migraine benefit from a long-term treatment for > or = 6 months.

Botulinum Toxins, Type A↗
PubMed2005

Recurrent vacuolar myelopathy in HIV infection.

OBJECTIVES: Vacuolar myelopathy is the major cause of spinal cord disease in HIV-1 infection. However, the pathogenesis remains unclear. Diagnosis is mainly based on characteristic clinical symptoms in combination with characteristic MRI changes. Usually, it is a slowly progressive chronic disease affecting HIV-infected individuals with low CD4 T-cell counts. CASE: Here, we report an uncommon case of vacuolar myelopathy in an HIV-infected woman with recurrent clinical symptoms and MRI changes of vacuolar myelopathy and with a preserved CD4 T-cell count when symptoms occurred for the first time. CONCLUSIONS: This is the first case, to show that vacuolar myelopathy can have relapsing-remitting clinical symptoms and MRI changes.

Adult↗
PubMed2005

Recommendations for the classification of HIV associated neuromanifestations in the German DRG system.

HIV associated neuromanifestations are of growing importance in the in-patient treatment of HIV infected patients. In Germany, all in-patients have to be coded according to the ICD-10 classification and the German DRG-system. We present recommendations how to code the different primary and secondary neuromanifestations of HIV infection. These recommendations are based on the commentary of the German DRG procedures and are aimed to establish uniform coding of neuromanifestations.

AIDS Dementia Complex↗
PubMed2005

HIV associated arthritis: case report and review of the literature.

HIV infection can be associated with different types of arthropathies which are often underdiagnosed. We present the case of a 52 year old HIV positive man on highly active antiretroviral therapy including indinavir who developed an acute painful oligoarthritis. We present this case on HIV associated arthritis and include a review on other HIV specific types of arthritis (acute symmetric arthritis and painful articular syndrome) which are assumed as entities exclusively apparent in HIV patients. The pathophysiology of arthritis in HIV infected patients is not yet completely understood but a direct role of the HIV on the initiation of synovitis is suspected in some of them. Additionally, there is evidence that antiretroviral drugs, in particular the protease inhibitor indinavir, can lead to arthritic complications as well.

Antiretroviral Therapy, Highly Active↗
PubMed2005

Are neurology residents in the United States being taught defensive medicine?

OBJECTIVE: To study whether and how fear of litigation and defensive medicine are communicated during residency training and to assess whether this affects residents' attitudes. METHODS: Neurology residents in the US (n=25) and, as a control group, Neurology residents training in Germany (n=42) were asked to rate multiple items regarding litigation, defensive strategies and how often these issues are raised by teaching physicians. Statistic analysis was performed using nonparametric tests. RESULTS: Residents in both countries indicated that litigation is an "important problem", although US residents stated this significantly more often (p<0.001). Initiation of tests motivated mainly by fear of litigation (p=0.004) and explicit teaching of defensive strategies by teaching physicians (p<0.02) were reported more often by US residents. CONCLUSION: Neurology residents in both the US and Germany perceive a litigational threat, but significantly less so in Germany. This difference may result at least in part from teaching of defensive strategies reported more often in US programs.

Defensive Medicine↗
PubMed2005

Enucleation and development of cluster headache: a retrospective study.

BACKGROUND: Cluster headache (CH) is a neurovascular, primary headache disorder. There are, however, several case reports about patients whose CH started shortly after a structural brain disease or trauma. Motivated by a patient who developed CH 3 weeks after the removal of an eye and by similar case reports, we tested the hypothesis that the removal of an eye is a risk factor for CH. METHODS: A detailed headache questionnaire was filled out by 112 patients on average 8 years after enucleation or evisceration of an eye. RESULTS: While 21 % of these patients experienced previously unknown headaches after the removal of an eye, no patient fulfilled the diagnostic criteria for CH. CONCLUSION: Our data does not suggest that the removal of an eye is a major risk factor for the development of CH.

Adult↗
PubMed2005

Expression of fragile X mental retardation-1 gene with nuclear export signal mutation changes the expression profiling of mouse cerebella immortal neuronal cell.

Fragile X syndrome (FXS) is the most frequent cause of inherited mental retardation and is largely caused by a loss of expression of fragile X mental retardation protein (FMRP), encoded by fragile X retardation gene-1 (Fmr1). FMRP is a multifunction protein, with intrinsic RNA-binding properties, which is a component of ribonucleoprotein complex associated with polyribosomes. The properties of FMRP indicate that it might participate in post-transcriptional processes in the regulation of some mRNA species, including localization, stability and translational control. However, the function of FMRP related to the pathologenesis in FXS is largely unknown. Many efforts were undertaken to identify the putative specific RNA targets as well as the FMRP-related proteins and to identify the effect of FMRP absence on the corresponding proteins. Here we present our efforts using proteomics approach to explore the differential expression profiling of mouse cerebella immortal cell, in which we changed the expression of FMRP by expressing Fmr1 gene with nuclear export signal (NES) mutation. This mutation makes FMRP unable to shuttle from nucleus to cytoplasm and leads to nuclear instead of cytoplasmic location as usual, which was hypothesized to affect the pathways of groups of RNAs or proteins related with FMRP. In present study, 56 proteins were found to be differentially expressed in transfected R2 neuronal cells, including 16 decreased expressions and 40 increased expressions. The differentially expressed proteins play roles in diverse physiological processes, such as neuronal plasticity, spermatogenesis and craniofacial and limb development etc. In addition, the expressions of three mRNA identified as FMRP targets in fragile X cell were tested in present model cells. All these results provide new insights to the role of FMRP in the disease.

Active Transport, Cell Nucleus↗