AIM OF STUDY: To determine whether a high dose of levodopa-carbidopa intestinal gel (LCIG), expressed as levodopa equivalent daily dose (LE daily dose), is a risk factor for acute polyneuropathy in patients treated with LCIG. CLINICAL RATIONALE FOR STUDY: Treatment with LCIG is an effective device-assisted therapy in the advanced stages of Parkinson's Disease (PD). Polyneuropathy is a well-known complication of PD treatment. Patients treated with oral levodopa usually suffer from sub-clinical or mild chronic sensory polyneuropathy. However, severe acute polyneuropathy occurs in patients treated with LCIG, which is causally related to the treatment and leads to its immediate discontinuation. The etiology is not yet clear, but some patients with acute polyneuropathy have been given high doses of LCIG. MATERIAL AND METHODS: A retrospective multicentre study of patients treated with LCIG was performed. Patients with acute polyneuropathy were subjected to a detailed analysis including statistical processing. RESULTS: Of 183 patients treated with LCIG in seven centres, six patients (five females, median age 63 years) developed acute polyneuropathy with LCIG discontinuation. The median (interquartile range) initial and final LE daily dose in patients with and without acute polyneuropathy was 3,015 (2,695-3,184) and 1,898 (1,484-2,167) mg, respectively. The final LE daily dose of 2,605 mg cut-off had 83% sensitivity and 93% specificity for the prediction of acute polyneuropathy. CONCLUSIONS AND CLINICAL IMPLICATIONS: The risk of acute polyneuropathy in LCIG-treated patients was associated with a daily LE dose of greater than 2,605 mg or with more than a 62% increase in the daily LE dose during LCIG treatment.

• MeSH
• antiparkinsonika * škodlivé účinky   aplikace a dávkování   MeSH
• fixní kombinace léků * MeSH
• gely * MeSH
• karbidopa * aplikace a dávkování   škodlivé účinky   MeSH
• levodopa * aplikace a dávkování   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc * farmakoterapie   MeSH
• polyneuropatie * chemicky indukované   farmakoterapie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

• Publikační typ
• abstrakt z konference MeSH

• Publikační typ
• abstrakt z konference MeSH

• Publikační typ
• abstrakt z konference MeSH

Publikácia sa zameriava na anatómiu, histológiu a fyziológiu nervového systému. Určené odbornej verejnosti.

• MeSH
• histologie MeSH
• nervový systém - fyziologické jevy MeSH
• nervový systém anatomie a histologie   MeSH
• neuroanatomie MeSH
• neurofyziologie MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Anatomie člověka a srovnávací anatomie
• NLK Obory
• neurovědy

Pokročilé štádiá Parkinsonovej choroby sú sprevádzané širokou škálou motorických i nemotorických komplikácií, ktoré závažnou mierou negatívne vplývajú na kvalitu života pacientov. Terapeutické ovplyvnenie týchto komplikácii, ktoré nielen vyplývajú z neurodegeneratívnej povahy základného ochorenia, ale sú podmienené i dlhodobým užívaním dopaminergnej liečby, predstavuje v klinickej praxi závažný problém. Liečebná stratégia sa v poslednom období upriamuje na zabezpečenie kontinuálnej dopaminergnej stimulácie, cieľom ktorej je dosiahnuť vyrovnanú kontrolu symptómov. S progresiou ochorenia a liekmi indukovaných komplikácií konvenčné farmakologické postupy často v tomto smere zlyhávajú. Do popredia terapeutického záujmu sa dostávajú iné, alternatívne spôsoby liečby, ktoré zohrávajú dôležitú úlohu pri liečbe prejavov Parkinsonovej choroby u pacientov v pokročilých štádiách ochorenia. Medzi tieto postupy patrí hĺbková mozgová stimulácia, subkutánne kontinuálne podávanie apomorfínu a liečba intestinálnym gélom levodopa/carbidopa. Správna selekcia pacientov, zohľadnenie prítomnosti špecifických nemotorických symptómov a potenciálnych rizík sprevádzajúcich jednotlivé liečebné modality sa významnou mieru podieľa na výbere najvhodnejšieho postupu.

Advanced stages of Parkinson‘s disease are accompanied by a broad scale of motor and non-motor complications which negatively impact patients' quality of life. The therapeutic influence of these complications resulting from the neurodegenerative nature of the underlying disease and are additionally caused by long-term use of dopaminergic treatment, represents a serious clinical problem. Recently, the therapeutic strategy has been focused on continuous dopaminergic stimulation to achieve the balanced control of symptoms. With disease progression and drug-induced complications conventional pharmacological procedures often fail to control clinical symptoms. Alternative methods rise to the forefront of therapeutic interest as they play an important role in the treatment of advanced Parkinson‘s disease. These options include: deep brain stimulation, subcutaneous application of apomorphine and levodopa/carbidopa intestinal gel therapy. Correct patient selection, consideration of specific non-motor symptoms and potential risks accompanying individual treatment modalities, significantly contribute to the selection of most appropriate procedure.

• MeSH
• apomorfin farmakologie   terapeutické užití   MeSH
• hluboká mozková stimulace metody   využití   MeSH
• karbidopa farmakologie   terapeutické užití   MeSH
• levodopa farmakologie   terapeutické užití   MeSH
• lidé MeSH
• motorické poruchy MeSH
• parenterální infuze metody   MeSH
• Parkinsonova nemoc * komplikace   terapie   MeSH
• podkožní absorpce MeSH
• Check Tag
• lidé MeSH

Infiltration of immune cells into CNS is one of the essential events in multiple sclerosis (MS) development. Adhesion molecules like the intercellular adhesion molecule 1 (ICAM-1) play critical role in this process. Therefore, the ICAM1 gene containing two important single-nucleotide polymorphisms (SNPs) belongs to candidate loci with possible involvement in MS susceptibility and/or severity. The objective of our case-control study was to analyze the association of two functional ICAM1 polymorphisms rs1799969 (or G241R) and rs5498 (or K469E) with susceptibility to MS and evaluate their influence on the age at disease onset, severity, neurological disability and progression rate. Two hundred forty-eight MS subjects (mean 39.2 years) and 208 age-matched controls (mean 35.6 years) were involved in the study. Genotyping of ICAM1 rs1799969 and rs5498 SNPs was performed by PCR-RFLP. Presence of the rs3135388 polymorphism tagging the major MS risk allele HLA-DRB1*15:01 allele was determined as well. Our analysis revealed no statistically significant association of ICAM1 polymorphisms with risk of MS development in the Slovak population. Stratification of study cohorts by gender, age at onset and presence of the HLA-DRB1*15:01 risk allele showed only moderate changes. Correlation of clinical findings as age at onset, Kurtzke Expanded Disability Status Scale, Multiple Sclerosis Severity Score and progression index with ICAM1 genotypes in MS patients revealed no significant association; however, patients with earlier onset of MS showed slightly higher frequencies of the homozygous G allele at rs5498 in comparison to other genotypes (P = 0.04), suggesting that GG carriers tend to induce MS at an earlier age.

• MeSH
• alely MeSH
• dospělí MeSH
• genetická predispozice k nemoci MeSH
• genotyp MeSH
• HLA-DRB1 řetězec genetika   MeSH
• jednonukleotidový polymorfismus * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezibuněčná adhezivní molekula-1 genetika   MeSH
• mladý dospělý MeSH
• roztroušená skleróza genetika   MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika MeSH

• Publikační typ
• abstrakt z konference MeSH

• Publikační typ
• abstrakt z konference MeSH

• Publikační typ
• abstrakt z konference MeSH