Presently, treatment of PD focuses on symptomatic therapy, that is to control motor symptoms, at the lowest possible dose, so as nor to develop early drug resistance, and consequent extrapyramidal symtoms. However, there has been no clinical trial, to date that has provided definitive evidence of pharmacological neuroprotection. Among the drugs with possible neuroprotective effects are the dopamine agonists.
OBJECTIVE: The objective of this study is to determine the efficacy and safety of Rotigotine transdermal patch in the treatment of early Parkinson's disease in terms of improvement in the functional capacity and the incidence of adverse effects in patients treatment with the said drug .
METHODOLOGY: Literature search of all randomized controlled trials, published from 1999-2009 comparing rotigotine patch with placebo, in patients with Parkinson's disease. Types of outcome measures- The primary outcome studied was the number of responders described as those with> 20% decrease in UPDRS Scores. The secondary outcome include the mean change in UPDRS score and the total incidence of adverse effects on patients on rotigotine patch.
RESULTS: The use of Rotigotine patch in early Parkinson's disease shows as trend toward benefit and was statistically significant (OR 0.33) in terms of number of patients who showed a significant change in UPRDS scores. In terms of UPDRS scoring, there was significant improvement for those who took Rotigotene (MD 5.2.5). However, incidence of adverse effects was higher in the Rotigotine group compared to the placebo group (OR 3.13)
CONCLUSION: The evidence from this review supports the use of Rorigotine patch for the treatment of early Parkinson's disease. This has shown to produce clinical improvement in parkinsonian symptoms as measured by the significant decrease in the UPDRS Scores on follow-up. However, adverse events were similar to those found with other dopamine agonists.

Human ; Dopamine Agonists ; Drug Resistance ; Neuroprotection ; Neuroprotective Agents ; Parkinson Disease ; Parkinsonian Disorders ; Tetrahydronaphthalenes ; Thiophenes ; Transdermal Patch

BACKGROUND AND PURPOSE: The purpose of this report is to increase awareness on the possible long-term effects cyanide poisoning by intentional silver jewelry cleaning agent.

CASE: We report a case of a 24 year old male who developed parkinsonism after surviving acute cyanide intoxication by intentional ingestion of a now-illegal cyanide-based silver jewelry cleaner. MRI showed multiple high signal intensities in the basal ganglia, substantia nigra, and cerebral cortex consistent with the clinical and radiological findings reported rarely in literature.

DISCUSSIONS: As cyanide causes neurotoxicity by impairing oxygen utilization, this adds evidence for the affinity of cyanide for structures with high oxygen requirement. Current theories on the pathomechanism of cyanide-induced neurotoxicity are reviewed.

 

Human ; Male ; Adult (a Person 19-44 Years Of Age) ; Male ; Silver ; Oxygen ; Jewelry ; Basal Ganglia ; Substantia Nigra ; Parkinsonian Disorders ; Cerebral Cortex ; Magnetic Resonance Imaging ; Cyanides ; Poisoning

BACKGROUND

Delayed cerebral vasospasm remains a major cause of delayed neurologic deficits and mortality in patients with aneurysmal subarachnoid hemorrhage (SAH). Statins may ameliorate clinically significant cerebral vasospasm by increasing endothelial NO synthase and hasten basal endothelial NO release.

OBJECTIVES

This study was conducted to determine whether acute statin therapy plus standard care compared to standard care alone can prevent incidence of cerebral vasospasm and improve functional outcome.

METHODS

The author searched Medline, Cochrane, Ovid, Stroke Group Trial Register and Herdin databases for eligible randomized controlled trials on the use of statins plus standard care versus standard care alone in patients with aneurysmal SAH. The studies were analyzed using Review Manager 4.2 software. An estimate of treatment effect was measured using relative risk with 95% confidence
interval.

RESULTS

Two studies involving 119 patients were included. Delayed ischemic neurologic deficits were observed in 12 of 59 patients in treatment group (20.33%) but 24 of 60 patients in control group (40%). Overall effect favors treatment (P value of .02).

Human ; Hydroxymethylglutaryl-coa Reductase Inhibitors ; Subarachnoid Hemorrhage ; Meta-analysis ; Aneurysm