Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antiepileptic drugs (AEDs) are used extensively to treat multiple non-epilepsy disorders, both in neurology and psychiatry. This article provides a review of the clinical efficacy of AEDs in non-epilepsy disorders based on recently published preclinical and clinical studies, and attempts to relate this efficacy to the mechanism of action of AEDs and pathophysiological processes associated with the disorders. Some newer indications for AEDs have been established, while others are under investigation. The disorders where AEDs have been demonstrated to be of clinical importance include neurological disorders, such as essential tremor, neuropathic pain and migraine, and psychiatric disorders, including anxiety, schizophrenia and bipolar disorder. Many of the AEDs have various targets of action in the synapse and have several proposed relevant mechanisms of action in epilepsy and in other disorders. Pathophysiological processes disturb neuronal excitability by modulating ion channels, receptors and intracellular signalling pathways, and these are targets for the pharmacological action of various AEDs. Attention is focused on the glutamatergic and GABAergic synapses. In psychiatric conditions such as schizophrenia and bipolar disorder, AEDs such as valproate, carbamazepine and lamotrigine appear to have clear roles based on their effect on intracellular pathways. On the other hand, some AEDs, e.g. topiramate, have efficacy for nonpsychiatric disorders including migraine, possibly by enhancing GABAergic and reducing glutamatergic neurotransmission. AEDs that seem to enhance GABAergic neurotransmission, e.g. tiagabine, valproate, gabapentin and possibly levetiracetam, may have a role in treating neurological disorders such as essential tremor, or anxiety disorders. AEDs with effects on voltage-gated sodium or calcium channels may be advantageous in treating neuropathic pain, e.g. gabapentin, pregabalin, carbamazepine, oxcarbazepine, lamotrigine and valproate. Co-morbid conditions associated with epilepsy, such as mood disorders and migraine, may often respond to treatment with AEDs. Other possible disorders where AEDs may be of clinical importance include cancer, HIV infection, drug and alcohol abuse, and also in neuroprotection. A future challenge is to evaluate the second-generation AEDs in non-epilepsy disorders and to design clinical trials to study their effects in such disorders in paediatric patients. Differentiation between the main mechanisms of action of the AEDs needs more consideration in drug selection for tailored treatment of the various non-epilepsy disorders.
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PMID:Antiepileptic drugs in non-epilepsy disorders: relations between mechanisms of action and clinical efficacy. 1807 13

A highly sensitive and selective method using liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS) was developed and validated for the measurement of three antiretroviral agents, efavirenz, lopinavir and ritonavir, in human hair. Hair samples from adherent HIV-infected patients on antiretroviral therapies were cut into about 1 mm length segments and drugs were extracted by first shaking the samples with methanol in a 37 degrees C water bath overnight (>14 h), followed by methyl tert-butyl ether/ethyl acetate (1:1) extraction under weak alkaline conditions. The extracted lopinavir and ritonavir were separated by reversed-phase chromatography and detected by tandem mass spectrometry in electrospray positive ionization mode with multiple reaction monitoring (MRM), while efavirenz was monitored in negative ionization MRM mode. This method was validated from 0.01 to 4.0 ng/mg hair for ritonavir and 0.05-20 ng/mg hair for lopinavir and efavirenz by using 2 mg of a human hair sample. The interday and intraday assay precision (coefficients of variation, CV) for spiked quality control (QC) samples at low, medium and high concentrations were within 15% and accuracy ranged from 89% to 110%. Assay reproducibility was also demonstrated by analysis of incurred hair QC samples (CV <14%). No significant matrix ionization suppression was observed. This developed method allowed for the monitoring of these target medications in the hair samples of HIV-infected women on antiretroviral therapy in an observational study using small amounts of hair.
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PMID:Sensitive analysis of anti-HIV drugs, efavirenz, lopinavir and ritonavir, in human hair by liquid chromatography coupled with tandem mass spectrometry. 1883 69

An 11-year-old girl was admitted with backpain, weight loss, fatigue and behavioural disturbances, starting seven weeks before admission. Physical examination showed acrodynia, tremor, cachexia, hypertension and extensive gingival ulceration. Routine laboratory tests were normal, except for a CRP of 98 mg/l. Screening tests for recreational drugs as well as antibody assays for HIV, hepatitis B and borrelia burgdorferia were negative. Chest X-ray, brain CAT and MRI scan were all normal. Lumbar puncture didn't show any abnormalities. Eventually a 24-hour urine test confirmed the diagnosis that was suspected by further questioning.
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PMID:A previously healthy 11-year-old girl with behavioural disturbances, desquamation of the skin and loss of teeth. 1904 36

A house to house survey was conducted in December 2005 in the Railway Colony of Shamli, located in the state of Uttar Pradesh, India using a semistructured questionnaire to study the awareness level regarding HIV/AIDS among Indian Railway's employees and their family members. Information regarding demographic characteristics and knowledge about various aspects of HIV/AIDS was recorded by a trained staff nurse of the local Railway Medical Unit from at least one person, aged 15 years to 59 years, from each household. Among 293 individuals interviewed, majority were males (61.8%), aged > 30 years (56.6%) and literate (85.3%). Majority were aware about existence of HIV infection in India (92.5%), AIDS is a fatal disease (92.8%) and laboratory tests are available for detecting HIV infection (89.4%). Although most of them knew the correct routes of HIV transmission viz. sexual (91.50%), parentral (90.8%), perinatal route (86.3%) and blood transfusion (86.0%), misconceptions such as transmission through shaking hands (89.1%), hugging (88.4%), sharing utensils (82.6%), mosquito bite (74.1%) and using public toilets (73.4%) were also observed. Most of them were also aware about preventive measures. Knowledge about various aspects was observed to be significantly higher among females, among individuals aged <45 years and literate individuals. The findings highlight the need of intensified health education focusing on removal of misconceptions and further improvement in awareness level of the study population.
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PMID:Awareness status about HIV/AIDS among Indian railway's employees and their family members. 1957 24

Human immunodeficiency virus-1 (HIV-1) infection may produce neurological deficits, such as cognitive decline, that may be worsened by concurrent ethanol (EtOH) abuse. Among the many biochemical cascades likely mediating HIV-1-associated neuronal injury is enhancement of N-methyl-d-aspartate (NMDA) receptor function and progression to excitotoxicity, an effect that may be directly or indirectly related to accumulation in brain of the HIV-1 trans-activator of transcription (Tat) factor. The present studies were designed to examine the hypothesis that binge-like EtOH pre-exposure would enhance effects of Tat on NMDA receptor function. These studies employed a modified in vivo binge EtOH exposure regimen designed to produce peak blood EtOH levels (BEL) of <200 mg/dl in adult male rats and were designed to examine effects of intra-hippocampal injection of Tat (0.5 microl/500 pM/2 min) on EtOH withdrawal-related behavior, spatial learning, and histological measures. Unilateral cannulae were implanted into the cornu ammonis 1 (CA1) pyramidal cell layer of animals prior to beginning a 4-day binge EtOH regimen. EtOH was administered via intragastric intubation ( approximately 3.0-5.0 g/kg) with dose determined by behavioral ratings of intoxication daily for 4 days (at 08:00, 16:00, and 24:00 h). EtOH withdrawal behaviors were monitored 12 h after the last administration of EtOH. Morris water maze learning was assessed during the following 4 days, at which times brains were harvested for autoradiographic measurement of NMDA receptor density and neuroinflammation. Maximal BELs of 187.69 mg/dl were observed 60 min after EtOH administration on day 2 of the regimen. In contrast, peak BELs of approximately 100 mg/dl were observed 60 min after EtOH administration on day 4 of the regimen, suggesting development of metabolic tolerance. Significant behavioral abnormalities were observed in EtOH withdrawn animals, including tremor and seizures. Intra-CA1 region injection of Tat significantly potentiated EtOH withdrawal behavioral abnormalities, an effect that was reduced by MK-801 pre-exposure. While EtOH withdrawn animals showed learning similar to control animals, EtOH withdrawn animals that received intra-CA1 Tat injection demonstrated persisting deficits in spatial learning on days 3 and 4 of training, effects that were markedly reduced by administration of the competitive NMDA receptor antagonist MK-801 30 min prior to Tat injection. No changes in [(3)H]MK-801 binding were observed. Binding density of [(3)H]PK11195, a ligand for peripheral benzodiazepine receptors expressed on activated microglia, was elevated proximal to cannula tracks in all animals, but was not altered by EtOH or Tat exposure. These findings suggest that EtOH abuse and/or dependence in HIV-positive individuals may promote HIV-1-associated cognitive deficits by altering NMDA receptor function in the absence of microglial activation or neuroinflammation.
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PMID:Intra-cornu ammonis 1 administration of the human immunodeficiency virus-1 protein trans-activator of transcription exacerbates the ethanol withdrawal syndrome in rodents and activates N-methyl-D-aspartate glutamate receptors to produce persisting spatial learning deficits. 1961 15

Cordyceps militaris is a potential harbour of bio-metabolites for herbal drugs and evidences are available about its applications for revitalization of various systems of the body from ancient times. Amongst all the species, C. militaris is considered as the oldest source of some useful chemical constituents. Besides their popular applications for tonic medicine by the all stairs of the community, the constituents of C. militaris are now used extensively in modern systems of medicine. The current survey records the mysterious potentials of C. militaris are boosting up the present herbal treatments, as well as gearing up the green pharmacy revolution, in order to create a friendly environment with reasonable safety. Evidence showed that the active principles of C. militaris are beneficial to act as pro-sexual, anti-inflammatory, anti-oxidant/anti-aging, anti-tumour/anti-cancer/anti-leukemic, anti-proliferative, anti-metastatic, immunomodulatory, anti-microbial, anti-bacterial, anti-viral, anti-fungal, anti-protozoal, insecticidal, larvicidal, anti-fibrotic, steroidogenic, hypoglacaemic, hypolipidaemic, anti-angiogenetic, anti-diabetic, anti-HIV, anti-malarial, anti-fatigue, neuroprotective, liver-protective, reno-protective as well as pneumo-protective, let alone their other synergistic activities, which let it be marketable in the western countries as over-the-counter medicine. A number of culture techniques for this mushroom have been noticed, for example, storage/stock culture, pre-culture, popular/indigenous culture (spawn culture, husked rice culture and saw dust culture) and, special/laboratory culture (shaking culture, submerged culture, surface liquid culture and continuous/repeated batch culture). The prospects for herbal biotechnology regarding drug discovery using C. militaris delivering what it has promised are high, as the technology is now extremely more powerful than before. This study chiefly highlights the medicinal uses of the mushroom C. militaris including its culture techniques, also aiming to draw sufficient attention of the researchers to the frontier research needs in this context.
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PMID:Medicinal uses of the mushroom Cordyceps militaris: current state and prospects. 2065 Mar 8

Movement disorders have been increasingly recognized in patients with HIV infection and may be due to distinct causes, as opportunistic infections or medication side effects for example. Parkinsonism, tremor and hemichorea have been more frequently noted in association with HIV and opportunistic infections. However, a variety of involuntary movements have already been described. We report a case of neurotoxoplasmosis in a patient with HIV infection who presented with a dystonic tic involving ocular, oral and cervical movements.
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PMID:Tic Disorder: An Unusual Presentation of Neurotoxoplasmosis in a Patient with AIDS. 2111 85

Uptake of VCT and other HIV prevention strategies among rural African women is affected by various socio-cultural and economic factors which need elucidation. Our aim was to establish the responsiveness to HIV education among rural women attending three dispensaries in Kenya. This study was designed to assess gender and psycho-social factors that influence HIV dynamics in rural Kenya. This was a cross-sectional questionnaire based study of 1347 women, conducted in October 2009. Socio-economic status as well as knowledge on methods of HIV transmission was assessed. Testing status, knowledge on existing VCT services and willingness to share HIV information with their children was assessed. Majority of the women have heard about VCT services, but significantly few of them have been tested. Those with secondary school education and above are more knowledgeable on methods of HIV transmission, while those with inadequate education are more likely to cite shaking hands, sharing utensils, mosquito bites and hugging as means of transmission (p = 0.001). 90% of educated women are willing to share HIV information with their children, compared to 40% of uneducated women. Marital status is seen to positively influence testing status, but has no significant effect on dissemination of information to children. We conclude that despite the aggressive HIV education and proliferation of VCT services in Kenya, women are not heeding the call to get tested. Education has a positive impact on dissemination of HIV information. Focus needs to shift into increasing acceptability of testing by women in rural Kenya.
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PMID:Responsiveness to HIV education and VCT services among Kenyan rural women: a community-based survey. 2149 9

The objective of this study was to develop and evaluate a simple scoring scheme to screen for active tuberculosis (TB) among HIV-infected patients. Two hundred fifty-seven HIV-infected patients were enrolled in the study between April 2009 and May 2010 from Mae Sai District Hospital and Lampang Regional Hospital. Participants underwent routine evaluations to diagnose TB. Data collection included demographics, medical history, signs and symptoms and laboratory results. Of the 257 HIV-infected patients enrolled, 66 (25.7%) were diagnosed with active TB. Six variables were statistically significant predictors of active TB (p < 0.05): BMI < or = 19 kg/m2, cough > 2 weeks, shaking chills > or = 1 week not taking antiretroviral drugs, a CD4+ cell count level < 200 cells/microl, and had a history of TB. A risk score (ranging from 0 to 16) gave a 92.1% sensitivity of being associated with active TB. A low risk score (< or = 2.0), a moderate risk score (3.0-7.0), and a high risk score (>7.0) gave positive likelihood ratios (LHR+) of 0.04 (95% CI 0.01-0.24), 2.56 (95% CI 1.71-3.85), and 11.72 (95% CI 4.91-27.96), respectively. This screening tool may be useful to identify patients who should have further diagnostic testing for TB, but requires further validation before adoption due to the variability of predicting factors and the prevalence of TB in the target population.
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PMID:Screening scheme development for active TB prediction among HIV-infected patients. 2229 69

A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.
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PMID:Sexual behavior among truck drivers. 2268 74


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