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Mercury poisoning: a case of a complex neuropsychiatric illness.

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Neurological aspects of hallucinogenic drugs.

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Level of sleep disorders among patients with chronic obstructive pulmonary disease.

OBJECTIVE: Erectile dysfunction (ED) is a major complication in diabetes mellitus. A novel method, high-tone external muscle stimulation (HTEMS), has been proven to be useful in the therapy of diabetic and uremic peripheral polyneuropathy. The aim of this study was to test the potential effect of HTEMS on ED in diabetic patients. DESIGN: An open-label, self-controlled interventional prospective study was conducted at the 2nd Department of Internal Medicine and N.C. University of Pécs, Hungary. Six Type 2 diabetic patients (mean age 59 ± 7 years) with severe ED (International Index of Erectile

Health technology assessment of drugs for rare diseases: insights, trends, and reasons for negative recommendations from the CADTH common drug review.

BackgroundA shift in biochemical research towards drugs for rare diseases has created new challenges for the pharmaceutical industry, government regulators, health technology assessment agencies, and public and private payers. In this article, we aim to comprehensively review, characterize, identify possible trends, and explore reasons for negative reimbursement recommendations in submissions made to the Common Drug Review (CDR) for drugs for rare diseases (DRD) at the Canadian Agency for Drugs and Technologies in Health (CADTH), a publicly funded pan-Canadian health technology assessment agen

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… Chemical/Central Nervous System Depressant Narcolepsy 25 a Withdrawn 05/05/2008 Thelin Sitaxsentan sodium Encysive Canada Inc. Chemical/Endothelin receptor antagonist Pulmonary arterial hypertension 3.3 a Do not list 09/07/2008 Xyrem sodium oxybate Valeant Canada Ltd. … | 25 a | Withdrawn 05/05/2008 | Thelin | Sitaxsentan sodium | Encysive Canada Inc. | Chemical/Endothelin receptor antagonist | Pulmonary arterial hypertension | 3.3 a | Do not list 09/07/2008 | Xyrem | sodium oxybate | Valeant Canada Ltd. | Chemical/Central Nervous System Depressant | Narcolepsy | 25 …

Psychogenic Non-epileptic Seizures: An Updated Primer.

BACKGROUND: Psychogenic non-epileptic seizures are the most common paroxysmal event misdiagnosed as epilepsy. They significantly affect quality of life, functional status, and use of medical resources. OBJECTIVE: The goal of this review is to provide guidance to psychiatrists and other mental health professionals in the understanding and practical management of this condition. RESULTS: An abundance of new reports on the pathogenesis and effective treatments have become available over the last decade, yet specific barriers impede the fluid transition to treatment and remain an important chall

Sleepy driver near-misses may predict accident risks.

STUDY OBJECTIVES: To quantify the prevalence of self-reported near-miss sleepy driving accidents and their association with self-reported actual driving accidents. DESIGN: A prospective cross-sectional internet-linked survey on driving behaviors. SETTING: Dateline NBC News website. RESULTS: Results are given on 35,217 (88% of sample) individuals with a mean age of 37.2 +/- 13 years, 54.8% women, and 87% white. The risk of at least one accident increased monotonically from 23.2% if there were no near-miss sleepy accidents to 44.5% if there were > or = 4 near-miss sleepy accidents (P < 0.0001

Characterization of the spontaneous and gripping-induced immobility episodes on taiep rats.

In 1989, we described a new autosomic-recessive myelin-mutant rat that develops a progressive motor syndrome characterized by tremor, ataxia, immobility episodes (IEs), epilepsy, and paralysis. taiep is the acronym of these symptoms. The rat developed a hypomyelination, followed by demyelination. At an age of 7-8 months, taiep rats developed IEs, characterized electroencephalographically by REM sleep-like cortical activity. In our study, we analyzed the ontogeny of gripping-induced IEs between 5 and 18 months, their dependence to light-dark changes, sexual dimorphism, and susceptibility to mil

Hyperexcitable arousal circuits drive sleep instability during aging.

Sleep quality declines with age; however, the underlying mechanisms remain elusive. We found that hyperexcitable hypocretin/orexin (Hcrt/OX) neurons drive sleep fragmentation during aging. In aged mice, Hcrt neurons exhibited more frequent neuronal activity epochs driving wake bouts, and optogenetic activation of Hcrt neurons elicited more prolonged wakefulness. Aged Hcrt neurons showed hyperexcitability with lower KCNQ2 expression and impaired M-current, mediated by KCNQ2/3 channels. Single-nucleus RNA-sequencing revealed adaptive changes to Hcrt neuron loss in the aging brain. Disruption of

Dopamine receptor gene polymorphisms in Parkinson's disease patients reporting "sleep attacks".

Genes encoding proteins involved in dopaminergic transmission are potential candidate genes for the induction of somnolence in Parkinson's disease (PD) because dopaminergic agents have been shown to be associated with sudden onset of sleep (SOS) in PD. We conducted an association study on dopamine D2, D3, and D4 receptor gene polymorphisms comparing 137 PD patients with SOS and 137 PD patients without SOS matched according to drug therapy, disease duration, sex, and age. Our results show a significant association between the dopamine D2 receptor gene polymorphism Taq IA and SOS in PD. No signi

Daytime sleepiness: a risk factor in community life.

The prevalence of daytime sleepiness and background factors associated with it were investigated in a study carried out at the UKK Institute. The inquiry took the form of a questionnaire mailed to 1600 people of middle age. Daytime sleepiness was found to be associated with disturbed night sleep. Women were more tired than men, but men slept more frequently during the day. Those suffering from tiredness complained of poor health more than other respondents. Traffic accidents and other mishaps attributable to tiredness had occurred in 1.3% of cases, and almost 5% of male respondents had dozed o

SPONTANEOUS LEG CRAMPS AND "RESTLESS LEGS" DUE TO DIABETOGENIC HYPERINSULINISM: OBSERVATIONS ON 131 PATIENTS.

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A population-based study of the clinical course of chronic fatigue syndrome.

BackgroundChronic fatigue syndrome (CFS) presents a challenge for patients, health care providers, and health insurance groups because of its incapacitating nature, unknown cause, and poorly understood prognosis. We conducted a longitudinal population-based study to characterize the clinical course of CFS.MethodsSixty-five CFS subjects were identified from a random-digit-dialing survey of Wichita, Kansas residents and followed for up to 3 years. We evaluated changes in CFS classification (partial or total remission, alternative medical or psychiatric diagnoses), CFS case-defining criteria, wel

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… Overall, 23.1% (15 of 65) were eventually diagnosed with permanent exclusions, of which the most common were sleep disorders (i.e. sleep apnea or narcolepsy) (3 of 15), major depressive disorder with melancholia (3 of 15) and inflammatory bowel disease (2 of 15). … Sleep apnea or narcolepsy and major depression disorder with melancholia were the most prevalent (20%). This proportion was remarkably higher than clinic-based studies that report rates between 2% and 13% [ 2 ]. …

Do payers value rarity? An analysis of the relationship between disease rarity and orphan drug prices in Europe.

Background and Objective: Orphan drugs have been a highlight of discussions due to their higher prices than non-orphan drugs. There is currently no European consensus on the method of value assessment for orphan drugs. This study assessed the relationship between the prevalence of rare diseases and the annual treatment cost of orphan drugs in France, Germany, Italy, Norway, Spain, Sweden, and UK. Methods: Approved orphan drugs and prevalence data were extracted from the European Medicines Agency website. Annual treatment costs were calculated using ex-factory price. Simple regression was used

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… 5.00 Wilzin* Hepatolenticular degeneration 0.60 Xagrid Essential thrombocythaemia 2.50 Xaluprine Acute lymphoblastic leukaemia 1.20 Xyrem* Narcolepsy 5.00 Yondelis Sarcoma 0.61 Zavesca Gaucher disease 0.60 *Orphan designation withdrawn or expired. ** No prices available in the countries in scope; probably … | 5.00 Wilzin* | Hepatolenticular degeneration | 0.60 Xagrid | Essential thrombocythaemia | 2.50 Xaluprine | Acute lymphoblastic leukaemia | 1.20 Xyrem* | Narcolepsy | 5.00 Yondelis | Sarcoma | 0.61 Zavesca | Gaucher disease | 0.60 Not all orphan drugs are commercially available in all seven countries …

Sodium Oxybate for Excessive Daytime Sleepiness and Sleep Disturbance in Parkinson Disease: A Randomized Clinical Trial.

IMPORTANCE: Sleep-wake disorders are a common and debilitating nonmotor manifestation of Parkinson disease (PD), but treatment options are scarce. OBJECTIVE: To determine whether nocturnal administration of sodium oxybate, a first-line treatment in narcolepsy, is effective and safe for excessive daytime sleepiness (EDS) and disturbed nighttime sleep in patients with PD. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled, crossover phase 2a study carried out between January 9, 2015, and February 24, 2017. In a single-center study in the sleep laboratory at the Uni…

Cerebral blood flow changes in man by wake-promoting drug, modafinil: a randomized double blind study.

To investigate the effects of a wake-promoting drug, modafinil on regional cerebral blood flow (rCBF) in healthy volunteers, we performed (99m)Tc-ethylcysteinate dimer single photon emission computed tomography (SPECT) before and after modafinil or placebo administration. Twenty-one healthy subjects received single doses of 400 mg modafinil or placebo in a double blind randomized crossover study design. Administrations of modafinil or placebo in a subject were separated by a 2-week washout. Brain SPECT was performed twice before and 3 h after modafinil or placebo administration. For statistica

Medical-psychological implications of recent sleep research.

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Amphetamine abuse.

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The neurocognitive effects of sleep disruption in children and adolescents.

Sleep problems in children and adolescents are common, and sleep disruption is associated with a wide range of behavioral, cognitive, and mood impairments, including hyperactivity, reduced school grades, and depression. Insufficient or fragmented sleep may induce sleepiness, which is associated with problematic behavior, impaired learning, and/or negative mood. Furthermore, treatment of sleep disruption, by improving sleep hygiene or treating specific sleep disorders, is often associated with improvements in daytime performance, suggesting a common mechanism for the behavioral manifestations.

Autonomic dysfunction in childhood hypersomnia disorders.

OBJECTIVE: Orthostatic intolerance (OI) is a common manifestation of autonomic dysfunction. It is characterized by light-headedness and palp … children and adolescents with hypersomnia disorders were reviewed. Subjects had been diagnosed with narcolepsy types 1 or 2 (NT1 or NT2), idiopathic hypersomnia (IH) or the KLS, or hypersomnia related to medical conditions, were under 18 years of age at sleep diagnosis, and had been evaluated at our sleep center between 2000 and 2018. Those with comorbiditie …

Differential expression of orexin receptors 1 and 2 in the rat brain.

Orexins (hypocretins) are neuropeptides synthesized in the central nervous system exclusively by neurons of the lateral hypothalamus. Orexin-containing neurons have widespread projections and have been implicated in complex physiological functions including feeding behavior, sleep states, neuroendocrine function, and autonomic control. Two orexin receptors (OX(1)R and OX(2)R) have been identified, with distinct expression patterns throughout the brain, but a systematic examination of orexin receptor expression in the brain has not appeared. We used in situ hybridization histochemistry to exami