scholarly journals Systematic review of the beneficial effects of thrombin and vitamin K inhibitors on migraine treatment

2019 ◽  
pp. 5-9
Author(s):  
Eduardo de Almeida Guimaraes Nogueira ◽  
Angela dos Anjos Couto ◽  
Beatriz Moraes Grossi ◽  
Gabriela Dias Nunes ◽  
Taliê Zanchetta B. Hanada ◽  
...  
Keyword(s):  
Systematic Review ◽  
Calcium Channel ◽  
Vitamin K ◽  
Beta Blockers ◽  
Case Series ◽  
Thrombin Inhibitors ◽  
Migraine Treatment ◽  
Calcium Channel Antagonists ◽  
Beneficial Effects ◽  
Patients With Epilepsy

Background: Prophylactic migraine therapy includes beta-blockers, anticonvulsants, tricyclic antidepressants and calcium channel modulators. These drugs have been serendipitously identified as agents capable of migraine control. In order to reduce drug intake, interactions and potential adverse events, patients who have high blood pressure and migraine are often prescribed beta-blockers or calcium channel antagonists. Patients with epilepsy and migraine can use anticonvulsants, those with depression and migraine can be treat with antidepressants, and those with heart arrhythmia or recurrent vertigo and concomitant migraine can benefit from use of calcium channel antagonists. The beneficial effects of vitamin K or thrombin inhibitors on migraine attacks were first described decades ago, and there may be a place for these drugs in migraine prophylaxis. Objective: To investigate the potential beneficial effects of this class of anticoagulants regarding prevention of migraine attacks. Method: Systematic review of the literature including papers with patients’ results. Results: A search of the literature yielded 16 papers with data on patients using inhibitors of vitamin K or thrombin for thromboembolic conditions. Articles typically reported on single cases or small case series. In all but one of these reports, the effect of the drug was remarkable in decreasing migraine severity. Conclusion: Although the level of recommendation is low due to the lack of proper clinical trials, vitamin K or thrombin inhibitors may be useful for migraine management in patients who also require anticoagulation. For these individuals, use of this class of anticoagulants could avoid adding extra drugs for migraine management.

scholarly journals Systematic review of the beneficial effects of thrombin and vitamin K inhibitors on migraine treatment

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Eduardo de Almeida Guimaraes Nogueira ◽  
Angela dos Anjos Couto ◽  
Beatriz Moraes Grossi ◽  
Gabriela Dias Nunes ◽  
Taliê Zanchetta B. Hanada ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin K ◽  
Migraine Treatment ◽  
Beneficial Effects

scholarly journals Treatment of migraine in patients with CADASIL

2019 ◽  
Vol 10 (6) ◽  
pp. 488-496
Author(s):  
Patrick A. Glover ◽  
Eric D. Goldstein ◽  
Mohammed K. Badi ◽  
Tara J. Brigham ◽  
Elizabeth R. Lesser ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autosomal Dominant ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Migraine Treatment ◽  
Controlled Trials ◽  
Consensus Guidelines ◽  
Safety And Efficacy ◽  
Cerebrovascular Autoregulation ◽  
Theoretical Risk

BackgroundMigraine is a common and often refractory feature for individuals with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) without consensus guidelines for treatment. Migraine treatment poses a theoretical risk within this unique population with precarious cerebrovascular autoregulation, given the vasomodulatory influence of many antimigraine medications. In this systematic review and meta-analysis, we evaluate the frequency and efficacy of treatments for migraine in individuals with CADASIL.MethodsA search protocol was designed to include all available publications reporting antimigraine therapies for CADASIL. Individual responses to medications were categorized as unfavorable, neutral, or favorable. Responses across medication classes were compared using the Mann-Whitney U test.ResultsThirteen studies were included, yielding a cohort of 123 individuals with a median age of 53 years (range: 23–83 years), with 61% (75/123) being women. No controlled trials were identified. Simple analgesics (35.8%, 44/123) and beta-blockers (22.0%, 27/123) were the most common abortive and prophylactic strategies, respectively. Over half (54.4%) of all patients had used more than 1 medication sequentially or concomitantly. Beta-blockers were significantly associated with a neutral or unfavorable response (13.5%, 22/163, p = 0.004). We found no significant associations among other medication categories.ConclusionsMigraine in CADASIL remains a formidable therapeutic challenge, with patients often tried on several medications. Antimigraine prophylaxis with beta-blockers may be contraindicated relative to other common therapies in CADASIL. Controlled studies are needed to rigorously evaluate the safety and efficacy of antimigraine therapies in this population.

scholarly journals Management of Calcium Channel Antagonist Overdose with Hyperinsulinemia-Euglycemia Therapy: Case Series and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shiwan K. Shah ◽  
Sanjeev Kumar Goswami ◽  
Rajesh V. Babu ◽  
Gulshan Sharma ◽  
Alexander G. Duarte
Keyword(s):  
Literature Review ◽  
Supportive Care ◽  
Calcium Channel ◽  
Fluid Resuscitation ◽  
Calcium Channel Antagonist ◽  
Case Series ◽  
Review Of The Literature ◽  
Calcium Channel Antagonists ◽  
Drug Overdoses ◽  
Potential Use

Calcium channel antagonists (CCAs) are commonly involved in drug overdoses. Standard approaches to the management of CCA overdoses, including fluid resuscitation, gut decontamination, administration of calcium, glucagon, and atropine, as well as supportive care, are often ineffective. We report on two patients who improved after addition of hyperinsulinemia-euglycemia (HIE) therapy. We conclude with a literature review on hyperinsulinemia-euglycemia therapy with an exploration of the physiology behind its potential use.

Effect of Vitamin K Supplementation on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 19 (1) ◽  
pp. 13-25 ◽  
Author(s):  
Hitesh Verma ◽  
Rajeev Garg
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Vitamin K ◽  
Cardiometabolic Risk ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Cardiometabolic Risk Factors ◽  
Beneficial Effects ◽  
Present Systematic Review

Background: Multiple cross sectional and longitudinal studies reported the benefits of vitamin K intake for management of cardiometabolic risk factors so as to minimize the risk of cardiovascular diseases. Objective: In present systematic review and meta-analysis, we aimed to evaluate the effect of vitamin K supplementation on cardiometabolic risk factors. Methodology: A systematic literature search of PubMed, Cochrane central, Clinicaltrials.gov, Google Scholar, Web of Science, EBSCO and Scopus databases was done from inception to November, 2017. A total of 13 trials were selected for inclusion into the present systematic review to evaluate the effect of vitamin K supplementation on cardiometabolic risk factors in healthy or in population at high risk of cardiovascular diseases. Results: Significant beneficial effects of vitamin K supplementation were found only in case of Creactive protein (p = 0.01) and insulin sensitivity index (p <0.001), while no significant effects of vitamin K supplementation were found in case of total cholesterol (p=0.857), low density lipoprotein – cholesterol (p=0.964), high density lipoprotein – cholesterol (p=0.998), interleukin – 6 (p=0.766), systolic blood pressure (p=0.660), diastolic blood pressure (p=0.818), fasting plasma glucose (p=0.362), fasting plasma insulin (p=0.928) and homeostasis model assessment for insulin resistance (p=0.672). Conclusion: Presently available evidence are insufficient to ascertain the beneficial effects of vitamin K supplementation for the management of cardiometabolic risk factors. In order to explore the true potential of vitamin K supplementation for management of cardiometabolic diseases, large randomized placebo controlled trials are required in population with disturbed cardiometabolic profile. Present systematic review and meta-analysis is registered with PROSPERO (Registration number: CRD42018084608).

scholarly journals A systematic review of calcium channel antagonists in bipolar disorder and some considerations for their future development

2016 ◽  
Vol 21 (10) ◽  
pp. 1324-1332 ◽  
Author(s):  
A Cipriani ◽  
K Saunders ◽  
M-J Attenburrow ◽  
J Stefaniak ◽  
P Panchal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Calcium Channel ◽  
Future Development ◽  
Calcium Channel Antagonists

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

Dental Implant Placement in Patients with a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review

2020 ◽  
Author(s):  
Judd Sher ◽  
Kate Kirkham-Ali ◽  
Denny Luo ◽  
Catherine Miller ◽  
Dileep Sharma
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Drug Therapy ◽  
Dental Implant ◽  
Case Series ◽  
Cochrane Central Register ◽  
Bisphosphonate Treatment ◽  
Implant Placement ◽  
Increased Risk ◽  
History Of

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

Sign in / Sign up

Export Citation Format

Share Document