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Score at Baseline, Score at Final Visit, Measure N Mean SD ; N Mean SD ; ADHD-RS-IV School Version All-patient group Modafinil 410 37.2 9.1 ; 411 20.8 13.5 ; Placebo 210 36.5 9.0 ; 210 28.1 12.6 ; Prior-stimulant group Modafinil 189 37.5 9.1 ; 189 23.3 14.2 ; Placebo 108 37.1 8.5 ; 108 27.7 13.2 ; Medication- or stimulant-naive group Modafinil 221 37.0 9.1 ; 222 18.8 12.6 ; Placebo 102 35.8 9.5 ; 102 28.5 12.0 ; ADHD-RS-IV Home Version All-patient group Modafinil 409 39.3 9.2 ; 410 24.1 14.1 ; Placebo 210 38.2 9.6 ; 208 30.7 13.3 ; Prior-stimulant group Modafinil 188 39.8 9.3 ; 189 25.3 14.5 ; Placebo 108 38.5 9.6 ; 107 31.0 13.3 ; Medication- or stimulant-naive group Modafinil 221 38.9 9.0 ; 221 23.1 13.7 ; Placebo 102 37.9 9.7 ; 101 30.4 13.3 ; a For the difference between modafinil and placebo in the mean change from baseline. Abbreviation: ADHD-RS-IV Attention-Deficit Hyperactivity Disorder Rating Scale-IV. N Change from Baseline, Mean SD ; p Valuea.
Modafinil home basic facts advanced reading community patient type view more » modafinil guide» modafinil is used to treat excessive sleepiness caused by narcolepsy a condition that causes excessive daytime sleepiness ; or shift work sleep disorder sleepiness during scheduled waking hours and difficulty falling asleep or staying asleep during scheduled.
Sponse to GH treatment. We found no relationship between the mean GH levels and the response to GH therapy. We speculate that increased GH secretory burst frequency may be a reflection of decreased GH and or IGF-I negative feedback on the hypothalamo-pituitary component of the somatotropic axis. Indeed, a similar picture of increased GH pulse frequency and poor spontaneous linear growth is also seen in insulin-dependent diabetes mellitus and caloric deprivation 33, 34 ; . The exact basis for putatively attenuated tissue and or feedback actions of GH or IGF-I in these conditions is not known. We conclude that a pattern of elevated GH pulse frequency is associated with low IGF-I levels and inefficient spontaneous growth in girls with Turner's syndrome, and that girls with such an endogenous pulse pattern may benefit most from exogenous GH therapy. We speculate that the high GH pulse frequency may be a marker of mildly impaired GH IGF-I autofeedback and or tissue action, which can be overcome by exogenous GH administration. Acknowledgments.
Table 3. Percentage of Well-Child Visits With Any Counseling, Stratified by Insurance Type and HMO Status.
Modafinil is used for narcolepsy, yes, but is also used for other sleep disorders, as those mentioned above
And non-positive parts are standard. k is a gamma-integer. L is a list e 1 ; , I where the e j ; are beta-integers, 1 le e 1 ; and the I j ; are binary rational isolating intervals, I j ; a j ; , for the r distinct real roots of A if for the r distinct real roots of A in the multiplicity of the root alpha j ; in I and abs b j ; -a j left-open and right-closed interval if a j ; one-point interval if a j ; procedure IPRCHS A, I, KL: LIST ; : LIST; fIntegral polynomial real root calculation, high-precision special. A is a positive, primitive, squarefree, univariate, integral polynomial of positive degrre with GCD A, APP ; 1. I is either the null list ; or a standard interval or an interval whose positive and non-positive parts are standard. k is a gamma-integer. L is a list I 1 ; , ., I binary rational isolating intervals I j ; a for the r distinct real roots of A if for the r distinct real roots of A of with b j ; -a j ; kl. I j ; is left-open and right-closed interval if a j ; one-point interval if a j ; procedure IPRCNP A, I: LIST; VAR SLP, SLPP, J: LIST fIntegral polynomial real root calculation, newton method preparation. A is a positive, primitive, squarefree, univariate integral polynomial of positive degree. I is an open interval a1, a2 ; with binary rational endpoints containing no roots of AP and APP. sp and spp, beta-integers, are the signs of AP and APP on I. J subinterval b1, b2 ; of I with binary rational endpoints, containing alpha and such that spp * SIGN AP b1 ; + where f -3 4 ; * sp * spp ; . J is left-open and right-closed interval if b1 lt b2, the one-point interval if b1 b2.g procedure IPRCN1 A, I, SL, KL: LIST ; : LIST; fIntegral polynomial real root calculation, 1 root. A is a positive primitive univariate integral polynomial of positive degree. I is an open interval a1, a2 ; with binary rational endpoints containing a unique root alpha of A and containing no roots of AP or APP. s, a beta-integer, is the sign of AP * APP on I. min abs AP a1 , abs AP a2 ; le max abs AP a1 , abs AP a2 ; . beta-integer. J is a subinterval of I of length 2 * k or less containing alpha and with binary rational endpoints.g procedure IPRIM A: LIST ; : LIST; fIntegral polynomial real root isolation, modi ed Uspensky method. A is a non-zero squarefree univariate integral polynomial. L is a list I sub 1 , ., I sub r ; of strongly disjoint isolating intervals for all of the real roots of A with I sub 1 lt I sub 2 lt . sub r. Each I sub j has binary rational endpoints and is either left-open and right-closed or a one-point interval.g procedure IPRIMO A, AP, I: LIST ; : LIST; fIntegral polynomial real root isolation, modi ed Uspensky method, open interval. A is a univariate integral polynomial without multiple roots. AP is the derivative of A. I open interval a, b ; with binary rational endpoints, represented by the list a, b ; , such that there are integers h and k for which a h * 2 * and b h + list I 1 ; , ., I isolating intervals for the real roots of A in Each I j ; is left open right closed interval with binary rational endpoints and I 1 ; lt procedure IPRIMS A, AP, I: LIST ; : LIST; fIntegral polynomial real root isolation, modi ed Uspensky method, standard interval. A is a univariate integral polynomial without multiple roots. AP is the derivative of A. I standard interval. L is a list I 1 ; , ., I isolating intervals for the real roots of A in Each interval I j ; is left open right closed interval a j ; , b with binary rational endpoints and I 1 ; lt procedure IPRIMU A: LIST ; : LIST; fIntegral polynomial real root isolation, modi ed Uspensky method, unit interval. A is a squarefree univariate integral polynomial. L is a list I 1 ; , ., I isolating intervals for all the roots of A in the left closed right open interval 0, 1 ; . Each I j ; is pair a j ; , b binary rational numbers, with 0 le a then a j ; , b represents the one-point interval a j ; , b then the pair a j ; , b represents the open interval and modicon.
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Who required intubation during his stem cell mobilization period. Another patient required noninvasive biphasic positive airway pressure throughout his course. Of the 14 evaluable patients, all have had neurologic improvement or stabilization. Other features have improved substantially. PBSCT for POEMS syndrome is effective therapy but may also be associated with significant morbidity. Blood. 2004; 104: 3400-3407.
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Carcinogenicity studies were conducted in which modafinil was administered in the diet to mice for 78 weeks and to rats for 104 weeks at doses of 6, 30 and 60 mg kg day. The highest dose studied represents 1.5 times mouse ; or 3 times rat ; greater than the maximum recommended human daily dose of 200 mg on a mg m2 basis. There was no evidence of tumorigenesis associated with modafinil administration in these studies, but because the mouse study used an inadequate high dose that was not representative of a maximum tolerated dose, the carcinogenic potential of modafinil has not been fully evaluated and moxifloxacin
The national institutes of health will study the use of provigil modafinil ; to treat fatigue in pps.
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1. O'Brien CP. Anticraving medications for relapse prevention: a possible new class of psychoactive medications. J Psychiatry 2005; 162: 14231431 Dackis CA, Kampman KM, Lynch KG, et al. A double-blind, placebo-controlled trial of modafinil for cocaine dependence.
Conclusions: modafinil is a promising countermeasure for sleep loss in normals; however, additional studies aimed at reducing side effects are needed before it should be used in aviators and multivitamin.
Fatigue Fatigue is a symptom commonly reported by headache patients. Two studies have indicated that 50% of migraine patients report significant "excessive daytime sleepiness". Unfortunately, little is understood about its cause. The following medications are sometimes utilized to treat fatigue: 1. Provigil modafinil ; : This fairly safe medication is classified as a wakepromoting agent. Usual doses start at 100 mg. daily and occasionally are increased up to 400 mg. a day if needed. Most patients are on 200 mg. a day. The most common side effects with this medication are headache, nausea and anxiety. Unfortunately, Provigil may actually increase headache. 2. Stimulants dextroamphetamine, methylphenidate, Adderall ; : These medications may be helpful for fatigue, as well as concurrent ADD ADHD. They may help to decrease pain or headache as well. Some of these medications come in short-acting and long-acting preparations, which is helpful. The main side effects consist of decreased appetite, insomnia and dry mouth. Adderall XR is a good long-acting preparation, usually dosed once daily. 3. Wellbutrin bupropion ; : This medication is an antidepressant which is beneficial due to its activating nature. The doses are available in SR slowrelease tablets 100 mg., 150 mg., and 200 mg. tablets, along with a once-daily XL form, which comes in 150 mg. and 300 mg. dosage. Depending on comorbid anxiety and depression, the dose range may vary from 100 mg. up to 300 mg. per day. The advantages of Wellbutrin are that sedation, weight gain and sexual side effects are much lower than with many of the other antidepressants. See previous section on Wellbutrin. 4. Caffeine: While caffeine may offset fatigue, it is not ideal due to it's shortacting activity. Caffeine may help headache, but overuse leads to more headaches. Doses should be limited to 200mg per day at most ; . See previous section on "Sources of Caffeine.
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Severe chronic renal failure did not significantly influence blood levels on modafinil, but one of the breakdown products increased and liver disease did decrease metabolism of modafinil by about 60 and modafinil.
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