"The Problem of Boutonniere Deformity". Clinical Orthopaedics and Related Research. 104 (104): 116–133. doi:10.1097/00003086-197410000-00012. PMID 4607222. Nalebuff, Edward A.; Millender, Lewis H. (July 1975). "Surgical Treatment of the Boutonniere Deformity in Rheumatoid Arthritis". Orthopedic Clinics of North America. 6 (3): 753–763. doi:10.1016/S0030-5898(20)30987-1. PMID 1099508. Littler, J. William; Eaton, Richard G. (October 1967). "Redistribution of Forces in the Correction of the Boutonnière Deformity". JBJS. 49 (7): 1267–1274. doi:10.2106/00004623-196749070-00002. PMID 5622971. To, Philip; Watson, Jeffry T. (January 2011). "Boutonniere Deformity". The Journal of Hand Surgery. 36 (1): 139–142. doi:10.1016/j.jhsa.2010.10.032. PMID 21193133. Massengill, James B. (November 1992). "The boutonniere deformity". Hand Clinics. 8 (4): 787–801. doi:10.1016/S0749-0712(21)00744-7. PMID 1460075. Aiache, Adrien; Barsky, Arthur J.; Weiner, Daniel L. (August 1970). "Prevention of the boutonniere deformity". Plastic and Reconstructive Surgery. 46 (2): 164–167. doi:10.1097/00006534-197008000-00010. PMID 5423482. S2CID 39268503. Curtis, Raymond M.; Reid, Robert L.; Provost, John M. (March 1983). "A staged technique for the repair of the traumatic boutonniere deformity". The Journal of Hand Surgery. 8 (2): 167–171. doi:10.1016/s0363-5023(83)80009-4. PMID 6833725. Urbaniak, James R.; Hayes, Michael G. (July 1981). "Chronic boutonniere deformity—An anatomic reconstruction". The Journal of Hand Surgery. 6 (4): 379–383. doi:10.1016/s0363-5023(81)80048-2. PMID 7252114. Dolphin, James A. (January 1965). "Extensor Tenotomy for Chronic Boutonnière Deformity of the Finger: REPORT OF TWO CASES". JBJS. 47 (1): 161–164. doi:10.2106/00004623-196547010-00011. PMID 14256963. External links
Boutonniere Deformity at eMedicine
Istradefylline, sold under the brand name Nourianz, is a medication used as an add-on treatment to levodopa/carbidopa in adults with Parkinsons disease (PD) experiencing "off" episodes. Istradefylline reduces "off" periods resulting from long-term treatment with the antiparkinson drug levodopa. An "off" episode is a time when a patients medications are not working well, causing an increase in PD symptoms, such as tremor and difficulty walking.Relatively common side effects include involuntary muscle movements (dyskinesia), constipation, hallucinations, dizziness and, much like its parent molecule caffeine, nausea and sleeplessness.The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication. Mechanism of action
Istradefylline is a selective antagonist at the adenosine A2A receptor (A2AR), but the precise mechanism by which it exerts its therapeutic effect in Parkinsons disease is unknown. However, it is known that dimers of these receptors form heterotetramers with the dimers of dopamine D2 receptors (D2R) within striatum. Adenosine acts as an endogenous A2AR agonist, but also as a negative allosteric modulator (NAM) within these tetramers towards D2Rs, thus inhibiting the D2R mediated effects of dopamine, an endogenous D2R agonist. Istradefylline is believed to bind an A2AR within an A2AR-D2R-tetramer and function as a NAM towards the other A2AR (instead of D2R), thus inhibiting the effects of adenosine and enhancing the movement (locomotion) promoting effects exerted by dopamine via D2R.