The neuropsychological assessment battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid hemorrhage

alkiviadis.1961 shared this article with you from Inoreader The neuropsychological assessment battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid hemorrhage Via Latest Results for BMC Neurology Abstract Background Detecting and treating neuropsychological deficits after aneurysmatic subarachnoid hemorrhage (aSAH) play a key role in regaining independence; however, detecting deficits relevant to social and professional reintegration has been difficult and optimal timing of assessments remains unclear. Therefore, we evaluated the feasibility of administering the Neuropsychological Assessment Battery screening module (NAB-S) to patients with aSAH, assessed its value in predicting the ability to return to work and characterized clinical as well as neuropsychological recovery over the period of 24 months. Methods A total of 104 consecutive patients treated for aSAH were recruited. After acute treatment, follow up visits were conducted at 3, 12 and 24 months after the hemorrhage. NAB-S, Montreal Cognitive Assessment (MoCA) and physical examination were performed at each follow up visit. Results The NAB-S could be administered to 64.9, 75.9 and 88.9% of the patients at 3, 12 and 24 months, respectively. Moderate impairment of two or more neuropsychological domains (e.g speech, executive function, etc.) significantly correlated with inability to return to work at 12 and 24 months as well as poor outcome assessed by the extended Glasgow Outcome Scale (GOSE) at 3, 12 and 24 months. The number of patients with favorable outcomes significantly increased from 25.5% at discharge to 56.5 and 57.1% at 3 and 12 months, respectively, and further increased to 74.1% after 24 months. Conclusion The NAB-S can be administered to the majority of patients with aSAH and can effectively detect clinically relevant neuropsychological deficits. Clinical recovery after aSAH continues for at least 24 months after the hemorrhage which should be considered in the design of future clinical trials. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The neuropsychological assessment battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid hemorrhage

alkiviadis.1961 shared this article with you from Inoreader The neuropsychological assessment battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid hemorrhage Via Latest Results for BMC Neurology Abstract Background Detecting and treating neuropsychological deficits after aneurysmatic subarachnoid hemorrhage (aSAH) play a key role in regaining independence; however, detecting deficits relevant to social and professional reintegration has been difficult and optimal timing of assessments remains unclear. Therefore, we evaluated the feasibility of administering the Neuropsychological Assessment Battery screening module (NAB-S) to patients with aSAH, assessed its value in predicting the ability to return to work and characterized clinical as well as neuropsychological recovery over the period of 24 months. Methods A total of 104 consecutive patients treated for aSAH were recruited. After acute treatment, follow up visits were conducted at 3, 12 and 24 months after the hemorrhage. NAB-S, Montreal Cognitive Assessment (MoCA) and physical examination were performed at each follow up visit. Results The NAB-S could be administered to 64.9, 75.9 and 88.9% of the patients at 3, 12 and 24 months, respectively. Moderate impairment of two or more neuropsychological domains (e.g speech, executive function, etc.) significantly correlated with inability to return to work at 12 and 24 months as well as poor outcome assessed by the extended Glasgow Outcome Scale (GOSE) at 3, 12 and 24 months. The number of patients with favorable outcomes significantly increased from 25.5% at discharge to 56.5 and 57.1% at 3 and 12 months, respectively, and further increased to 74.1% after 24 months. Conclusion The NAB-S can be administered to the majority of patients with aSAH and can effectively detect clinically relevant neuropsychological deficits. Clinical recovery after aSAH continues for at least 24 months after the hemorrhage which should be considered in the design of future clinical trials. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

EFFICACY PROFILE AND SAFETY IMPLICATIONS OF VERY LOW DOSE RITUXIMAB IN PATIENTS WITH GRAVES' ORBITOPATHY.

alkiviadis.1961 shared this article with you from Inoreader EFFICACY PROFILE AND SAFETY IMPLICATIONS OF VERY LOW DOSE RITUXIMAB IN PATIENTS WITH GRAVES' ORBITOPATHY. Via thyroid Related Articles EFFICACY PROFILE AND SAFETY IMPLICATIONS OF VERY LOW DOSE RITUXIMAB IN PATIENTS WITH GRAVES' ORBITOPATHY. Thyroid. 2020 Nov 24;: Authors: Vannucchi G, Campi I, Covelli D, Currò N, Lazzaroni E, Palomba A, Soranna D, Zambon A, Fugazzola L, Muller I, Guastella C, Salvi M Abstract BACKGROUND: Rituximab (RTX), a chimeric human-murine anti-CD20 monoclonal antibody, has been used for treatment of active moderate-severe Graves' orbitopathy (GO) since 2004 as second line therapy in patients unresponsive to intravenous steroids. We conducted an open label, prospective study (EUDRACT 2012-001980-53) in which patients were treated with a single infusion of only 100 mg RTX to analyze the efficacy and safety of this low dose. METHODS: Seventeen patients, of whom nine had disease that was unresponsive to intravenous methylprednisolone, and eight with newly diagnosed GO were enrolled. Disease activity was assessed with the clinical activity score (CAS) and severity with a composite ophthalmic score. Long term surgical treatment and quality of life were also assessed, as well as treatment-related adverse events. RESULTS: Mean baseline CAS was 4.56±0.96 and decreased to 1.25±1.14 at 24 weeks (P=0.001). Disease inactivation occurred within 24 weeks in >90% of patients and was unrelated to disease duration. Severity improved in about 60% of patients, with no relapses. All patients showed peripheral depletion of CD20+ and CD19+ cells at the end of the RTX infusion (60 minutes). Two patients required surgical orbital decompression because of optic neuropathy (ON). Among adverse events observed, there was one patient who developed a cytokine release syndrome. CONCLUSIONS: A dose of 100 mg RTX is effective in patients with active moderate-severe GO. Low doses are better tolerated, expose patients to immune suppression for a shorter period of time and are extremely cost effective, compared to higher doses. This dose, consistently with all other immunosuppressants, does not prevent the progression of GO to dysthyroid optic neuropathy. PMID: 33234032 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ca19.9 positivity and doubling time are prognostic factors of mortality in patients with advanced medullary thyroid cancer with no evidence of structural disease progression according to RECIST.

alkiviadis.1961 shared this article with you from Inoreader Ca19.9 positivity and doubling time are prognostic factors of mortality in patients with advanced medullary thyroid cancer with no evidence of structural disease progression according to RECIST. Via thyroid Related Articles Ca19.9 positivity and doubling time are prognostic factors of mortality in patients with advanced medullary thyroid cancer with no evidence of structural disease progression according to RECIST. Thyroid. 2020 Nov 24;: Authors: Lorusso L, Romei C, Piaggi P, Fustini C, Molinaro E, Agate L, Bottici V, Viola D, Pellegrini G, Elisei R Abstract BACKGROUND: Serum Ca19.9 positivity is a prognostic factor for mortality in patients with advanced medullary thyroid cancer (aMTC), independently from calcitonin (Ct) doubling time (DT). However, it is unknown whether aMTC patients who become positive for Ca19.9 also have progressive disease (PD) according to Response Evaluation Criteria in Solid Tumors (RECIST) and whether Ca19.9 DT has a role in the management of aMTC patients. The aims of this study was to evaluate whether in aMTC, when serum Ca19.9 become positive, PD develops and to determine the role of Ca19.9 DT in predicting mortality and PD. PATIENTS AND METHODS: Serum Ca19.9 was periodically measured in 107 aMTC patients, and the DTs were calculated. Restaging of the disease was radiologically performed in 104/107 and PD was evaluated according to RECIST. RESULTS: At the end of follow-up, 25 of 107 patients were Ca19.9 positive and PD was identified in 30 of 104 patients. No significant association was found between Ca19.9 positivity and PD while there was a significant association between Ca19.9 positivity and mortality (p<0.0001). Ca19.9 DTs <6 months and <1year were not associated with PD but were associated with mortality (p<0.0001 and p<0.0001, respectively). In particular, 3 patients who had a Ca19.9 DT <6 months with no evidence of PD according to RECIST died of their disease after 6, 5 and 3 months, respectively. CONCLUSIONS: Serum Ca19.9 positivity and DTs <6 months and < 1 year are prognostic factors for mortality but not for PD. Serum Ca19.9 positivity and DTs <6 months and < 1 year should be considered in the decision-making process of whether to initiate systemic therapy even if there is no evidence of PD according to RECIST.  . PMID: 33234054 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gut microbiota may play a significant role in the pathogenesis of Graves' disease.

alkiviadis.1961 shared this article with you from Inoreader Gut microbiota may play a significant role in the pathogenesis of Graves' disease. Via thyroid Related Articles Gut microbiota may play a significant role in the pathogenesis of Graves' disease. Thyroid. 2020 Nov 24;: Authors: Jiang W, Yu X, Kosik RO, Song Y, Qiao T, Tong J, Liu S, Fan S, Luo Q, Chai L, Lv Z, Li D Abstract BACKGROUND: Gut microbiota are considered to be intrinsic regulators of thyroid autoimmunity. We designed a cross-sectional study to examine the makeup and metabolic function of microbiota in Graves' disease (GD) patients, with the ultimate aim of offering new perspectives on the diagnosis and treatment of GD. METHODS: The 16S rRNA V3-V4 DNA regions of microbiota were obtained from fecal samples collected from 45 GD patients and 59 controls. Microbial differences between the two groups were subsequently analyzed based on high-throughput sequencing. RESULTS: Compared with controls, GD patients had reduced alpha diversity (p <0.05). At the phylum level, GD patients had a significantly lower proportion of Firmicutes (p = 0.008) and a significantly higher proportion of Bacteroidetes (p = 0.002) compared to the controls. At the genus level, GD patients had greater numbers of Bacteroides and Lactobacillus, though fewer Blautia, [Eubacterium]_hallii_group, Anaerostipes, Collinsella, Dorea, unclassified_f_Peptostreptococcaceae, and [Ruminococcus]_torques_group than controls (all p < 0.05). Subgroup analysis of GD patients revealed that Lactobacillus may play a key role in the pathogenesis of AITD. Nine distinct genera showed significant correlations with certain thyroid function tests. Functional prediction revealed that Blautia may be an important microbe in certain metabolic pathways that occur in the hyperthyroid state. Additionally, linear discriminant analysis (LDA) and effect size (LEfSe) analysis showed that there were significant differences in the levels of 18 genera between GD patients and controls (LDA > 3.0, all p < 0.05). A diagnostic model using the top nine genera had an area under the curve (AUC) of 0.8109 (95% CI: 0.7274-0.8945). CONCLUSIONS: Intestinal microbiota are different in GD patients. The microbiota we identified offer an alternative non-invasive diagnostic methodology for GD. Microbiota may also play a role in thyroid autoimmunity, and future research is needed to further elucidate the role. PMID: 33234057 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Psychology of Giving Thanks

alkiviadis.1961 shared this article with you from Inoreader The Psychology of Giving Thanks Via Scientific American Content: Global As we all sit down tonight to feast on turkey and pumpkin pie, many of us will be going around the table giving thanks for our everyday sources of gratitude, like friendships, relationships, and good... -- Read more on ScientificAmerican.com Attachments: View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Psoriasis and Comorbidities

alkiviadis.1961 shared this article with you from Inoreader Psoriasis and Comorbidities Via Latest Results Abstract Psoriasis is increasingly recognised as one of a group of immune-mediated inflammatory diseases (IMIDs) with overlapping pathogenesis. The ability to detect diseases associated with psoriasis has been complemented through interrogation of large datasets utilising genome wide association scans to demonstrate overlapping genetic risk factors of associated diseases. Many of these associated conditions, such as psoriatic arthritis and inflammatory bowel disease have a significant impact on morbidity. In addition the inflammatory burden associated with psoriasis is associated with a myriad of systemic sequalae including higher levels of cardiovascular risk. This provides the dermatologist with an opportunity to holistically treat a patient and to promote relevant primary and secondary care prevention strategies. Additionally, effective control of the inflammatory burden of psoriasis may modify the risk of comorbidities associated with psoriasis and would su pport earlier use of immunomodulatory therapies. This chapter will cover the comorbidities (including cardiovascular disease [CVD], metabolic syndrome and malignancy) associated with psoriasis and consider how these factors may influence or impact on management of the patient. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Secukinumab for the Treatment of Inflammatory Skin and Joint Disease

alkiviadis.1961 shared this article with you from Inoreader Secukinumab for the Treatment of Inflammatory Skin and Joint Disease Via Latest Results Abstract Psoriasis is a chronic inflammatory skin condition characterized by thick, erythematous, scaly plaques commonly found on the extensor surfaces, scalp, and trunk. While the etiology of this skin condition has not been fully elucidated, research has unequivocally shown that psoriasis represents a bona fide T cell-mediated disease that involves the skin, joints, and a myriad of other organs/tissues. The recent discovery of a set of pathogenic T cells that produce high levels of interleukin-17 in response to interleukin-23 led to a major paradigm shift in the pathogenic model for this condition resulting in numerous novel targeted immune therapies. The robust phase 3 clinical trial program for anti-interleukin-17A via secukinumab (sold under the brand Cosentyx®) for the treatment of moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis provides a solid foundation supporting the high clinical efficacy and safety of this medic ation in dermatology and rheumatology. While the exact roles of interleukin-17 in the development of inflammatory diseases is not entirely clear, ongoing research and clinical studies are expanding our knowledge base and leading to the development of new treatments that can improve clinical outcomes for patients affected by these conditions. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Etanercept

alkiviadis.1961 shared this article with you from Inoreader Etanercept Via Latest Results Abstract Etanercept is a soluble dimeric fusion protein that was the first anti-tumor necrosis factor (TNF-α(alpha)) drug to be approved for the treatment of psoriasis and psoriatic arthritis. It is administered subcutaneously by self-injection. As with other biologic drugs for psoriasis, etanercept offers a targeted approach to treatment that lacks end organ side effects of traditional systemic therapies such as methotrexate, cyclosporine, or acitretin. With over 8 years of postmarketing experience in psoriasis (and over 14 years since approval for moderate to severe RA in 1998), a large body of safety data exists for etanercept. Here, we review the safety and efficacy of etanercept in the treatment of plaque psoriasis and psoriatic arthritis, with emphasis on published Phase 3 and Phase 4 clinical trial data. Safety considerations, recommended monitoring, and studies of combination therapy are also discussed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Psoriasis

alkiviadis.1961 shared this article with you from Inoreader Pediatric Psoriasis Via Latest Results Abstract Psoriasis is a chronic multi-system inflammatory condition with an autoimmune component. One-third to one-half of cases have onset in childhood. There are a variety of pediatric variant types of psoriasis, including generalized disease, that is similar to adult psoriasis, and types distinctive to childhood, including diaper involvement and pityriasis amiantacea. Pediatric psoriasis is associated with infectious triggers and exacerbation by the Koebner phenomenon. Children with psoriasis may have more of a tendency toward obesity as reflected by a large waist circumference. More extensive disease in childhood is associated with a poor quality of life, anxiety, and depression. Therapeutics of pediatric psoriasis generally requires a global approach including identifying infectious triggers, addressing health risks including obesity, and psychological support. Prescription care includes application of mid-potency topical corticosteroids and/or calcipotrie ne, phototherapy with Narrowband UVB or excimer laser. In severe cases, cyclic prescribing of systemic agents for 6–12 months including methotrexate, cyclosporine, etanercept, adalimumab, and recently approved agents ixekizumab and ustekinumab can aid in disease clearance with minimization of side effects. Emerging studies for the efficacious and safe use of biologics in children broaden treatment options for managing severe psoriatic disease early. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparison of the in vitro permeation of 3‐O‐ethyl‐l‐ascorbic acid in human skin and in a living skin equivalent (LabSkinTM)

alkiviadis.1961 shared this article with you from Inoreader A comparison of the in vitro permeation of 3‐O‐ethyl‐l‐ascorbic acid in human skin and in a living skin equivalent (LabSkinTM) Via International Journal of Cosmetic Science Abstract The EU Scientific Committee on Consumer Safety (SCCS) and the Cosmetic Ingredient Review (CIR) Expert Panel have listed a number of requirements for safety evaluation of cosmetics (1‐3). These include data on the percutaneous absorption of selected cosmetic ingredients, such as actives, colouring agents, UV filters and preservatives. For such studies, the European Centre for the Validation of Alternative Methods (ECVAM), the European Medicine Agency (EMA) and the UK National Centre for the 3Rs (NC3Rs) have encouraged the replacement of animal testing with alternative in vitro models (4‐6). In 2003, a ban on in vivo animal testing for cosmetic products was introduced by Directive 2003/15/EC of the European Parliament and of the Council, and became law a few years later with the Cosmetics Regulation (EC) No. 1223/2009 (1). Currently, percutaneous absorption of cosmetic ingredients may be determined in human or porcine skin in vitro according to procedures de scribed by the Organisation for Economic Co‐operation and Development (OECD), SCCS and COLIPA ‐ The European Cosmetic and Perfumery Association (1, 7‐9). The use of porcine tissue offers advantages for routine permeability testing given the financial and safety considerations associated with sourcing human tissue. However, this testing still requires consideration of ethical and animal welfare issues. Consequently, various human skin equivalents (HSEs) have been developed as alternative sources of tissue for skin permeation experiments (10). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.