6,282 results match your criteria Clinical Safety in Neurology


Low-dose versus standard-dose intravenous alteplase for octogenerian acute ischemic stroke patients: A multicenter prospective cohort study.

J Neurol Sci 2019 Jan 29;399:76-81. Epub 2019 Jan 29.

School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background And Purpose: The optimal dose of alteplase for acute ischemic stroke among geriatric patients is unclear. We aimed to assess the efficacy and safety of a low-dose (0.6 mg/kg) and standard-dose (0. Read More

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http://dx.doi.org/10.1016/j.jns.2019.01.047DOI Listing
January 2019

Protein-coding variants implicate novel genes related to lipid homeostasis contributing to body-fat distribution.

Authors:
Anne E Justice Tugce Karaderi Heather M Highland Kristin L Young Mariaelisa Graff Yingchang Lu Valérie Turcot Paul L Auer Rebecca S Fine Xiuqing Guo Claudia Schurmann Adelheid Lempradl Eirini Marouli Anubha Mahajan Thomas W Winkler Adam E Locke Carolina Medina-Gomez Tõnu Esko Sailaja Vedantam Ayush Giri Ken Sin Lo Tamuno Alfred Poorva Mudgal Maggie C Y Ng Nancy L Heard-Costa Mary F Feitosa Alisa K Manning Sara M Willems Suthesh Sivapalaratnam Goncalo Abecasis Dewan S Alam Matthew Allison Philippe Amouyel Zorayr Arzumanyan Beverley Balkau Lisa Bastarache Sven Bergmann Lawrence F Bielak Matthias Blüher Michael Boehnke Heiner Boeing Eric Boerwinkle Carsten A Böger Jette Bork-Jensen Erwin P Bottinger Donald W Bowden Ivan Brandslund Linda Broer Amber A Burt Adam S Butterworth Mark J Caulfield Giancarlo Cesana John C Chambers Daniel I Chasman Yii-Der Ida Chen Rajiv Chowdhury Cramer Christensen Audrey Y Chu Francis S Collins James P Cook Amanda J Cox David S Crosslin John Danesh Paul I W de Bakker Simon de Denus Renée de Mutsert George Dedoussis Ellen W Demerath Joe G Dennis Josh C Denny Emanuele Di Angelantonio Marcus Dörr Fotios Drenos Marie-Pierre Dubé Alison M Dunning Douglas F Easton Paul Elliott Evangelos Evangelou Aliki-Eleni Farmaki Shuang Feng Ele Ferrannini Jean Ferrieres Jose C Florez Myriam Fornage Caroline S Fox Paul W Franks Nele Friedrich Wei Gan Ilaria Gandin Paolo Gasparini Vilmantas Giedraitis Giorgia Girotto Mathias Gorski Harald Grallert Niels Grarup Megan L Grove Stefan Gustafsson Jeff Haessler Torben Hansen Andrew T Hattersley Caroline Hayward Iris M Heid Oddgeir L Holmen G Kees Hovingh Joanna M M Howson Yao Hu Yi-Jen Hung Kristian Hveem M Arfan Ikram Erik Ingelsson Anne U Jackson Gail P Jarvik Yucheng Jia Torben Jørgensen Pekka Jousilahti Johanne M Justesen Bratati Kahali Maria Karaleftheri Sharon L R Kardia Fredrik Karpe Frank Kee Hidetoshi Kitajima Pirjo Komulainen Jaspal S Kooner Peter Kovacs Bernhard K Krämer Kari Kuulasmaa Johanna Kuusisto Markku Laakso Timo A Lakka David Lamparter Leslie A Lange Claudia Langenberg Eric B Larson Nanette R Lee Wen-Jane Lee Terho Lehtimäki Cora E Lewis Huaixing Li Jin Li Ruifang Li-Gao Li-An Lin Xu Lin Lars Lind Jaana Lindström Allan Linneberg Ching-Ti Liu Dajiang J Liu Jian'an Luan Leo-Pekka Lyytikäinen Stuart MacGregor Reedik Mägi Satu Männistö Gaëlle Marenne Jonathan Marten Nicholas G D Masca Mark I McCarthy Karina Meidtner Evelin Mihailov Leena Moilanen Marie Moitry Dennis O Mook-Kanamori Anna Morgan Andrew P Morris Martina Müller-Nurasyid Patricia B Munroe Narisu Narisu Christopher P Nelson Matt Neville Ioanna Ntalla Jeffrey R O'Connell Katharine R Owen Oluf Pedersen Gina M Peloso Craig E Pennell Markus Perola James A Perry John R B Perry Tune H Pers Ailith Ewing Ozren Polasek Olli T Raitakari Asif Rasheed Chelsea K Raulerson Rainer Rauramaa Dermot F Reilly Alex P Reiner Paul M Ridker Manuel A Rivas Neil R Robertson Antonietta Robino Igor Rudan Katherine S Ruth Danish Saleheen Veikko Salomaa Nilesh J Samani Pamela J Schreiner Matthias B Schulze Robert A Scott Marcelo Segura-Lepe Xueling Sim Andrew J Slater Kerrin S Small Blair H Smith Jennifer A Smith Lorraine Southam Timothy D Spector Elizabeth K Speliotes Kari Stefansson Valgerdur Steinthorsdottir Kathleen E Stirrups Konstantin Strauch Heather M Stringham Michael Stumvoll Liang Sun Praveen Surendran Karin M A Swart Jean-Claude Tardif Kent D Taylor Alexander Teumer Deborah J Thompson Gudmar Thorleifsson Unnur Thorsteinsdottir Betina H Thuesen Anke Tönjes Mina Torres Emmanouil Tsafantakis Jaakko Tuomilehto André G Uitterlinden Matti Uusitupa Cornelia M van Duijn Mauno Vanhala Rohit Varma Sita H Vermeulen Henrik Vestergaard Veronique Vitart Thomas F Vogt Dragana Vuckovic Lynne E Wagenknecht Mark Walker Lars Wallentin Feijie Wang Carol A Wang Shuai Wang Nicholas J Wareham Helen R Warren Dawn M Waterworth Jennifer Wessel Harvey D White Cristen J Willer James G Wilson Andrew R Wood Ying Wu Hanieh Yaghootkar Jie Yao Laura M Yerges-Armstrong Robin Young Eleftheria Zeggini Xiaowei Zhan Weihua Zhang Jing Hua Zhao Wei Zhao He Zheng Wei Zhou M Carola Zillikens Fernando Rivadeneira Ingrid B Borecki J Andrew Pospisilik Panos Deloukas Timothy M Frayling Guillaume Lettre Karen L Mohlke Jerome I Rotter Zoltán Kutalik Joel N Hirschhorn L Adrienne Cupples Ruth J F Loos Kari E North Cecilia M Lindgren

Nat Genet 2019 Feb 18. Epub 2019 Feb 18.

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.

Body-fat distribution is a risk factor for adverse cardiovascular health consequences. We analyzed the association of body-fat distribution, assessed by waist-to-hip ratio adjusted for body mass index, with 228,985 predicted coding and splice site variants available on exome arrays in up to 344,369 individuals from five major ancestries (discovery) and 132,177 European-ancestry individuals (validation). We identified 15 common (minor allele frequency, MAF ≥5%) and nine low-frequency or rare (MAF <5%) coding novel variants. Read More

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http://dx.doi.org/10.1038/s41588-018-0334-2DOI Listing
February 2019

OnabotulinumtoxinA and cognitive behavioral therapy in functional dystonia: A pilot randomized clinical trial.

Parkinsonism Relat Disord 2019 Feb 13. Epub 2019 Feb 13.

Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA. Electronic address:

Introduction: Functional dystonia (FD) is a disabling movement disorder with limited therapeutic options. We aimed to examine the efficacy and safety of chemodenervation with OnabotulinumtoxinA (BoNT) versus placebo prior to cognitive behavioral therapy (CBT) in FD patients.

Methods: FD patients with a Psychogenic Movement Disorders Rating Scale (PMDRS) score ≥ 10 and persistent dystonic posturing for ≥ 1 year were randomized to BoNT or placebo injections prior to 12 weekly individualized 1-h CBT sessions. Read More

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http://dx.doi.org/10.1016/j.parkreldis.2019.02.009DOI Listing
February 2019

Time to Loading Dose and Risk of Recurrent Events in the SOCRATES Trial.

Stroke 2019 Feb 19:STROKEAHA118022675. Epub 2019 Feb 19.

Department of Medicine & Therapeutics, The Chinese University of Hong Kong (K.S.L.W.).

Background and Purpose- Recurrent ischemia risk is high in the acute period after cerebral ischemic events. Effects of antiplatelet agents may vary by time to loading dose (TLD). We explored the risk of recurrent events and safety and efficacy of ticagrelor versus aspirin in relation to TLD. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.022675DOI Listing
February 2019

Measles Virus-Based Treatments Trigger a Pro-inflammatory Cascade and a Distinctive Immunopeptidome in Glioblastoma.

Mol Ther Oncolytics 2019 Mar 31;12:147-161. Epub 2018 Dec 31.

Interdisciplinary Division of Neuro-Oncology, Hertie Institute for Clinical Brain Research, Departments of Neurology and Neurosurgery, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen 72076, Germany.

Glioblastoma is an aggressive primary brain tumor with bad prognosis. On the other hand, oncolytic measles virus (MeV) therapy is an experimental glioma treatment strategy with clinical safety and first evidence of anti-tumoral efficacy. Therefore, we investigated the combination of MeV with conventional therapies by cytotoxic survival assays in long-term glioma cell lines LN229, LNZ308, and glioma stem-like GS8 cells, as well as the basal viral infectivity in primary glioblastoma cultures T81/16, T1094/17, and T708/16. Read More

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http://dx.doi.org/10.1016/j.omto.2018.12.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365369PMC

Ten-year follow-up of a randomised trial of drainage, irrigation and fibrinolytic therapy (DRIFT) in infants with post-haemorrhagic ventricular dilatation.

Health Technol Assess 2019 Feb;23(4):1-116

Neonatal Neurology, University of Bristol, Bristol, UK.

Background: The drainage, irrigation and fibrinolytic therapy (DRIFT) trial, conducted in 2003-6, showed a reduced rate of death or severe disability at 2 years in the DRIFT compared with the standard treatment group, among preterm infants with intraventricular haemorrhage (IVH) and post-haemorrhagic ventricular dilatation.

Objectives: To compare cognitive function, visual and sensorimotor ability, emotional well-being, use of specialist health/rehabilitative and educational services, neuroimaging, and economic costs and benefits at school age.

Design: Ten-year follow-up of a randomised controlled trial. Read More

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http://dx.doi.org/10.3310/hta23040DOI Listing
February 2019

[Efficacy and mechanism of loading dose clopidogrel in patients with transient ischemic attack and minor stroke].

Zhonghua Yi Xue Za Zhi 2019 Jan;99(5):349-353

Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou 215000, China.

To assess outcome, safety and possible mechanism of loading dose clopidogrel in patients with transient ischemic attack (TIA) and minor stroke. We reviewed patients with confirmed TIA and minor stroke admitted between July 2016 and December 2017 into the First Affiliated Hospital of Soochow University. Loss-of-function allele carriers of CYP2C19 were included and randomly divided into loading dose group (first dose of 300 mg clopidogrel) and standard dose group (first dose of 75 mg clopidogrel), 100 mg aspirin was gave at the same time, followed by aspirin 100 mg/d plus clopidogrel 75 mg/d maintaining for 20 days. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2019.05.006DOI Listing
January 2019

IVIG efficacy in CIDP patients is not associated with terminal complement inhibition.

J Neuroimmunol 2019 Feb 10;330:23-27. Epub 2019 Feb 10.

Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster 48149, Germany; Institute of Experimental Immunology, Department of Neuroinflammation, University of Zurich, Zürich 8057, Switzerland. Electronic address:

Patients with acute and chronic inflammatory demyelinating neuropathies exhibit elevated serum and cerebrospinal fluid (CSF) levels of terminal complement activation products and therapeutic inhibition of complement activation is currently tested for its safety and efficacy in patients with Guillain-Barré syndrome (GBS). Here, we determined serum levels of the complement activation products C3a, C5a and the soluble terminal complement complex (sTCC) in 39 individuals with chronic inflammatory demyelinating polyneuropathy (CIDP) who participated in one of the largest ever conducted clinical trial in patients with CIDP (ICE trial) and received Intravenous Immunoglobulin (IVIG) or placebo (albumin) in 3 week intervals for up to 24 weeks. In placebo-treated patients with spontaneous disease remission, serum sTCC levels moderately decreased over time. Read More

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http://dx.doi.org/10.1016/j.jneuroim.2019.02.001DOI Listing
February 2019
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Trial of intrathecal rituximab in progressive multiple sclerosis patients with evidence of leptomeningeal contrast enhancement.

Mult Scler Relat Disord 2019 Feb 11;30:136-140. Epub 2019 Feb 11.

Department of Neurology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Pathology 627, Baltimore, MD 21287, USA.

Background: Leptomeningeal inflammation is associated with increased cortical damage and worse clinical outcomes in MS. It may be detected on contrast-enhanced T2-FLAIR imaging as focal leptomeningeal contrast-enhancement (LME).

Objective: To assess the safety of intrathecal (IT) rituximab in progressive MS (PMS) and to assess its effects on LME and CSF biomarkers. Read More

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http://dx.doi.org/10.1016/j.msard.2019.02.013DOI Listing
February 2019

Cannabis for refractory epilepsy in children: A review focusing on CDKL5 Deficiency Disorder.

Epilepsy Res 2019 Feb 5;151:31-39. Epub 2019 Feb 5.

Telethon Kids Institute, University of Western Australia, Perth, WA, Australia(2). Electronic address:

Severe paediatric epilepsies such as CDKL5 Deficiency Disorder (CDD) are extremely debilitating, largely due to the early-onset and refractory nature of the seizures. Existing treatment options are often ineffective and associated with a host of adverse effects, causing those that are affected to seek alternative treatments. Cannabis based products have attracted significant attention over recent years, primarily driven by reports of miraculous cures and a renewed public preference for 'natural' therapies, thus placing intense pressure on health professionals and the government for regulatory change. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2019.02.001DOI Listing
February 2019

A new avenue for treating neuronal diseases: ceftriaxone, an old antibiotic demonstrating behavioral neuronal effects.

Behav Brain Res 2019 Feb 12. Epub 2019 Feb 12.

Department of Psychology, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung 402, Taiwan, ROC. Electronic address:

Several neurodegenerative disorders, namely Parkinson's disease dementia, dementia with Lewy bodies, and Alzheimer's disease, share common pathophysiological features, such as (1) cognitive deficits, (2) glutamatergic hyperactivity-related excitotoxicity, and (3) deposition of α-synuclein (α-syn) and β-amyloid (Aβ). Ceftriaxone (CEF) is a well-tested and safe drug that has been used as an antibiotic for several decades. Recent studies have demonstrated the following effects of CEF: (1) increasing glutamate transporter-1 expression and glutamate reuptake and suppressing excitotoxicity, (2) binding well with α-syn and inhibition of α-syn polymerization, (3) modulating expression of genes related to Aβ metabolism, and (4) enhancing neurogenesis and recovery of neuronal density. Read More

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http://dx.doi.org/10.1016/j.bbr.2019.02.020DOI Listing
February 2019

Long-term safety and efficacy of eculizumab in generalized myasthenia gravis.

Muscle Nerve 2019 Feb 14. Epub 2019 Feb 14.

Department of Neurology, University of North Carolina, Chapel Hill, North Carolina, USA.

Introduction: Eculizumab is effective and well tolerated in patients with anti-acetylcholine receptor antibody-positive refractory generalized myasthenia gravis (gMG; REGAIN; NCT01997229). We report an interim analysis of an open-label extension of REGAIN evaluating eculizumab's long-term safety and efficacy.

Methods: 117 patients received eculizumab (1,200 mg every 2 weeks) for 22. Read More

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http://doi.wiley.com/10.1002/mus.26447
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http://dx.doi.org/10.1002/mus.26447DOI Listing
February 2019
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Drug-Eluting Stent Versus Drug-Coated Balloon Revascularization in Patients With Femoropopliteal Arterial Disease.

J Am Coll Cardiol 2019 Feb;73(6):667-679

Division of Angiology, Department of Internal Medicine, Neurology and Dermatology, University Hospital Leipzig, Leipzig, Germany. Electronic address:

Background: Randomized trials of drug-eluting stents (DES) and drug-coated balloons (DCB) for femoropopliteal interventions reported superior patency rates for both strategies compared to standard balloon angioplasty. To date, head-to-head comparisons are missing.

Objectives: The authors sought to compare DES versus DCB for femoropopliteal lesions through 36 months. Read More

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http://dx.doi.org/10.1016/j.jacc.2018.11.039DOI Listing
February 2019

Natalizumab, rituximab and fingolimod as escalation therapy in multiple sclerosis.

Eur J Neurol 2019 Feb 14. Epub 2019 Feb 14.

Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.

Background And Purpose: Breakthrough disease on first line injectables in relapsing-remitting multiple sclerosis (RRMS) is a common clinical situation where so far comparative studies between different escalation therapies are lacking. The aim of this study was to compare the efficacy, safety and medication persistence of natalizumab, rituximab and fingolimod as escalation therapy in RRMS METHODS: Patients switching from interferon or glatiramer acetate (INF/GA) to natalizumab, rituximab or fingolimod due to breakthrough disease were identified through the Swedish MS registry at four large MS centers in this retrospective observational study. Data were collected from the MS registry and medical charts. Read More

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http://dx.doi.org/10.1111/ene.13936DOI Listing
February 2019

Therapies Directed Against B-Cells and Downstream Effectors in Generalized Autoimmune Myasthenia Gravis: Current Status.

Drugs 2019 Feb 14. Epub 2019 Feb 14.

Division of Neurology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta Hospital, 7-112 Clinical Sciences Building, 11350-83 Ave, Edmonton, AB, T6G 2G3, Canada.

Myasthenia gravis is a rare, heterogeneous, classical autoimmune disease characterized by fatigable skeletal muscle weakness, which is directly mediated by autoantibodies targeting various components of the neuromuscular junction, including the acetylcholine receptor, muscle specific tyrosine kinase, and lipoprotein-related protein 4. Subgrouping of myasthenia gravis is dependent on the age of onset, pattern of clinical weakness, autoantibody detected, type of thymic pathology, and response to immunotherapy. Generalized immunosuppressive therapies are effective in all subgroups of myasthenia gravis; however, approximately 15% remain refractory and more effective treatments with improved safety profiles are needed. Read More

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http://dx.doi.org/10.1007/s40265-019-1065-0DOI Listing
February 2019

Comparison of Clopidogrel and Ticlopidine/ in Patients With Clopidogrel Resistance and Carotid Stenting.

Front Neurol 2019 30;10:44. Epub 2019 Jan 30.

Department of Neurology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, South Korea.

Patients undergoing carotid artery stenting (CAS) who show low responsiveness to clopidogrel may have a higher risk of peri-procedural embolic events. This study aimed to compare the effectiveness and safety of clopidogrel and ticlopidine plus in clopidogrel-resistant patients undergoing CAS. In this multi-center, randomized, controlled trial, we used platelet reactivity test to select patients undergoing CAS who showed clopidogrel resistance, and compared treatments using clopidogrel and ticlopidine plus ginkgo. Read More

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http://dx.doi.org/10.3389/fneur.2019.00044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363652PMC
January 2019

Efficacy and safety of mTOR inhibitors (rapamycin and its analogues) for tuberous sclerosis complex: a meta-analysis.

Orphanet J Rare Dis 2019 Feb 13;14(1):39. Epub 2019 Feb 13.

Department of Pharmacy, Peking University First Hospital, 6 Dahongluochang Street, Xicheng District, Beijing, 100034, China.

Background: The treatment of tuberous sclerosis complex (TSC) using mammalian target of rapamycin (mTOR) inhibitors is clinically promising. The aim of the present study was to evaluate the efficacy and safety of mTOR inhibitors for improving the clinical symptoms of TSC.

Methods: We performed a systematic search of major electronic databases (PubMed, EMBASE, Cochrane Library and WanFang, CNKI, and VIP databases) to identify randomized controlled trials (RCTs) and quasi-randomized studies from the date of database inception to November 2017; the Chinese Food and Drug Administration and clinicaltrials. Read More

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http://dx.doi.org/10.1186/s13023-019-1012-xDOI Listing
February 2019

Study of effects of ifenprodil in patients with methamphetamine dependence: Protocol for an exploratory, randomized, double-blind, placebo-controlled trial.

Neuropsychopharmacol Rep 2019 Feb 12. Epub 2019 Feb 12.

Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Aims: Pharmacotherapy for methamphetamine dependence has not yet been developed in Japan or elsewhere in the world. Ifenprodil is a blocker of G protein-activated inwardly rectifying potassium channels that play a key role in the mechanism of action of addictive substances. Our aim is to examine the safety, efficacy, and outcomes of ifenprodil for the treatment of methamphetamine dependence in a randomized, double-blind, placebo-controlled trial. Read More

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http://dx.doi.org/10.1002/npr2.12050DOI Listing
February 2019

Editorial: Implications for BACE1 Inhibitor Clinical Trials: Adult Conditional BACE1 Knockout Mice Exhibit Axonal Organization Defects in the Hippocampus.

Authors:
R Vassar

J Prev Alzheimers Dis 2019 ;6(2):78-84

R. Vassar, Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, IL 60611, USA, Email:

BACE1 is the rate-limiting enzyme for the production of the Aβ peptide that forms amyloid plaques in Alzheimer's disease (AD). Small molecule inhibitors of BACE1 are being tested in clinical trials for AD, but the safety and efficacy of BACE1 inhibition has yet to be fully explored. Knockout of the Bace1 gene in the germline of mice causes multiple neurological phenotypes, suggesting that BACE1 inhibition could be toxic. Read More

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http://dx.doi.org/10.14283/jpad.2019.3DOI Listing
January 2019

Epilepsy gene therapy using an engineered potassium channel.

J Neurosci 2019 Feb 12. Epub 2019 Feb 12.

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK.

Refractory focal epilepsy is a devastating disease for which there is frequently no effective treatment. Gene therapy represents a promising alternative, but treating epilepsy in this way involves irreversible changes to brain tissue, so vector design must be carefully optimized to guarantee safety without compromising efficacy. We set out to develop an epilepsy gene therapy vector optimized for clinical translation. Read More

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http://dx.doi.org/10.1523/JNEUROSCI.1143-18.2019DOI Listing
February 2019

Acute Endovascular Reperfusion Treatment in Patients with Ischemic Stroke and Large Vessel Occlusion, Denmark 2011-2017.

Eur J Neurol 2019 Feb 12. Epub 2019 Feb 12.

Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

Background: Acute endovascular reperfusion treatment (aERT) of stroke patients with large vessel occlusions (LVO) is efficacious and safe according to several clinical trials. Data on outcome and safety of aERT in daily clinical routine is warranted, and in this study we present national data from Denmark 2011 -2017.

Methods: National data for Denmark from 2011 through 2017 on all aERT procedures in patients with acute ischemic stroke and CTA/MRA verified LVO. Read More

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http://dx.doi.org/10.1111/ene.13931DOI Listing
February 2019

Summit-07: A randomized trial of NKTR-181, a new molecular entity, full mu-opioid receptor agonist for chronic low-back pain.

Pain 2019 Feb 8. Epub 2019 Feb 8.

Gold Coast Research, LLC, Plantation, FL.

NKTR-181, a new molecular entity, full mu-opioid receptor agonist with an inherently slow rate of CNS entry, was designed to provide analgesia while reducing abuse potential. The objective of this phase 3, enriched-enrollment, randomized-withdrawal trial was to evaluate the analgesic efficacy, safety, and tolerability of NKTR-181 in patients with chronic low-back pain (CLBP). Adults with moderate-to-severe CLBP refractory to non-opioid analgesics achieving an analgesic NKTR-181 dosage (100-400 mg twice daily) during the open-label titration period were randomized to continued NKTR-181 treatment, double-blind, or switched to placebo. Read More

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http://dx.doi.org/10.1097/j.pain.0000000000001517DOI Listing
February 2019
1 Read

The Acute Stroke or Transient Ischemic Attack Treated with Ticagrelor and Aspirin for Prevention of Stroke and Death (THALES) trial: Rationale and design.

Int J Stroke 2019 Feb 12:1747493019830307. Epub 2019 Feb 12.

7 Department of Neurology, Beijing Tiantan Hospital, Beijing, China.

Rationale: In patients with acute cerebral ischemia, the rate of stroke, myocardial infarction, or death during 90 days was reported to be non-significantly lower with ticagrelor compared with aspirin, with no increase in major hemorrhage. Dual antiplatelet therapy may be more effective in this setting.

Aim: To investigate whether ticagrelor combined with aspirin are superior to aspirin alone in preventing stroke or death in patients with non-severe, non-cardioembolic ischemic stroke or high-risk transient ischemic attack. Read More

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http://dx.doi.org/10.1177/1747493019830307DOI Listing
February 2019
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Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study.

Int J Oral Maxillofac Surg 2019 Feb 8. Epub 2019 Feb 8.

Cerebrovascular Medicine and Neurology, Cerebrovascular Center, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.

The aim of this study was to compare the safety of tooth extraction in patients receiving direct oral anticoagulants (DOACs) or warfarin without cessation of their antithrombotic treatment. This prospective observational study included 367 patients undergoing tooth extraction (119 receiving DOACs and 248 receiving warfarin). All extractions in DOAC patients were performed 6-7h after taking DOACs in consideration of the half-life in blood under continued antithrombotic treatment. Read More

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http://dx.doi.org/10.1016/j.ijom.2019.01.013DOI Listing
February 2019

Rituximab therapy for primary central nervous system vasculitis: A 6 patient experience and review of the literature.

Autoimmun Rev 2019 Feb 8. Epub 2019 Feb 8.

Division of Rheumatology, Mayo Clinic, Rochester, MN, United States.

Objectives: To assess the efficacy and safety of Rituximab (RTX) in adult primary central nervous system vasculitis (PCNSV).

Methods: We retrospectively assessed the effect of RTX in 6 patients with PCNSV. Five of the 6 were refractory to high dose glucocorticoids (GCs) and/or conventional immunosuppressants (IS). Read More

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http://dx.doi.org/10.1016/j.autrev.2018.12.002DOI Listing
February 2019
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Association Between ABCB1 Polymorphisms and Outcomes of Clopidogrel Treatment in Patients With Minor Stroke or Transient Ischemic Attack: Secondary Analysis of a Randomized Clinical Trial.

JAMA Neurol 2019 Feb 11. Epub 2019 Feb 11.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Importance: Genetic variants of ABCB1 may affect intestinal absorption of clopidogrel bisulfate. However, it is unclear whether ABCB1 polymorphisms are associated with clopidogrel efficacy for minor ischemic stroke or transient ischemic attack (TIA).

Objectives: To investigate the association between ABCB1 polymorphisms and clopidogrel efficacy for minor stroke or TIA. Read More

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http://dx.doi.org/10.1001/jamaneurol.2018.4775DOI Listing
February 2019
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Neoadjuvant nivolumab modifies the tumor immune microenvironment in resectable glioblastoma.

Nat Med 2019 Feb 11. Epub 2019 Feb 11.

Centro de Investigación Biomedica en Red de Oncología (CIBERONC), Madrid, Spain.

Glioblastoma is the most common primary central nervous system malignancy and has a poor prognosis. Standard first-line treatment, which includes surgery followed by adjuvant radio-chemotherapy, produces only modest benefits to survival. Here, to explore the feasibility, safety and immunobiological effects of PD-1 blockade in patients undergoing surgery for glioblastoma, we conducted a single-arm phase II clinical trial (NCT02550249) in which we tested a presurgical dose of nivolumab followed by postsurgical nivolumab until disease progression or unacceptable toxicity in 30 patients (27 salvage surgeries for recurrent cases and 3 cases of primary surgery for newly diagnosed patients). Read More

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http://dx.doi.org/10.1038/s41591-018-0339-5DOI Listing
February 2019
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Tranexamic Acid in Cerebral Hemorrhage: A Meta-Analysis and Systematic Review.

CNS Drugs 2019 Feb 11. Epub 2019 Feb 11.

Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China.

Background: Tranexamic acid functions as an antifibrinolytic medication and is widely used to treat or prevent excessive blood loss in menorrhagia and during the perioperative period. The efficacy of tranexamic acid in reducing mortaligy and disability, and the occurrence of complications during treatment of cerebral hemorrhage remains controversial.

Objective: The objective of this systematic literature review and meta-analysis was to evaluate the efficacy and safety of tranexamic acid in patients with cerebral hemorrhage, aiming to improve the evidence-based medical knowledge of treatment options for such patients. Read More

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http://dx.doi.org/10.1007/s40263-019-00608-4DOI Listing
February 2019
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Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial.

Lancet 2019 Feb 6. Epub 2019 Feb 6.

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, UK.

Background: Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressure for optimal outcome is uncertain. We assessed intensive blood pressure lowering compared with guideline-recommended blood pressure lowering in patients treated with alteplase for acute ischaemic stroke.

Methods: We did an international, partial-factorial, open-label, blinded-endpoint trial of thrombolysis-eligible patients (age ≥18 years) with acute ischaemic stroke and systolic blood pressure 150 mm Hg or more, who were screened at 110 sites in 15 countries. Read More

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http://dx.doi.org/10.1016/S0140-6736(19)30038-8DOI Listing
February 2019
1 Read

Adjunctive Perampanel Oral Suspension in Pediatric Patients From ≥2 to <12 Years of Age With Epilepsy: Pharmacokinetics, Safety, Tolerability, and Efficacy.

J Child Neurol 2019 Feb 10:883073819827407. Epub 2019 Feb 10.

12 Formerly: Eisai Neurology Business Group, Eisai Inc., Woodcliff Lake, NJ, USA.

Study 232, an open-label pilot study with an extension phase, evaluated the pharmacokinetics and preliminary safety/tolerability and efficacy of adjunctive perampanel oral suspension (≤0.18 mg/kg/d) in epilepsy patients aged ≥2 to <12 years. Patients were grouped into cohorts 1 (aged ≥7 to <12 years) and 2 (aged ≥2 to <7 years). Read More

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http://dx.doi.org/10.1177/0883073819827407DOI Listing
February 2019
2 Reads

Long-term outcomes of stenting and endarterectomy for symptomatic carotid stenosis: a preplanned pooled analysis of individual patient data.

Lancet Neurol 2019 Feb 6. Epub 2019 Feb 6.

Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK; Department of Neurology and Stroke Center, Department of Clinical Research, University Hospital, University of Basel, Basel, Switzerland.

Background: The risk of periprocedural stroke or death is higher after carotid artery stenting (CAS) than carotid endarterectomy (CEA) for the treatment of symptomatic carotid stenosis. However, long-term outcomes have not been sufficiently assessed. We sought to combine individual patient-level data from the four major randomised controlled trials of CAS versus CEA for the treatment of symptomatic carotid stenosis to assess long-term outcomes. Read More

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http://dx.doi.org/10.1016/S1474-4422(19)30028-6DOI Listing
February 2019
1 Read

Effectiveness and safety of long-term dabigatran among patients with non-valvular atrial fibrillation in clinical practice: J-dabigatran surveillance.

J Cardiol 2019 Feb 5. Epub 2019 Feb 5.

Medicine Division, Nippon Boehringer Ingelheim Co., Ltd., Tokyo, Japan.

Background: The effectiveness and safety of dabigatran etexilate (DE) have not been elucidated thoroughly in clinical practice for Japanese patients with non-valvular atrial fibrillation (NVAF). In particular, those of DE at a reduced dose due to dose reduction recommendations (DRR) remain unknown.

Methods: NVAF patients who had newly initiated DE treatment for prevention of thromboembolic events between December 2011 and November 2013 were enrolled. Read More

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http://dx.doi.org/10.1016/j.jjcc.2018.12.013DOI Listing
February 2019
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Vinpocetine in the treatment of poststroke cognitive dysfunction: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2019 Feb;98(6):e13685

Department of Neurology, Fifth Central Hospital of Tianjin, Binhai Hospital of Peking University, Tianjin, 300450.

Background: Previous clinical trials have reported that vinpocetine can be used for the treatment of cognitive dysfunction. However, its efficacy is still inconclusive. In this systematic review study, we aim to assess its efficacy and safety for the treatment of poststroke cognitive dysfunction (PSCD). Read More

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http://dx.doi.org/10.1097/MD.0000000000013685DOI Listing
February 2019
1 Read

American Medical Society for Sports Medicine Position Statement on Concussion in Sport.

Clin J Sport Med 2019 Feb 4. Epub 2019 Feb 4.

Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota.

Sport-related concussion (SRC) is a common injury in recreational and organized sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment, and management of SRC. In addition to a growing need for knowledgeable health care professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC. Read More

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http://dx.doi.org/10.1097/JSM.0000000000000720DOI Listing
February 2019
2 Reads

A Longitudinal Study of the Neurologic Safety of Acute Baclofen Use After Spinal Cord Injury.

Neurotherapeutics 2019 Feb 6. Epub 2019 Feb 6.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, British Columbia, V5Z 1M9, Canada.

The objective of our study was to determine whether treatment with baclofen is neurologically safe with respect to exposure during recovery from spinal cord injury. We performed a secondary longitudinal analysis of a cohort of adult patients with traumatic acute spinal cord injury. Cumulative baclofen dose was computed over the first 4 weeks following injury from concomitant medication information from a completed clinical trial. Read More

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http://dx.doi.org/10.1007/s13311-019-00713-8DOI Listing
February 2019
2 Reads

Acute ischemic stroke patients with diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score ≤ 5 can benefit from endovascular treatment: a single-center experience and literature review.

Neuroradiology 2019 Feb 6. Epub 2019 Feb 6.

Department of Neurology, Clinical Neuroscience Institute, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China.

Purpose: The recommendation strength of the guidelines for mechanical thrombectomy among patients with large pre-treatment core infarct is weak. We evaluated the safety and outcome of endovascular treatment for acute ischemic stroke with diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) ≤ 5.

Methods: Data on acute ischemic stroke patients with DWI-ASPECTS ≤ 5 who underwent endovascular treatment within 6 h, or presented an arterial spin labeling-DWI (ASL-DWI) mismatch within 12 h, at our center were retrospectively collected. Read More

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http://dx.doi.org/10.1007/s00234-019-02177-1DOI Listing
February 2019
1 Read

Risk factors for injury in a community-treated cohort of patients with epilepsy in Australia.

Epilepsia 2019 Feb 5. Epub 2019 Feb 5.

Department of Medicine, University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.

Objective: There remains a paucity of knowledge regarding specific epilepsy-related risk factors for accidents and injuries in people with epilepsy. Injury studies in people with epilepsy are overrepresented, with tertiary based populations that are prone to bias from severe disease. This study aims to assess the contribution of epilepsy-related risk factors to injuries in a community-based cohort. Read More

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http://dx.doi.org/10.1111/epi.14659DOI Listing
February 2019
9 Reads

Central nervous system effects of the histamine-3 receptor antagonist CEP-26401, in comparison with modafinil and donepezil, after a single dose in a cross-over study in healthy volunteers.

Br J Clin Pharmacol 2019 Feb 2. Epub 2019 Feb 2.

Research and Development Teva Pharmaceuticals, Netanya, Israel.

Aims: In previous studies, the H R antagonist CEP-26401 had a subtle effect on spatial working memory, with the best effect seen at the lowest dose tested (20μg), and a dose-dependent disruption of sleep. In the current study, three low dose levels of CEP-26401 were compared with modafinil and donepezil.

Methods: In this double-blind, placebo- and positive-controlled, randomized, partial six-way cross-over study, 40 healthy subjects received single doses of placebo, CEP-26401 (5, 25, or 125 μg) or modafinil 200mg or donepezil 10mg. Read More

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http://dx.doi.org/10.1111/bcp.13885DOI Listing
February 2019

Effects of onabotulinumtoxinA treatment in chronic migraine patients with and without daily headache at baseline: results from the COMPEL Study.

J Headache Pain 2019 Feb 1;20(1):12. Epub 2019 Feb 1.

Headache Center of Southern California, The Neurology Center, Carlsbad, CA, USA.

Background: OnabotulinumtoxinA is effective in preventing chronic migraine (CM); however, the benefit of onabotulinumtoxinA in patients with CM with daily headache is unknown because these patients are typically excluded from clinical trials. This subanalysis of the COMPEL Study assessed the efficacy and safety of onabotulinumtoxinA in people with CM with and without daily headache.

Methods: In total, 715 patients received onabotulinumtoxinA 155 U with or without concomitant oral preventive treatment. Read More

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http://dx.doi.org/10.1186/s10194-018-0953-0DOI Listing
February 2019

American Medical Society for Sports Medicine position statement on concussion in sport.

Br J Sports Med 2019 Feb;53(4):213-225

Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.

Sport-related concussion (SRC) is a common injury in recreational and organised sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment and management of SRC. In addition to a growing need for knowledgeable healthcare professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC. Read More

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http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-100338
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http://dx.doi.org/10.1136/bjsports-2018-100338DOI Listing
February 2019
4 Reads

Tele-monitored tDCS rehabilitation: feasibility, challenges and future perspectives in Parkinson's disease.

J Neuroeng Rehabil 2019 Jan 31;16(1):20. Epub 2019 Jan 31.

The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, Department of Neurology, NYU School of Medicine, 222 East 41st Street, New York, NY, 10017, USA.

Transcranial direct current stimulation (tDCS) is a modality of non-invasive brain stimulation involving the application of low amplitude direct current via surface electrodes on the scalp. tDCS has been studied in healthy populations and in multiple brain disorders and has the potential to be a treatment for several neuropsychiatric conditions by virtue of its capability of influencing cognitive, motor and behavioral processes. tDCS is a generally safe technique when performed within standardized protocols in research or clinical settings. Read More

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http://dx.doi.org/10.1186/s12984-019-0481-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357497PMC
January 2019
4 Reads
2.740 Impact Factor

Opioid response in paediatric cancer patients and the Val158Met polymorphism of the human catechol-O-methyltransferase (COMT) gene: an Italian study on 87 cancer children and a systematic review.

BMC Cancer 2019 Jan 31;19(1):113. Epub 2019 Jan 31.

Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy.

Background: Genetic polymorphisms in genes involved in pain modulation have been reported to be associated to opioid efficacy and safety in different clinical settings.

Methods: The association between COMT Val158Met polymorphism (rs4680) and the inter-individual differences in the response to opioid analgesic therapy was investigated in a cohort of 87 Italian paediatric patients receiving opioids for cancer pain (STOP Pain study). Furthermore, a systematic review of the association between opioid response in cancer patients and the COMT polymorphism was performed in accordance with the Cochrane Handbook and the Prisma Statement. Read More

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https://bmccancer.biomedcentral.com/articles/10.1186/s12885-
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http://dx.doi.org/10.1186/s12885-019-5310-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357360PMC
January 2019
3 Reads

Evidence of Repurposing Drugs and Identifying Contraindications from Real World Study in Parkinson's Disease.

ACS Chem Neurosci 2019 Feb 7;10(2):954-963. Epub 2019 Feb 7.

Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital , Fudan University , Shanghai 200040 , China.

There is great unmet need in discovering novel treatment for Parkinson's disease (PD) and identifying the new agents potentially causing drug-induced parkinsonism. New indications and contraindications of drugs are typically approved following rigorous randomized controlled trial (RCT) evaluation. However, RCTs have their inherent limitations, since they are usually conducted in ideal conditions, with high cost and limited follow-up periods. Read More

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http://dx.doi.org/10.1021/acschemneuro.8b00456DOI Listing
February 2019

Case of iatrogenic botulism after botulinotherapy in clinical practice.

Ter Arkh 2018 Nov;90(11):102-104

Bashkir State Medical University, Ufa, Bashkortostan, Russia.

Injections of botulinum toxin are widely used in different medical fields, namely neurology, urology, stomatology, cosmetology, gastroenterology etc. Preparations of botulinum toxin type A (BTA) prevent the release of acetylcholine at the endings of motor nerves leading to the long-term muscle relaxation. It has been acknowledged that treatment with BTA has very good safety profile and tolerability. Read More

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http://dx.doi.org/10.26442/terarkh20189011102-104DOI Listing
November 2018
4 Reads

A homozygous missense variant in the alkaline phosphatase gene ALPL is associated with a severe form of canine hypophosphatasia.

Sci Rep 2019 Jan 30;9(1):973. Epub 2019 Jan 30.

Department of Veterinary Biosciences, University of Helsinki, 00014, Helsinki, Finland.

Inherited skeletal disorders affect both humans and animals. In the current study, we have performed series of clinical, pathological and genetic examinations to characterize a previously unreported skeletal disease in the Karelian Bear Dog (KBD) breed. The disease was recognized in seven KBD puppies with a variable presentation of skeletal hypomineralization, growth retardation, seizures and movement difficulties. Read More

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http://dx.doi.org/10.1038/s41598-018-37801-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353930PMC
January 2019

Immunoadsorption or plasma exchange in steroid-refractory multiple sclerosis and neuromyelitis optica.

J Clin Apher 2019 Jan 30. Epub 2019 Jan 30.

Department of Nephrology and Rheumatology, Georg-August-University Göttingen, Germany.

Background: Plasma exchange (PE) and immunoadsorption (IA) are alternative treatments of steroid-refractory relapses of multiple sclerosis (MS) or neuromyelitis optica (NMO).

Methods: Adverse events and neurological follow-ups in 127 MS- (62 PE, 65 IA) and 13 NMO- (11 PE, 2 IA) patients were retrospectively analyzed. Response was defined by improvements in either expanded disability status scale (EDSS) by at least 1. Read More

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http://dx.doi.org/10.1002/jca.21686DOI Listing
January 2019

Bortezomib in antibody-mediated autoimmune diseases (TAVAB): study protocol for a unicentric, non-randomised, non-placebo controlled trial.

BMJ Open 2019 Jan 28;9(1):e024523. Epub 2019 Jan 28.

Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Introduction: The clinical characteristics of autoantibody-mediated autoimmune diseases are diverse. Yet, medical treatment and the associated complications are similar, that is, the occurrence of long-term side effects and the problem that a significant proportion of patients are non-responders. Therefore, new therapeutic options are needed. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024523DOI Listing
January 2019
1 Read

More than depression: a multi-dimensional assessment of postpartum distress symptoms before and after a residential early parenting program.

BMC Psychiatry 2019 Jan 29;19(1):48. Epub 2019 Jan 29.

Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia.

Introduction: Parents are vulnerable to psychological distress symptoms in the postpartum period. It is routine to screen for depressive symptoms, but anxiety, stress, fatigue, irritability and insomnia symptoms are less often assessed despite their prevalence. This study aimed to assess multiple dimensions of psychological distress, and their reliable change and clinically significant change among women admitted to a residential program for assistance with unsettled infant behaviors (UIB). Read More

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http://dx.doi.org/10.1186/s12888-019-2024-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352433PMC
January 2019
1 Read

Laser interstitial thermal therapy in drug-resistant epilepsy.

Curr Opin Neurol 2019 Jan 28. Epub 2019 Jan 28.

Department of Neurology, Jefferson Comprehensive Epilepsy Center.

Purpose Of Review: MRI-guided stereotactic laser interstitial thermal therapy (LiTT) has been utilized in the surgical treatment of discrete, small epileptogenic lesions. This review summarizes the current literature and addresses the clinical application of this technique.

Recent Findings: LiTT has the potential to reduce the morbidity and discomfort of epilepsy surgery. Read More

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http://dx.doi.org/10.1097/WCO.0000000000000662DOI Listing
January 2019
1 Read
5.307 Impact Factor