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Mashup Score: 2Weighing the impact of post hoc studies - 9 day(s) ago
In their JNNP study, Dr Sun et al report post hoc analyses of data from the ‘Minimally Invasive Surgery plus Alteplase for Intracerebral haemorrhage Evacuation trial (MISTIE III)’.1 2 The parent study was a randomised open-label trial comparing image-guided minimally invasive haematoma evacuation followed by alteplase irrigation (MIS+alteplase) to standard medical care. The primary endpoint of the MISTIE-III was a good functional outcome defined as the proportion of patients who achieved a modified Rankin Scale score of 0–3 at 1 year. This post hoc study focused on 310 subjects …
Source: jnnp.bmj.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 2
Background Stereotactic thrombolysis reduces intracerebral haemorrhage (ICH) volume in patients with spontaneous ICH. Whether intrahaematomal alteplase administration is associated with a change in intraventricular haemorrhage volume (deltaIVH) and functional outcomes is unknown. Methods Post hoc secondary analysis of the Minimally Invasive Surgery plus Alteplase for Intracerebral Hemorrhage Evacuation Phase III (MISTIE-III) trial in patients with IVH on the stability CT scan. Exposure was minimally invasive surgery plus alteplase (MIS+alteplase). Primary outcome was deltaIVH defined as IVH volume on end-of-treatment CT minus IVH volume on stability CT scan. Secondary outcomes were favourable functional outcome (modified Rankin Scale 0–3) and mortality at 365 days. We assessed the relationship between MIS+alteplase and deltaIVH in the primary analysis using multivariable linear regression, and between deltaIVH and functional outcomes in secondary analyses using multiple logistic regres
Source: jnnp.bmj.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 11
Background Multiple sclerosis (MS) and presymptomatic axonal injury appear to develop only after an Epstein-Barr virus (EBV) infection. This association remains to be confirmed across a broad preclinical time range, for lytic and latent EBV seroreactivity, and for potential cross-reacting antigens. Methods We performed a case–control study with 669 individual serum samples obtained before clinical MS onset, identified through cross-linkage with the Swedish MS register. We assayed antibodies against EBV nuclear antigen 1 (EBNA1), viral capsid antigen p18, glycoprotein 350 (gp350), the potential cross-reacting protein anoctamin 2 (ANO2) and the level of sNfL, a marker of axonal injury. Results EBNA1 (latency) seroreactivity increased in the pre-MS group, at 15–20 years before clinical MS onset, followed by gp350 (lytic) seroreactivity (p=0.001–0.009), ANO2 seropositivity appeared shortly after EBNA1-seropositivity in 16.7% of pre-MS cases and 10.0% of controls (p=0.001).With an average l
Source: jnnp.bmj.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 4Risk of stroke with different levels of leisure-time physical activity: a systematic review and meta-analysis of prospective cohort studies - 2 month(s) ago
Background Leisure-time physical activity (LTPA) protects against vascular diseases. Whether and to what extent different levels of LTPA, including lower ones, benefit stroke prevention is still unclear. Methods We searched prospective cohort studies, indexed on PubMed and Scopus, published in English up to 22 April 2023, that investigated, in a general healthy population, the relationship between different predefined LTPA levels, compared with inactivity, and the risk of any type of stroke. We applied random effect modelling for meta-analyses and meta-regression to control for the impact of age and sex. Results Out of 3064 screened articles, 15 articles on 16 cohorts of subjects were included in meta-analyses, with a total of 752 050 followed-up subjects. Mean follow-up was 125.7±77.5 months. Included studies identified three (none, below target and ideal) to five (none, insufficient, low, moderate and intense) levels of LTPA. In the five studies identifying three levels of LTPA, comp
Source: jnnp.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 4Risk of stroke with different levels of leisure-time physical activity: a systematic review and meta-analysis of prospective cohort studies - 2 month(s) ago
Background Leisure-time physical activity (LTPA) protects against vascular diseases. Whether and to what extent different levels of LTPA, including lower ones, benefit stroke prevention is still unclear. Methods We searched prospective cohort studies, indexed on PubMed and Scopus, published in English up to 22 April 2023, that investigated, in a general healthy population, the relationship between different predefined LTPA levels, compared with inactivity, and the risk of any type of stroke. We applied random effect modelling for meta-analyses and meta-regression to control for the impact of age and sex. Results Out of 3064 screened articles, 15 articles on 16 cohorts of subjects were included in meta-analyses, with a total of 752 050 followed-up subjects. Mean follow-up was 125.7±77.5 months. Included studies identified three (none, below target and ideal) to five (none, insufficient, low, moderate and intense) levels of LTPA. In the five studies identifying three levels of LTPA, comp
Source: jnnp.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 4
Background Functional neurological disorder (FND) is characterised by neurological symptoms, such as seizures and abnormal movements. Despite its significance to patients, the clinical features of chronic pain in people with FND, and of FND in people with chronic pain, have not been comprehensively studied. Methods We systematically reviewed PubMed, Embase and PsycINFO for studies of chronic pain in adults with FND and FND in patients with chronic pain. We described the proportions of patients reporting pain, pain rating and timing, pain-related diagnoses and responsiveness to treatment. We performed random effects meta-analyses of the proportions of patients with FND who reported pain or were diagnosed with pain-related disorders. Results Seven hundred and fifteen articles were screened and 64 were included in the analysis. Eight case–control studies of 3476 patients described pain symptoms in a higher proportion of patients with FND than controls with other neurological disorders. A
Source: jnnp.bmj.comCategories: General Medicine News, Hem/OncsTweet
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Mashup Score: 12The influence of epigenetic biological age on key complications and outcomes in aneurysmal subarachnoid haemorrhage - 3 month(s) ago
Background We aimed to investigate the association between DNA-methylation biological age (B-age) calculated as age acceleration (ageAcc) and key aneurysmal subarachnoid haemorrhage (aSAH) complications such as vasospasm, delayed cerebral ischaemia (DCI), poor outcome, and mortality. Methods We conducted a prospective study involving 277 patients with aSAH. B-age was determined in whole blood samples using five epigenetic clocks: Hannum’s, Horvath’s, Levine’s and both versions of Zhang’s clocks. Age acceleration was calculated as the residual obtained from regressing out the effect of C-age on the mismatch between C-age and B-age. We then tested the association between ageAcc and vasospasm, DCI and 12-month poor outcome (mRS 3–5) and mortality using linear regression models adjusted for confounders. Results Average C-age was 55.0 years, with 66.8% being female. Vasospasm occurred in 143 cases (51.6%), DCI in 70 (25.3%) and poor outcomes in 99 (35.7%), with a mortality rate of 20.6%. Lo
Source: jnnp.bmj.comCategories: General Medicine News, Future of MedicineTweet-
Helping to show that increased #age acceleration by the Hannum’s #epigenetic clock is asociated with increased #mortality in #brain #aneurysm. Article @JNNP_BMJ led by @Joan_Balado Drs Jimenez_Conde and Cuadrado-Godia from @HMar_research @hospitaldelmar https://t.co/0w6jN7wQxL https://t.co/q5uOXqajOS
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Mashup Score: 12The influence of epigenetic biological age on key complications and outcomes in aneurysmal subarachnoid haemorrhage - 3 month(s) ago
Background We aimed to investigate the association between DNA-methylation biological age (B-age) calculated as age acceleration (ageAcc) and key aneurysmal subarachnoid haemorrhage (aSAH) complications such as vasospasm, delayed cerebral ischaemia (DCI), poor outcome, and mortality. Methods We conducted a prospective study involving 277 patients with aSAH. B-age was determined in whole blood samples using five epigenetic clocks: Hannum’s, Horvath’s, Levine’s and both versions of Zhang’s clocks. Age acceleration was calculated as the residual obtained from regressing out the effect of C-age on the mismatch between C-age and B-age. We then tested the association between ageAcc and vasospasm, DCI and 12-month poor outcome (mRS 3–5) and mortality using linear regression models adjusted for confounders. Results Average C-age was 55.0 years, with 66.8% being female. Vasospasm occurred in 143 cases (51.6%), DCI in 70 (25.3%) and poor outcomes in 99 (35.7%), with a mortality rate of 20.6%. Lo
Source: jnnp.bmj.comCategories: General Medicine News, Future of MedicineTweet-
Helping to show that increased #age acceleration by the Hannum’s #epigenetic clock is asociated with increased #mortality in #brain #aneurysm. Article @JNNP_BMJ led by @Joan_Balado Drs Jimenez_Conde and Cuadrado-Godia from @HMar_research @hospitaldelmar https://t.co/0w6jN7wQxL https://t.co/q5uOXqajOS
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Mashup Score: 4
Background Pain is an important symptom in Huntington’s disease (HD), however, not systematically studied and understood. The objective of the current study is to assess the prevalence of pain, pain interference in daily activities, painful conditions, analgesic use and the severity of the pain burden across different disease stages and ‘Age at symptom Onset’ groups. Additionally, the association between pain and disease burden was investigated. Methods A cross-sectional analysis was conducted within two large data sets, which included different types of pain scales. Multivariable logistic regression analyses and analyses of variance were performed to compare the pain levels with those in the general population. The analyses were adjusted for sex and age. Locally Estimated Scatterplot Smoothing was used to test the association between pain and the HD pathology score: a measure of disease burden. Results The mean prevalence of pain in the HD population was 40% and for pain interference
Source: jnnp.bmj.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 17ON/OFF non-motor evaluation: a new way to evaluate non-motor fluctuations in Parkinson’s disease - 3 month(s) ago
Background NMF are currently poorly evaluated in therapeutic decisions. A quantification of their severity would facilitate their integration. The objective of this study was to validate an autoquestionnaire evaluating the severity of non-motor fluctuations (NMF) in Parkinson’s disease (PD). Methods Patients with PD were included in presurgical situation for deep brain stimulation of subthalamic nuclei. They participated in the PREDISTIM cohort (a study evaluating the predictive factors for therapeutic response of subthalamic stimulation in PD) in 17 centres in France. Our questionnaire, resulting from previous phases of development, included 11 non-motor symptoms (NMS). Their severity ranged from 0 to 10 and was assessed in OFF and then ON-Dopa to study their fluctuations. Results 310 patients were included, of whom 98.8% had NMS and 98.0% had NMF. Each NMS was significantly improved by L-Dopa (decrease in severity score ranging from 43.1% to 69.9%). Fatigue was the most frequent and
Source: jnnp.bmj.comCategories: General Medicine News, NeurologyTweet
Weighing the impact of post hoc studies https://t.co/7p55N1RHPF https://t.co/9rWS89qsOu