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Health-related quality-of-life and burden for caregivers of individuals with neurogenic orthostatic hypotension. 神经源性直立性低血压患者护理人员的健康相关生活质量和负担
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2023-02-01 DOI: 10.2217/nmt-2022-0015
Katy Gallop, Ngan Pham, Grant Maclaine, Emma Saunders, Bonnie Black, Lena Hubig, Sarah Acaster

Aim: This study explores the burden of caring for an individual with neurogenic orthostatic hypotension (nOH) and an underlying neurodegenerative disease (Parkinson's disease, multiple system atrophy, pure autonomic failure or dementia with Lewy bodies). Materials & methods: A survey including several validated instruments was conducted with informal caregivers of individuals with Parkinson's disease, multiple system atrophy, pure autonomic failure or dementia with Lewy bodies. Results: Caregivers of patients with nOH (n = 60) reported greater burden across all outcomes compared with those without nOH (n = 60). Receiving pharmacological treatment for nOH was the variable most consistently associated with significantly better caregiver health-related quality-of-life (p < 0.05). Conclusion: This study demonstrates the burden of nOH on informal caregivers and highlights the potential benefit of pharmacological treatment not only for patients but also indirectly, their caregivers.

目的:本研究探讨神经源性直立性低血压(nOH)和潜在神经退行性疾病(帕金森病、多系统萎缩、纯自主神经衰竭或路易体痴呆)患者的护理负担。材料与方法:对帕金森病、多系统萎缩、纯自主神经衰竭或路易体痴呆患者的非正式照顾者进行了一项调查,包括几种经过验证的工具。结果:与没有nOH的患者(n = 60)相比,nOH患者(n = 60)的护理人员在所有结果中报告了更大的负担。接受药物治疗的nOH是最一致地与更好的护理者健康相关生活质量显著相关的变量(p结论:本研究表明nOH对非正式护理者的负担,并强调药物治疗不仅对患者而且间接对其护理者的潜在益处。
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引用次数: 1
Disease stability over five years in people with multiple sclerosis treated with cladribine tablets: a plain language summary. 用克拉德滨片治疗多发性硬化症患者5年以上的疾病稳定性:简单的语言总结。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-12-01 Epub Date: 2022-08-26 DOI: 10.2217/nmt-2022-0018
Gavin Giovannoni, Giancarlo Comi, Kottil Rammohan, Peter Rieckmann, Fernando Dangond, Dominic Jack, Patrick Vermersch

What is this summary about?: This is a summary of an article originally published in the journal Advances in Therapy. Cladribine tablets are approved for treating people with relapsing multiple sclerosis (shortened to MS). People with MS take cladribine tablets for 2 periods of 4 to 5 days per year. This analysis looks at the results from 2 studies called the CLARITY and CLARITY Extension studies. These studies looked at what effect a 2-year course of treatment with cladribine tablets had on disability over 5 years in people with MS.

How was the analysis carried out?: In this analysis, researchers measured disability worsening at regular intervals during the 2-year treatment period in the CLARITY study and thereafter in the 2-year CLARITY Extension study. As many patients had a bridging interval between CLARITY and CLARITY extension, the researchers were able to assess disability over a 5-year timeframe.

What were the results?: When measurements were taken at Year 5 of the study, disability remained stable in more than half of participants. Over the 5-year period, 70% of participants did not experience persistent disease worsening that lasted more than 6 months.

What do the results mean?: Researchers concluded that a 2-year course of cladribine tablets may provide long-term benefits on disability for up to 5 years. Clinical Trial Registration: NCT00213135 (ClinicalTrials.gov) Clinical Trial Registration: NCT00641537 (ClinicalTrials.gov).

这个总结是关于什么的?这是最初发表在《治疗进展》杂志上的一篇文章的摘要。克拉德滨片被批准用于治疗复发性多发性硬化症(简称MS)。多发性硬化症患者每年服用克拉德里滨片剂2次,每次4 - 5天。该分析着眼于两项研究的结果,分别是CLARITY和CLARITY扩展研究。这些研究着眼于用克拉德滨片治疗2年对多发性硬化症患者超过5年的残疾有什么影响,分析是如何进行的?在这项分析中,研究人员在CLARITY研究的2年治疗期间和随后的2年CLARITY扩展研究中定期测量残疾恶化情况。由于许多患者在CLARITY和CLARITY扩展之间有一个桥接间隔,研究人员能够在5年的时间框架内评估残疾。结果如何?在研究的第5年进行测量时,超过一半的参与者的残疾状况保持稳定。在5年期间,70%的参与者没有经历持续6个月以上的持续疾病恶化。这些结果意味着什么?研究人员得出结论,2年疗程的克拉宾片可能对残疾患者提供长达5年的长期益处。临床试验注册:NCT00213135 (ClinicalTrials.gov)临床试验注册:NCT00641537 (ClinicalTrials.gov)。
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引用次数: 0
Relapses in people with multiple sclerosis treated with cladribine tablets followed for up to 5 years: a plain language summary. 多发性硬化症患者接受克拉德滨片治疗后复发的随访时间长达5年:简单的语言总结。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-12-01 Epub Date: 2022-08-26 DOI: 10.2217/nmt-2022-0019
Nicola De Stefano, Maria Pia Sormani, Gavin Giovannoni, Kottil Rammohan, Thomas P Leist, Patricia K Coyle, Fernando Dangond, Nektaria Alexandri, Andrew Galazka

What is this summary about?: This is a summary of an article originally published in the Multiple Sclerosis Journal. The article presents the results from the CLARITY and CLARITY Extension studies, which looked at how well cladribine tablets work in treating people with multiple sclerosis (shortened to MS). Cladribine tablets are a medication approved for treating relapsing forms of MS. This study looked at how treatment with cladribine tablets affects the frequency and severity of relapses in people with MS. A relapse is when new symptoms develop or old symptoms return or get worse after a period of stability or improvement.

What happened in the studies?: In the CLARITY study, 870 people received either cladribine tablets (3.5 mg/kg, the approved dose) or placebo (a dummy pill). After the CLARITY study ended, some participants who received cladribine tablets chose to take part in a second study called the CLARITY Extension study. Of these participants, 98 were given placebo for 2 more years following an interval period of up to 10 months between participating in each study.

What were the results?: People with MS who were treated with cladribine tablets for 2 years in the CLARITY study had lower risks of any relapse compared with those given placebo. Participants taking placebo (after cladribine tablets) in the CLARITY Extension study experienced these same benefits, which continued for up to 3 more years after having received cladribine tablets in the CLARITY study.

What do the results mean?: Researchers concluded the recommended 2-year dosing of cladribine tablets may reduce the number and severity of relapses in people with MS for up to 5 years. Clinical Trial Registration: NCT00213135 (ClinicalTrials.gov) Clinical Trial Registration: NCT00641537 (ClinicalTrials.gov).

这个总结是关于什么的?这是最初发表在《多发性硬化症杂志》上的一篇文章的摘要。这篇文章介绍了CLARITY和CLARITY Extension研究的结果,研究了克拉德里滨片治疗多发性硬化症(简称MS)的效果。克拉德滨是一种被批准用于治疗复发型多发性硬化症的药物。这项研究着眼于克拉德滨治疗如何影响多发性硬化症患者复发的频率和严重程度。复发是指在一段时间的稳定或改善后出现新症状或旧症状复发或恶化。研究中发生了什么?在CLARITY研究中,870人接受了克拉德里滨片剂(3.5 mg/kg,批准剂量)或安慰剂(一种假药丸)。CLARITY研究结束后,一些接受克拉德里滨片剂的参与者选择参加第二项名为CLARITY扩展研究的研究。在这些参与者中,98人在每项研究之间间隔10个月后再服用安慰剂2年。结果如何?在CLARITY研究中,接受克拉德里滨片剂治疗2年的多发性硬化症患者与接受安慰剂治疗的患者相比,复发的风险较低。在CLARITY扩展研究中,服用安慰剂(在服用克拉德里滨片之后)的参与者也经历了同样的益处,在CLARITY研究中服用克拉德里滨片后,这种益处持续了3年。这些结果意味着什么?研究人员得出结论,推荐的2年剂量的克拉德滨片可以减少多发性硬化症患者复发的次数和严重程度,最多可达5年。临床试验注册:NCT00213135 (ClinicalTrials.gov)临床试验注册:NCT00641537 (ClinicalTrials.gov)。
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引用次数: 0
The use of lumbar puncture and safety recommendations in Alzheimer's disease: a plain language summary. 在阿尔茨海默病中腰椎穿刺的使用和安全性建议:一个简单的语言总结。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-07-22 DOI: 10.2217/nmt-2022-0012
Harald Hampel, Aya Elhage, Leslie M Shaw, Paul Aisen, Christopher Chen, Alberto Lleó, Takeshi Iwatsubo, Atsushi Iwata, Masahito Yamada, Takeshi Ikeuchi, Jianping Jia, Huali Wang, Charlotte E Teunissen, Elaine Peskind, Kaj Blennow, Jeffrey Cummings, Andrea Vergallo

What is this summary about?: This is a plain language summary of an article published in Alzheimer's & Dementia. It looks at a type of test called a lumbar puncture (also known as spinal tap) used in people suspected of having Alzheimer's disease or some other form of dementia. This summary focuses on how to do a lumbar puncture safely.

Why is this important?: Alzheimer's disease is a progressive condition, which means it gets worse over time. This leads to difficulties with thinking and memory. People with Alzheimer's disease show a build up of proteins called amyloid-β and tau in the brain. This is followed by a gradual loss of brain cells and brain function. The changes in the brain are thought to occur years before symptoms appear. Lumbar puncture is a medical procedure during which samples of cerebrospinal fluid are collected. In Alzheimer's disease, it is used to examine cerebrospinal fluid biomarkers that can help diagnose disease. Lumbar puncture is traditionally considered as a painful and invasive procedure with frequent side effects. However, multiple studies indicate that a lumbar puncture can be performed safely. Side effects are typically mild and do not require specialist intervention.

What are the key takeaways?: Despite the low risk of serious complications associated with a lumbar puncture, physicians and their patients may be reluctant to recommend or undergo this procedure. Patient education, specialist training, as well as new methods concerning patient safety are important factors to support the widespread use of lumbar puncture in Alzheimer's disease.

这个总结是关于什么的?这是发表在《阿尔茨海默病与痴呆症》杂志上的一篇文章的简明扼要的总结。它着眼于一种被称为腰椎穿刺(也称为脊髓穿刺)的测试,这种测试用于怀疑患有阿尔茨海默病或其他形式的痴呆症的人。这篇总结的重点是如何安全地做腰椎穿刺。为什么这很重要?阿尔茨海默病是一种进行性疾病,这意味着它会随着时间的推移而恶化。这会导致思考和记忆方面的困难。患有阿尔茨海默病的人大脑中淀粉样蛋白-β和tau蛋白的含量增加。随之而来的是脑细胞和大脑功能的逐渐丧失。大脑的变化被认为在症状出现前几年就发生了。腰椎穿刺是一种收集脑脊液样本的医疗程序。在阿尔茨海默病中,它被用来检查脑脊液生物标志物,帮助诊断疾病。腰椎穿刺传统上被认为是一种痛苦和侵入性的手术,而且经常有副作用。然而,多项研究表明,腰椎穿刺可以安全进行。副作用通常是轻微的,不需要专家干预。关键的收获是什么?尽管与腰椎穿刺相关的严重并发症的风险很低,但医生和他们的患者可能不愿意推荐或接受这种手术。患者教育、专家培训以及有关患者安全的新方法是支持腰椎穿刺在阿尔茨海默病中广泛应用的重要因素。
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引用次数: 3
Friedreich ataxia: clinical features and new developments. 弗里德里希共济失调:临床特点和新进展。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-06-29 DOI: 10.2217/nmt-2022-0011
Medina Keita, Kellie McIntyre, Layne N Rodden, Kim Schadt, David R Lynch

Friedreich's ataxia (FRDA), a neurodegenerative disease characterized by ataxia and other neurological features, affects 1 in 50,000-100,000 individuals in the USA. However, FRDA also includes cardiac, orthopedic and endocrine dysfunction, giving rise to many secondary disease characteristics. The multifaceted approach for clinical care has necessitated the development of disease-specific clinical care guidelines. New developments in FRDA include the advancement of clinical drug trials targeting the NRF2 pathway and frataxin restoration. Additionally, a novel understanding of gene silencing in FRDA, reflecting a variegated silencing pattern, will have applications to current and future therapeutic interventions. Finally, new perspectives on the neuroanatomy of FRDA and its developmental features will refine the time course and anatomical targeting of novel approaches.

弗里德里希共济失调(FRDA)是一种以共济失调和其他神经系统特征为特征的神经退行性疾病,在美国,每5-10万人中就有1人患有这种疾病。然而,FRDA还包括心脏、骨科和内分泌功能障碍,从而产生许多继发性疾病特征。临床护理的多方面方法使得制定针对特定疾病的临床护理指南成为必要。FRDA的新进展包括靶向NRF2途径和frataxin修复的临床药物试验的进展。此外,对FRDA中基因沉默的新理解,反映了一种多样化的沉默模式,将在当前和未来的治疗干预中得到应用。最后,对FRDA的神经解剖学及其发育特征的新观点将完善新方法的时间进程和解剖学靶向。
{"title":"Friedreich ataxia: clinical features and new developments.","authors":"Medina Keita,&nbsp;Kellie McIntyre,&nbsp;Layne N Rodden,&nbsp;Kim Schadt,&nbsp;David R Lynch","doi":"10.2217/nmt-2022-0011","DOIUrl":"10.2217/nmt-2022-0011","url":null,"abstract":"<p><p>Friedreich's ataxia (FRDA), a neurodegenerative disease characterized by ataxia and other neurological features, affects 1 in 50,000-100,000 individuals in the USA. However, FRDA also includes cardiac, orthopedic and endocrine dysfunction, giving rise to many secondary disease characteristics. The multifaceted approach for clinical care has necessitated the development of disease-specific clinical care guidelines. New developments in FRDA include the advancement of clinical drug trials targeting the NRF2 pathway and frataxin restoration. Additionally, a novel understanding of gene silencing in FRDA, reflecting a variegated silencing pattern, will have applications to current and future therapeutic interventions. Finally, new perspectives on the neuroanatomy of FRDA and its developmental features will refine the time course and anatomical targeting of novel approaches.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"267-283"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9517959/pdf/nmt-12-267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40408649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
The effectiveness of aromatherapy and reflexology in neurodegenerative disorders: a systematic review and meta-analysis. 芳香疗法和反射疗法在神经退行性疾病中的有效性:系统回顾和荟萃分析。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-06-30 DOI: 10.2217/nmt-2021-0056
Raj Rawal, Joy Read, Elizabeth Chesterman, Kate Walters, Anette Schrag, Gareth Ambler, Megan Armstrong

Many neurodegenerative conditions are chronic disorders and result in a range of debilitating symptoms, with many people turning to complementary therapies. A systematic review and meta-analysis were conducted to investigate the evidence on effectiveness of aromatherapy and reflexology on all neurodegenerative conditions. We identified nine eligible studies (total sample n = 504 participants) all of which were on multiple sclerosis only. A meta-analysis was conducted including data from six studies, which demonstrated no significant benefit of aromatherapy/reflexology; however, the sample sizes were small and of low quality. This systematic review confirmed that it is not possible to draw conclusions regarding the effectiveness of reflexology and aromatherapy in multiple sclerosis. Larger high-quality studies are required to test these widely used therapies.

许多神经退行性疾病是慢性疾病,并导致一系列衰弱症状,许多人转向补充疗法。我们进行了系统回顾和荟萃分析,以调查芳香疗法和反射疗法对所有神经退行性疾病有效的证据。我们确定了9项符合条件的研究(总样本n = 504名参与者),所有这些研究均仅针对多发性硬化症。我们对六项研究的数据进行了荟萃分析,结果显示芳香疗法/反射疗法没有显著的益处;然而,样本量小,质量低。本系统综述证实,不可能得出关于反射疗法和芳香疗法在多发性硬化症中的有效性的结论。需要更大规模的高质量研究来测试这些广泛使用的疗法。
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引用次数: 2
Digital interventions for people with dementia and carers: effective, cost-effective and equitable? 针对痴呆症患者和照护者的数字化干预措施:有效、具有成本效益且公平吗?
IF 2.3 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-07-14 DOI: 10.2217/nmt-2022-0025
Martin Knapp, Xheni Shehaj, Gloria Wong
{"title":"Digital interventions for people with dementia and carers: effective, cost-effective and equitable?","authors":"Martin Knapp, Xheni Shehaj, Gloria Wong","doi":"10.2217/nmt-2022-0025","DOIUrl":"10.2217/nmt-2022-0025","url":null,"abstract":"","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"215-219"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9517957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40592266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The AT(N) system for describing biological changes in Alzheimer's disease: a plain language summary. 描述阿尔茨海默病生物学变化的AT(N)系统:简单的语言总结。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-07-22 DOI: 10.2217/nmt-2022-0013
Harald Hampel, Aya Elhage, Jeffrey Cummings, Kaj Blennow, Peng Gao, Clifford R Jack, Andrea Vergallo

What is this summary about?: This is a plain language summary of an article published in Nature Reviews Neurology. It explains how Alzheimer's disease is diagnosed. It also looks at whether a newer way to assess people with Alzheimer's disease could help improve how the condition is diagnosed, monitored, and treated.

Why is this important?: Alzheimer's disease is a long-term progressive brain disease that leads to difficulties with thinking and memory. It is a progressive condition, which means it gets worse over time. Biological changes occur in the brain of people with Alzheimer's disease. This includes a build-up of toxic protein clusters called amyloid plaques and tau tangles, gradual damage to the brain cells (neurodegeneration), and brain shrinkage due to loss of neurons. It is often due to multiple factors and doctors usually diagnose Alzheimer's disease by looking at a person's symptoms and ruling out other causes of dementia. However, research shows that people diagnosed in this way do not always have the biological changes in the brain that are related to Alzheimer's disease. This means that some people may be misdiagnosed. Additionally, there may be a delay in the appearance of Alzheimer's symptoms, by which point changes in the brain may be severe. For example, people with Alzheimer's disease show biological changes in the brain, years before symptoms appear.

What are the key takeaways?: An assessment of biological changes in the brain, by measuring substances that indicate disease progress (biomarkers), may offer a fuller picture of a person's Alzheimer's disease, how advanced it is, and which treatments are likely to work best. A recently developed classification scheme known as the AT(N) system provides a way to assess and describe the biological changes in amyloid (A), tau (T), and neurodegeneration (N) that occur in people with Alzheimer's disease. The goal is to include biomarker testing in clinical practice to help physicians and practitioners diagnose, monitor, and treat people with Alzheimer's disease more effectively. The AT(N) system is being used for various purposes in clinical studies, and has the potential to assist physicians and practitioners in early detection, accurate diagnosis, staging, and treatment selection for people with Alzheimer's disease.

这个总结是关于什么的?这是一篇发表在《自然评论神经学》上的文章的简明扼要的总结。它解释了阿尔茨海默病的诊断方法。它还研究了一种评估阿尔茨海默病患者的新方法是否有助于改善这种疾病的诊断、监测和治疗方式。为什么这很重要?阿尔茨海默病是一种长期的进行性脑部疾病,会导致思考和记忆困难。这是一种进行性疾病,这意味着它会随着时间的推移而恶化。阿尔茨海默病患者的大脑会发生生物学变化。这包括被称为淀粉样斑块和tau蛋白缠结的有毒蛋白质簇的积累,对脑细胞的逐渐损伤(神经变性),以及由于神经元丧失而导致的大脑萎缩。它通常是由多种因素引起的,医生通常通过观察一个人的症状来诊断阿尔茨海默病,并排除痴呆症的其他原因。然而,研究表明,以这种方式诊断的人并不总是有与阿尔茨海默病相关的大脑生物学变化。这意味着有些人可能会被误诊。此外,阿尔茨海默病的症状可能会延迟出现,到那时大脑的变化可能会很严重。例如,患有阿尔茨海默病的人在症状出现前几年就表现出大脑的生物学变化。关键的收获是什么?通过测量指示疾病进展的物质(生物标志物)来评估大脑的生物变化,可以更全面地了解一个人的阿尔茨海默病,了解病情的进展程度,以及哪种治疗方法可能最有效。最近开发的分类方案称为AT(N)系统提供了一种评估和描述发生在阿尔茨海默病患者的淀粉样蛋白(A), tau (T)和神经变性(N)的生物学变化的方法。目标是将生物标志物测试纳入临床实践,以帮助医生和从业人员更有效地诊断、监测和治疗阿尔茨海默病患者。AT(N)系统在临床研究中被用于各种目的,并有可能帮助医生和从业人员对阿尔茨海默病患者进行早期发现、准确诊断、分期和治疗选择。
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引用次数: 2
Off-Adherence Keeping (OAK) observational study: intentional off-adherence immunomodulatory multiple sclerosis treatment. 非依从性保持(OAK)观察性研究:有意的非依从性免疫调节多发性硬化治疗。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-09-07 DOI: 10.2217/nmt-2021-0016
Marco Peresson, Salvatore Cottone, Vincenzo Brescia Morra, Giuseppe Salemi, Antonio Gallo, Paola Valentino, Luca Prosperini

Aims: To evaluate how improved treatment adherence with a lower-frequency regimen/treatment of intramuscular (IM) IFNβ-1a impacts therapeutic effectiveness in relapsing-remitting multiple sclerosis (MS) patients switching from a higher-frequency injectable regimen/treatment. Patients & methods: Italian patients with relapsing-remitting MS and prior poor adherence to high-frequency injectable treatments (n = 181) were followed for 24 months after starting IM IFNβ-1a. Results: During the study, 97.4% of patients were treatment adherent; 22.1% of patients reported a relapse. The estimated probability of remaining relapse-free after 2 years was 78%. A high dropout rate (52.5%) led to small sample size and reduced statistical power. Conclusion: Intramuscular IFNβ-1a treatment was associated with high adherence and a low relapse rate. Unfortunately, low patient retention limited the generalizability of these findings.

目的:评估低频方案/肌注(IM) IFNβ-1a治疗依从性的改善如何影响复发-缓解型多发性硬化症(MS)患者从高频注射方案/治疗转换的治疗效果。患者和方法:意大利复发-缓解型MS患者,既往对高频注射治疗依从性差(n = 181),在开始IM IFNβ-1a后随访24个月。结果:研究期间,97.4%的患者坚持治疗;22.1%的患者复发。估计2年后无复发的概率为78%。高辍学率(52.5%)导致样本量小,统计效力降低。结论:肌肉注射IFNβ-1a治疗具有高依从性和低复发率。不幸的是,低患者保留率限制了这些发现的普遍性。
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引用次数: 0
The 5-Cog paradigm to improve detection of cognitive impairment and dementia: clinical trial protocol. 改善认知障碍和痴呆症检测的 5-Cog 范式:临床试验方案。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-08-01 Epub Date: 2022-05-23 DOI: 10.2217/nmt-2021-0043
Rachel Chalmer, Emmeline Ayers, Erica F Weiss, Rubina Malik, Amy Ehrlich, Cuiling Wang, Jessica Zwerling, Asif Ansari, Katherine L Possin, Joe Verghese

Cognitive impairment related to dementia is under-diagnosed in primary care despite availability of numerous cognitive assessment tools; under-diagnosis is more prevalent for members of racial and ethnic minority groups. Clinical decision-support systems may improve rates of primary care providers responding to positive cognitive assessments with appropriate follow-up. The 5-Cog study is a randomized controlled trial in 1200 predominantly Black and Hispanic older adults from an urban underserved community who are presenting to primary care with cognitive concerns. The study will validate a novel 5-minute cognitive assessment coupled with an electronic medical record-embedded decision tree to overcome the barriers of current cognitive assessment paradigms in primary care and facilitate improved dementia care.

尽管有许多认知评估工具,但在初级保健中与痴呆症有关的认知障碍诊断不足;少数种族和少数族裔群体成员的诊断不足现象更为普遍。临床决策支持系统可提高初级保健提供者对认知评估结果做出积极回应并进行适当随访的比率。5-Cog 研究是一项随机对照试验,对象是来自城市服务不足社区的 1200 名主要是黑人和西班牙裔的老年人,他们因认知问题向初级保健机构求诊。该研究将验证一种新颖的 5 分钟认知评估方法,并将其与嵌入电子病历的决策树相结合,以克服初级保健中现有认知评估范例的障碍,促进痴呆症护理的改善。
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引用次数: 0
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Neurodegenerative disease management
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