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Utility of patient subgrouping in ALS clinical trials: a World Federation of Neurology white paper.

The heterogeneity among the amyotrophic lateral sclerosis (ALS)/MND patient population is well recognized but not well understood. Such heterogeneity may represent a significant confound in our current and prior clinical trials as certain subgroups of patients might have a selective response (or resistance) to a novel therapeutic. The basis on which to segregate the patient population is, however, unclear. The ALS/MND Committee of the World Federation of Neurology (WFN) convened a symposium to discuss various strategies that might be considered for separating (stratifying) the population to fu…

Current and Future Roles of Chimeric Antigen Receptor T-Cell Therapy in Neurology: A Review.

IMPORTANCE: Advancements in molecular engineering have facilitated the creation of engineered T cells that express synthetic receptors, termed chimeric antigen receptors (CARs). This is promising not only in cancer treatment but also in addressing a spectrum of other conditions. This review provides a comprehensive overview of the current approaches and future potential of CAR T-cell therapy in the field of neurology, particularly for primary brain tumors and autoimmune neurological disorders. OBSERVATIONS: CAR T-cell therapy for glioblastoma is promising; however, first-in-human trials did n…

Carpal Tunnel Syndrome at the Intersection of Internal Medicine, Gastroenterology, and Neurology: A Thorough Examination.

Background/Objectives: This study was designed to investigate the potential clinical, biochemical, haematological, and pathological associations of carpal tunnel syndrome through a multidisciplinary approach encompassing the fields of internal medicine, gastroenterology, and neurology. Methods: The study group (CTS-positive) comprised 265 patients who presented with dyspeptic complaints and underwent upper gastrointestinal endoscopy, gastric antrum biopsy, electromyography, and comprehensive biochemical and haematological analyses. A control group of 265 patients with similar symptoms but with…

Специальный выпуск: резюме 11th Конгресс Европейской академии неврологии, Хельсинки, Финляндия.

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… Sîrbu 2 1 Department of Neurology, Central Military Emergency University Hospital “Dr. … Unit, Division of Neuroscience, Neurology Unit, and Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 6 Neurology Unit, Neurorehabilitation Unit, Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy; 7 Neurology Unit, Neurorehabilitation Unit, …

Education Research: Secondary Trauma in Third-Year Medical Students During a Neurology/Emergency Medicine Clerkship.

BACKGROUND AND OBJECTIVES: Exposure to emotionally taxing patients can lead to secondary trauma that can result in burnout and emotional exhaustion in healthcare providers. Understanding whether secondary trauma is present in medical students could provide an opportunity to address the issue earlier in physician training. We sought to determine if secondary trauma characteristics exist in third-year medical students during a combined neurology/emergency medicine clerkship. METHODS: Six cohorts of third-year medical students at a MD-granting institution were invited to complete the Professiona…

AI-generated neurology consultation summaries improve efficiency and reduce documentation burden in the emergency department.

Physicians face a significant documentation burden, spending twice as much time on electronic health records (EHRs) as on direct patient care. Consultation summary reports from the emergency department (ED) are critical for continuity of care and clinical decision-making. This study aims to evaluate the quality and utility of automatically generated neurological consultation reports with clear recommendations, while reducing neurologists' documentation burden. We used neurological consultation reports (n = 250) from the ED as reference outputs. For each case, we fed the report's constituent co

Sex differences in multiple sclerosis treatment with disease modifying drugs: a step towards gender neurology.

INTRODUCTION: Multiple sclerosis (MS) is an immune-mediated demyelinating disorder of the central nervous system. Relevant differences between men and women are known in MS epidemiology, disease course, clinical manifestations and instrumental findings. However, differences in response to disease-modifying treatments (DMTs) have been rarely assessed. METHODS: We performed a registry-based study on patients of our reference center in Palermo, Italy. Only patients with relapsing-remitting course or clinically isolated syndrome were included. Efficacy endpoints we considered were confirmed disea

Outcome predictors of post-COVID conditions in the European Academy of Neurology COVID-19 registry.

Several neurological manifestations are part of the post-COVID condition. We aimed to: (1) evaluate the 6-month outcome in the cohort of patients with neurological manifestations during the COVID-19 acute phase and surviving the infection, and find outcome predictors; (2) define the prevalence and type of neurological symptoms persistent at six months after the infection. Data source was an international registry of patients with COVID-19 infection and neurological symptoms, signs or diagnoses established by the European Academy of Neurology. Functional status at six-month follow-up was measur…

Twenty-Five Years of AI in Neurology: The Journey of Predictive Medicine and Biological Breakthroughs.

Neurological disorders are the leading cause of physical and cognitive disability across the globe, currently affecting up to 15% of the world population, with the burden of chronic neurodegenerative diseases having doubled over the last 2 decades. Two decades ago, neurologists relying solely on clinical signs and basic imaging faced challenges in diagnosis and treatment. Today, the integration of artificial intelligence (AI) and bioinformatic methods is changing this landscape. This paper explores this transformative journey, emphasizing the critical role of AI in neurology, aiming to integra…

Является ли табличка "Своллоу" полезной иллюстрацией биомаркера в клинической неврологии? Систематический обзор.

Утрата дорсосторонней нигральной гиперинтенсивности (ДН) в чувствительных к железому последовательностях магнитно-резонансного воображения (MRI), также описываемого как потеря "габаритного хвостового знака" (STS), показала многообещающее диагностическое значение в болезни Паркинсона (PD) и атипичных синдромах Паркинсона (APS). ЦЕЛЬ: Проведение библиометрического анализа субстантийских нигра МРТ и систематического обзора клинической полезности визуальной оценки СТС на предмет сушкебельности в различных клинических образованиях. METODIS: Сеть сообщников VOSviewer использовалась с использованием

Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis.

BACKGROUND: The risk of aspiration is high in stroke patients due to dysphagia/loss of swallowing. This problem can cause problems affecting the nutrition of patients. Due to the possible risk of aspiration during feeding, patient relatives are hesitant to feed their patients. Because of this fear, malnutrition and hospital readmissions may increase. It is important to evaluate the fear of aspiration risk of relatives of patients hospitalized in the neurology service. The aim of this study is to determine the views of the relatives of patients treated in the neurology service about the risk of…

Institutional Evaluation of Fetal Neurology Consults and Postnatal Outcomes: A 10-Year Retrospective Cohort Review.

BACKGROUND AND OBJECTIVES: An increasing number of centers are offering fetal neurology consultation services; however, there is limited information available in overall institutional experiences. Data are lacking on the fetal characteristics, pregnancy course, and the influence of fetal consultation on perinatal outcomes. The aim of this study is to provide insight on the institutional fetal neurology consult process and areas of strengths and weaknesses. METHODS: We performed a retrospective electronic chart review of fetal consults from April 2, 2009, to August 8, 2019, at Nationwide Child…

Description of neurological mimics presented to the neurology service of a small animal referral hospital.

BACKGROUND: Clinicians observe that cats and dogs referred to neurology services often do not have an underlying neurological disorder. There has been no analysis of the frequency or categorisation of these neurological mimics. METHODS: Retrospective study of 520 cases was carried out. Data on signalment, presenting clinical signs, neurological examination findings and final diagnosis were collected. Final diagnoses were classified as primary neurological, non-neurological in origin but with neurological clinical manifestation, completely non-neurological (neurological mimics) or undiagnosed.…

Rapid screening for neglect following stroke: A systematic search and European Academy of Neurology recommendations.

BACKGROUND AND PURPOSE: Unilateral neglect is a common cognitive disorder following stroke. Neglect has a significant impact on functional outcomes, so it is important to detect. However, there is no consensus on which are the best screening tests to administer to detect neglect in time-limited clinical environments. METHODS: Members of the European Academy of Neurology Scientific Panel on Higher Cortical Functions, neuropsychologists, occupational therapists, and researchers produced recommendations for primary and secondary tests for bedside neglect testing based on a rigorous literature re…

The Society of Vascular and Interventional Neurology (SVIN) Mechanical Thrombectomy Registry: Methods and Primary Results.

BACKGROUND: A better understanding of real-world practice patterns in the endovascular treatment for large vessel occlusion acute ischemic stroke is needed. Here, we report the methods and initial results of the Society of Vascular and Interventional Neurology (SVIN) Registry. METHODS: The SVIN Registry is an ongoing prospective, multicenter, observational registry capturing patients with large vessel occlusion acute ischemic stroke undergoing endovascular treatment since November 2018. Participating sites also contributed pre-SVIN Registry data collected per institutional prospective registr…

The importance of neurology and genetic testing in the patient with non-cleft velopharyngeal dysfunction.

OBJECTIVE: A significant proportion of the referrals made to a speech investigation clinic in a cleft unit include patients with non-cleft v … . Of those presenting without a known aetiology, fifty-eight were referred onto our genetics and/or neurology colleagues. Although a genetic or neurological cause could not be identified in some of those patients, thirty-one patients received a new diagnosis, with subsequent implications for ongoing care. CONCLUSION: There are a wide range of diagnoses res …

Analysis of psychiatric consultations in the department of neurology and stroke unit: diagnosis and therapy.

OBJECTIVES: The aim of this study was to analyze psychiatric consultations of patients hospitalized in the Department of Neurology and Stroke Unit (DN/SU) of University Clinical Center in Katowice from 2017 to 2018. METHODS: A retrospective analysis of psychiatric consultations, psychiatric diagnoses (according to the ICD-10) and treatment recommendations was done. RESULTS: 719 psychiatric consultations were performed in all hospital departments in the analyzed period. 488 (67.87%) consultations were conducted in the Department of Neurology and Stroke Unit. Most patients who required psychia…

Child Neurology: A young child with an undiagnosed case of dystonia responsive to l-dopa.

Childhood-onset dystonias are a heterogeneously diverse group. There exists a specific set of dystonias that respond profoundly well to low doses of l-dopa (dopa-responsive dystonia [DRD]). Classical DRD is caused by deficiency of GTP cyclohydrolase 1 or tyrosine hydroxylase, but other conditions can cause dystonias that are partially responsive to dopamine. The idea of a diagnostic therapeutic trial with l-dopa for children who present with dystonia has been around for decades and is frequently advocated for; however, l-dopa trials are not without risk.