US neurology最新文献_第3页

Cladribine Tablets: A Review of the Practical Considerations in Multiple Sclerosis Nursing Practice 克拉德滨片:多发性硬化症护理实践中应注意的事项综述

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.81

Del Thomas, N. Barker, W. Brownlee, E. Butler, E. Celius, Anne Berit Vesterås, H. Salloukh, Michelle Gerard (Allan)

{"title":"Cladribine Tablets: A Review of the Practical Considerations in Multiple Sclerosis Nursing Practice","authors":"Del Thomas, N. Barker, W. Brownlee, E. Butler, E. Celius, Anne Berit Vesterås, H. Salloukh, Michelle Gerard (Allan)","doi":"10.17925/usn.2022.18.2.81","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.81","url":null,"abstract":"Nurses specializing in the care of patients with multiple sclerosis (MS) are uniquely positioned to provide personalized care. Patients prescribed cladribine tablets (taken for ≤10 days per year for 2 years), indicated for adults with highly active relapsing MS in the EU and Australia, can benefit from an active partnership with their healthcare professionals, including MS nurses, who can promote an understanding of and the adherence to treatment. In clinical studies, patients treated with cladribine tablets had lower annual relapse rates, greater odds of being relapse free, a longer time to sustained progression of disability and a significant reduction in radiological disease activity compared with patients receiving placebo. Patients should be advised that, although everyone will have a different experience, the safety of cladribine tablets is supported by 16 years of clinical trial and post-approval data. Furthermore, there is no indication of a more serious disease course or more severe outcomes for patients with MS treated with cladribine tablets who acquire coronavirus disease 2019 compared with the general population or other patients with MS. This article presents practical considerations that may help achieve a greater understanding of the potential benefits and drawbacks of MS treatment, build the patient–nurse relationship, encourage shared decision-making and ultimately may improve care.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Posterior Reversible Encephalopathy Syndrome in a Patient with Systemic Lupus Erythematosus: A Case Report 系统性红斑狼疮患者后侧可逆性脑病综合征1例报告

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.153

Angky Saputra, Benjamin Sastro, R. Janitra, Subagia Santosa Sudjono, Satyanegara, R. Hasan

{"title":"Posterior Reversible Encephalopathy Syndrome in a Patient with Systemic Lupus Erythematosus: A Case Report","authors":"Angky Saputra, Benjamin Sastro, R. Janitra, Subagia Santosa Sudjono, Satyanegara, R. Hasan","doi":"10.17925/usn.2022.18.2.153","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.153","url":null,"abstract":"Background: Posterior reversible encephalopathy syndrome (PRES) is characterized by a combination of clinical and radiological features. PRES presents with the rapid onset of neurological symptoms, such as headache, convulsion, altered consciousness and visual disturbance. If PRES is recognized and treated early, it has a good prognosis. We present a patient with PRES due to systemic lupus erythematosus (SLE) and hypertension. This report aims to provide information for the early diagnosis and prompt management of SLE-related PRES to maximize patient outcomes. Case presentation: A 24-year-old woman came to the emergency department with an acute severe headache and visual disturbance. Two years earlier, she was diagnosed with SLE and hypertension. She was fully awake with normal orientation. Her initial blood pressure was 170/100 mmHg. Her visual acuity was 1/∞ (light perception only). Brain T2-weighted magnetic resonance imaging showed multiple hyperintensity patches at the occipital lobe and cerebellum; these findings suggested a diagnosis of PRES. Due to SLE-related PRES, she was treated with intravenous methylprednisolone, and her blood pressure was monitored. Her blood pressure was maintained using a combination of oral antihypertensive drugs. She was also treated with intravenous phenytoin for seizure prophylaxis. Her symptoms resolved completely, and her visual acuity returned to normal after 2 days. She was discharged without any neurological sequelae. Conclusion: PRES is a clinical syndrome with specific imaging findings. The diagnosis of PRES requires thorough clinical and neuroimaging examinations. Identifying the underlying cause and delivering prompt treatment is important for achieving a better outcome and minimizing neurological sequelae or mortality in patients with PRES.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Bird in the Hand: A Neurologist's Guide to Efficient Tweeting in the Age of Social Media 手中的鸟:神经学家在社交媒体时代高效发推特的指南

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.76

D. Garg, Ayush Agarwal, V. Vishnu

引用次数: 1

Ublituximab: A Novel Anti-CD20 Therapy for Multiple Sclerosis Ublituximab:一种新的抗cd20治疗多发性硬化症的药物

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.117

Andrew B. Wolf, E. Alvarez

{"title":"Ublituximab: A Novel Anti-CD20 Therapy for Multiple Sclerosis","authors":"Andrew B. Wolf, E. Alvarez","doi":"10.17925/usn.2022.18.2.117","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.117","url":null,"abstract":"Ublituximab is a novel anti-CD20 therapy developed for the treatment of patients with multiple sclerosis. It is a glycoengineered chimeric antibody with a novel epitope on CD20, with high antibody-dependent cell-mediated cytotoxicity. Maintenance doses are administered every 6 months over an hour, providing a convenient dosing regimen. The identical phase III randomized, double-blind, active comparator to teriflunomide trials ULTIMATE I and II were completed in early 2022. ULTIMATE I and II, respectively, demonstrated that ublituximab had a strong clinical effect, with annualized relapse rates of 0.08 and 0.09 or reductions of 59% and 49% over teriflunomide. In addition, in ULTIMATE I and II, radiographic efficacy similarly reduced contrast-enhancing lesions by 97% and 96% and new/enlarging T2 lesions by 92% and 90%, respectively. Although ublituximab did not decrease confirmed disability progression in a pooled analysis of both studies, there was an increase in the confirmed disability improvement. Ublituximab was well tolerated, including infusion reactions that were predominantly mild and only seen with the first infusion. Further long-term safety data, as well as relative efficacy compared with current anti-CD20 therapies, will need to be evaluated in the real-world setting if ublituximab is to be approved as expected in December 2022.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Efgartigimod: A First-in-class Investigational Antibody Fragment for the Treatment of Generalized Myasthenia Gravis Efgartigimod:一种治疗广泛性重症肌无力的一流研究性抗体片段

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.127

F. Vanoli, R. Mantegazza

{"title":"Efgartigimod: A First-in-class Investigational Antibody Fragment for the Treatment of Generalized Myasthenia Gravis","authors":"F. Vanoli, R. Mantegazza","doi":"10.17925/usn.2022.18.2.127","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.127","url":null,"abstract":"Myasthenia gravis (MG) is a rare autoimmune disorder characterized by fatigue and muscle weakness. About 85–90% of patients with generalized MG display pathogenic immunoglobulin (Ig)G antibodies against the skeletal muscle nicotinic acetylcholine receptor (AChR), the muscle-specific tyrosine kinase or the lipoprotein receptor-related protein, which all exert their effect by disrupting neuromuscular transmission. Therapy for MG includes immunomodulation and non-specific immunosuppression; the latter comprises corticosteroids and non-steroidal immunosuppressive therapies, which non-selectively suppress the immune system and are frequently accompanied by burdensome side effects. This, together with the fact that up to 20% of patients are refractory to immunosuppressive therapy, highlights a compelling unmet need for more effective and better-tolerated therapies. Efgartigimod, a humanized IgG1-derived fragment crystallizable region that competitively blocks the neonatal fragment crystallizable receptor, holds great promise in meeting this need, having good tolerability and a more targeted effect. Efgartigimod has been recently approved by the US Food and Drug Administration (FDA) for the treatment of AChR-positive patients with generalized MG, making it the first FDA-approved neonatal fragment crystallizable receptor antagonist. This review focuses on the clinical development of efgartigimod, which offers an encouraging new therapeutic option for generalized MG.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hirayama Disease: Review on Pathophysiology, Clinical Features, Diagnosis and Treatment 平山病:病理生理学、临床特征、诊断和治疗综述

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.109

S. Gomathy, Ayush Agarwal, A. Garg, V. Vishnu

{"title":"Hirayama Disease: Review on Pathophysiology, Clinical Features, Diagnosis and Treatment","authors":"S. Gomathy, Ayush Agarwal, A. Garg, V. Vishnu","doi":"10.17925/usn.2022.18.2.109","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.109","url":null,"abstract":"Hirayama disease is a relatively unusual cause of cervical myelopathy characterized by uni- or bilateral asymmetric weakness, fasciculations and atrophy of the distal upper limbs, mostly seen in young males. The insidious weakness progresses over 3–5 years, after which it stops. Hirayama disease results from the abnormal anterior shifting of the posterior cervical dura that occurs during cervical flexion, leading to cord impingement. Electrophysiologic studies reveal denervation of C7–T1 myotomes and absence of sensory involvement. Dynamic magnetic resonance imaging of the cervical spine is essential in confirming the diagnosis. Treatment is aimed at primarily avoiding neck flexion, which is achieved with the help of a cervical brace; however, progressive disease calls for surgical intervention. Although the disease is self-limiting, it causes many functional impairments in affected individuals. In this review, we describe the epidemiology, pathophysiology, clinical manifestations, imaging characteristics, electrophysiologic findings, differential diagnoses and updates in the treatment of Hirayama disease. This review also aims to improve the awareness of this disease among clinicians, enabling early suspicion, diagnosis and management.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient Satisfaction in a Multidisciplinary Multiple Sclerosis Care Unit: A Swiss Single-centre Study 多学科多发性硬化症护理单位的患者满意度:瑞士单中心研究

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.142

Maha Wybitul, H. Njago, Agata Luczkiewicz, H. Pihan

{"title":"Patient Satisfaction in a Multidisciplinary Multiple Sclerosis Care Unit: A Swiss Single-centre Study","authors":"Maha Wybitul, H. Njago, Agata Luczkiewicz, H. Pihan","doi":"10.17925/usn.2022.18.2.142","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.142","url":null,"abstract":"Introduction: Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease. Patients are commonly diagnosed when they are between 20 to 50 years and require life-long treatment. Appropriate treatment is complex and involves a wide range of professional disciplines and expertise. This multifariousness highlights the need for multidisciplinary MS care units that offer a comprehensive and well-managed treatment approach. Such care units would enable (1) time-efficient organization and coordination, (2) better inter-, intradisciplinary and patient communication, (3) neurologists, nurses and therapists specialized in MS and (4) formalized diagnostic workup procedures and protocols for the initiation and follow-up of disease-modifying therapies. Methods: The current single-centre pilot study evaluated such a multidisciplinary MS care unit by measuring patient satisfaction and quality of life prior to and after the reorganization of a Swiss clinical centre. Results: A significant improvement in patient satisfaction was seen after the reorganization of the Swiss clinical centre into an MS centre, and quality of life was maintained throughout. Conclusion: This study exemplifies the importance of MS-specialized care and encourages further longitudinal, large-scale multicentre studies.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe Cytomegalovirus Encephalomyelitis and Polyradiculitis in the Immunocompetent: An Unusual Case of Critical Illness 免疫功能正常的严重巨细胞病毒脑脊髓炎和多根性炎:一个罕见的危重病例

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.157

Khawla Abusamra, Ashwini Kini, Y. Siddharthan, Zain Guduru

引用次数: 0

Potential Uses for Precision Tinted Lenses in a Neurology Clinic 精密有色镜片在神经病学诊所的潜在用途

US neurology Pub Date : 2022-01-01 DOI: 10.17925/usn.2022.18.2.93

A. Wilkins, B. Evans, G. Plant

{"title":"Potential Uses for Precision Tinted Lenses in a Neurology Clinic","authors":"A. Wilkins, B. Evans, G. Plant","doi":"10.17925/usn.2022.18.2.93","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.93","url":null,"abstract":"Photophobia is a complex disorder that can involve aversion not simply to bright light but to spatial patterns, colour and flicker. The use of tinted lenses to reduce photophobia in neurological diseases has a long history. Rarely has the possibility that different individuals might require lenses individually tailored to their needs been considered. Here we explore this possibility using the Intuitive Colorimeter system. The colorimeter illuminates text with coloured light and permits the colour, strength of colour and brightness to be manipulated separately. Many individuals find that a colour other than white is comfortable for viewing text. This colour is optimized in the colorimeter by a search strategy that allows for colour adaptation. Spectacle lenses are then individually tinted so that the chosen colour is experienced under conventional lighting. In this article, we review the use of the Intuitive Colorimeter in photosensitive epilepsy, autism, migraine, cluster headache, visual snow, stroke, multiple sclerosis and concussion; these are disorders in which individually coloured tints have featured in scientific and clinical reports. The evidence is preliminary rather than conclusive, but it suggests that precision tints can reduce photophobia. In patients with autism, the perception of emotion in facial expression is improved. Occasionally, the clinical benefit extends to the reduction of seizures and headaches and to an increase in reading speed.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Radial Neuropathy Following Surgical Procedures Conducted Under General Anesthesia—A Single-center Cross-sectional Study 全麻手术后桡骨神经病变-单中心横断面研究

US neurology Pub Date : 2020-01-01 DOI: 10.17925/usn.2020.16.1.61

Nasser Malekpour Alamdari, S. Besharat, M. Abbasi, Parima Safe

引用次数: 2