Publications by authors named "Adam Stepien"

The treatment of multiple sclerosis (MS) has undergone significant changes since the first disease-modifying therapy (DMT) drug was introduced. Currently, 19 original DMT drugs are registered in the European Union. The choice of optimal therapy is becoming increasingly challenging in the absence of reliable biomarkers on the basis of which disease progression and prognosis can be determined.

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Background: Nonsteroidal anti-inflammatory drugs-exacerbated respiratory disease (NSAIDs-ERD) is characterized by altered arachidonic acid (AA) metabolism. Aspirin hypersensitivity is diagnosed using aspirin challenge, while induced sputum is collected to perform cell counts and to identify local biomarkers in induced sputum supernatant (ISS). This study aimed to assess the levels of a newly identified eicosanoid, 15-oxo-eicosatetraenoic acid (15-oxo-ETE), in ISS at baseline and during aspirin-induced bronchospasm in patients with NSAIDs-ERD.

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  • The study investigates the role of brain-derived neurotrophic factor (BDNF) and specific genetic variations (SNPs) in the early-onset of Parkinson's disease (PD), focusing on patients under 55 years old.
  • Researchers analyzed the genetic profiles of 163 PD patients and 91 healthy controls, revealing that individuals with the AG genotype of the BDNF gene have a threefold higher risk of developing early PD compared to those with the GG genotype.
  • The findings also showed that lower levels of serum BDNF were associated with the AG and AA genotypes, indicating that the Val66Met polymorphism in the BDNF gene contributes to lower blood BDNF levels and increased risk of early-onset
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Importance: Patients with migraine often cycle through multiple nonspecific preventive medications due to poor tolerability and/or inadequate efficacy leading to low adherence and increased disease burden.

Objective: To compare the efficacy, tolerability, patient adherence, and patient satisfaction between erenumab and nonspecific oral migraine preventive medications (OMPMs) in patients with episodic migraine (EM) who had previously failed 1 or 2 preventive treatments.

Design, Setting, And Participants: The 12-month prospective, interventional, global, multicenter, active-controlled, randomized clinical trial comparing sustained benefit of 2 treatment paradigms (erenumab qm vs oral prophylactics) in adult episodic migraine patients (APPRAISE) trial was a 12-month open-label, multicenter, active-controlled, phase 4 randomized clinical trial conducted from May 15, 2019, to October 1, 2021.

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Introduction: The complexity of the associations between religiosity and indicators of well-being suggests the presence of a mediating mechanism. Previous studies indicate that religion may influence subjective well-being because it helps to find meaning and purpose. Therefore, the aim of our study was to examine the mediating role of the presence and search dimensions of meaning in life in the relationship between religious meaning system and life satisfaction in patients with multiple sclerosis (MS).

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  • The study investigates the sense of happiness in individuals with multiple sclerosis (PwMS) compared to patients with other neurological conditions, focusing on factors that contribute to their happiness.
  • A total of 589 PwMS and 145 control subjects were assessed using various questionnaires to gauge their happiness levels, revealing that PwMS reported lower happiness scores than the control group.
  • Key factors influencing happiness in PwMS include life satisfaction and a positive outlook, suggesting that improving these areas could benefit their overall well-being, making them important targets for psychological interventions.
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  • - About 70% of patients with relapsing-remitting multiple sclerosis (RRMS) will transition to secondary progressive multiple sclerosis (SPMS) within 10-15 years, leading to worsening neurological functions and difficulties in daily activities.
  • - Both inflammation and neurodegeneration play key roles in the progression of MS, making early disease-modifying therapy essential to slow down the disease.
  • - Currently, diagnosing SPMS often takes 6-12 months of monitoring for disability, which can result in delays of up to 3 years; thus, there is a pressing need for objective biomarkers to better predict and define SPMS transition.
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Introduction: Our trial (ClinicalTrials.gov Identifier: NCT04246619) evaluates the efficacy of two generic medications, pregabalin and duloxetine, for treating pain in PDPN patients.

Methods: The patients were randomised either into the pregabalin (99) or the duloxetine (102) arm.

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Introduction: Treatment with cladribine tablets is indicated in highly active relapsing-remitting multiple sclerosis (RRMS). Cladribine tablets proved safe and effective in the pivotal CLARITY trial, but that trial included primarily treatment-naïve patients. In clinical practice however, cladribine tablets are often given to patients who have failed other treatments.

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Depressive disorders are currently diagnosed based on the ICD-10 and DSM-5 diagnostic criteria and include axial depressive symptoms and additional symptoms that must coexist for at least two weeks. Migraine is diagnosed based on the International Classification of Headache Disorders. It is generally divided into migraine with and without aura, and with regard to the frequency of attacks into episodic and chronic migraine.

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Coexistence of migraine and depression is a significant clinical problem. Health examination surveys indicate that patients who suffer from migraine are more likely to develop depression than the general population. The inverse relationship is also observed.

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Objectives: The medical care of patients with gestational diabetes mellitus (GDM) during the COVID-19 pandemic was influenced by changing epidemiological conditions and government regulations. Aim - To compare the clinical pregnancy data of GDM women between waves I and III of the pandemic.

Material And Methods: We performed a retrospective analysis of medical records from the GDM clinic and compared the periods of March-May 2020 (wave I) and March-May 2021 (wave III).

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  • * Flail leg syndrome progresses slowly and has a relatively long survival rate, distinguishing it from more aggressive forms of familial ALS; this case illustrates that patients with the L144S mutation often experience a milder disease course.
  • * The report highlights the importance of recognizing atypical ALS phenotypes, as seen in this family, and aims to inspire more research into why patients with the L144S mutation have delayed disease progression.
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Background And Objectives: COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.

Methods: This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection.

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Background: Frequent scanning of intermittently scanned continuous glucose monitoring (isCGM) devices is associated with improvements in glycemic indices. Limited data is available for its correlation with fear of hypoglycemia (FOH), an established factor affecting quality of life and glycemic control in type 1 diabetes (T1DM).

Aim: The aim of the study was to analyze the association of sensor scanning frequency with FOH and glycemic indices in T1DM patients using isCGM.

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As Alzheimer's disease develops, the central nervous system is gradually damaged. It is manifested by progressive dementia and the appearance of neurological and extrapyramidal symptoms that impair everyday functioning. The aim of the study was to evaluate the influence of physical exercise on cognitive and motor functions in various stages of Alzheimer's disease.

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Almost half of the patients surveyed report impaired function of the upper limbx and handx after stroke. The effect of the passive trunk and shoulder stabilization on the recovery of coordinated hand movement is unclear. This study examined whether passive stabilization of the trunk and shoulder could improve the functional state of the hands after various types of strokes.

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  • Asundexian is an oral FXIa inhibitor that may prevent thrombosis without raising bleeding risk, and its role in preventing recurrent stroke is being investigated in a clinical trial.
  • The PACIFIC-Stroke trial was a phase 2b study that randomly assigned patients with recent ischaemic stroke to receive different doses of asundexian or a placebo while undergoing antiplatelet therapy.
  • The study aimed to measure the effectiveness of asundexian in reducing brain infarcts and recurrent stroke, while also monitoring safety related to bleeding events, and included 1,808 participants from 23 countries.
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  • * It involved 139 patients over 65, focusing on their clinical and echocardiographic data, with a screening diagnosis of dementia based on specific cognitive test results.
  • * Findings showed that older age and a specific measure (RWT) related to heart structure were independently linked to a higher likelihood of dementia, but RWT was only moderately effective for prediction.
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This study is designed to determine the efficacy of Cerebrolysin treatment as an add-on therapy to mechanical thrombectomy (MT) in reducing global disability in subjects with acute ischemic stroke (AIS). We have planned a single center, prospective, open-label, single-arm study with a 12-month follow-up of 50 patients with moderate to severe AIS, with a small established infarct core and with good collateral circulation who achieve significant reperfusion following MT and who receive additional Cerebrolysin within 8 h of stroke onset compared to 50 historical controls treated with MT alone, matched for age, clinical severity, occlusion location, baseline perfusion lesion volume, onset to reperfusion time, and use of iv thrombolytic therapy. The primary outcome measure will be the overall proportion of subjects receiving Cerebrolysin compared to the control group experiencing a favorable functional outcome (by modified Rankin Scale 0-2) at 90 days, following stroke onset.

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Almost half of stroke patients report impaired function of the upper limb and hand. Stability of the trunk is required for the proper movement of the body, including the legs and arms. The aim of the study was to analyze the effect of trunk stabilization exercises on coordinated movement of the affected upper limb in patients after stroke, using an Armoe®Spring device and the “wall” and “abacus” functional tests.

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