Burden of Illness Among Patients with Psychosis due to Dementia with Lewy Bodies and Other Dementias.

Limited research is available on the real-world experiences of patients with dementia with Lewy bodies (DLB). This study evaluated clinical events, healthcare utilization, and healthcare costs of patients with DLB vs other dementia types with psychosis (ODP). Study patients included commercial and Medicare Advantage with Part D enrollees aged ≥40 years with evidence of DLB and ODP from 6/01/2015‒5/31/2019.

Exposures to lead during urban combat training.

Lead exposure is still a major concern for occupations that regularly train or work with firearms, such as law enforcement and military personnel. Due to the increasing number of women of fertile age in such professions, there is a strong incentive to monitor lead exposures during firearms training. Personal air sampling was performed during two sessions of a nine-day urban combat training (UCT) course for cadets in the Swedish Armed Forces, one session employing leaded ammunition (leaded scenario) and one session employing unleaded ammunition (unleaded scenario).

Prevalence of Spasticity and Below-Level Neuropathic Pain Related to Spinal Cord Injury Level and Damage to the Lower Spinal Segments.

Objective: To evaluate spasticity and below-level spinal cord injury neuropathic pain after spinal cord injury in patients with, or without, damage to the lumbar spinal cord and roots.

Design/patients: Chart review of 269 patients with spinal cord injury from segments C1 to T11.

Methods: Patients were interviewed concerning leg spasticity and below-level spinal cord injury neuropathic pain in the lower trunk and legs.

Burden of illness among patients with dementia-related psychosis.

More than 5.6 million Americans suffer from dementia, and that number is expected to double by 2060. This comes at a considerable burden to the health care system with costs estimated at $157-$215 billion in 2010.

Intrathecal Baclofen Dosage for Long-Term Treatment of Patients With Spasticity Due to Traumatic Spinal Cord Injuries or Multiple Sclerosis.

Objective: To investigate dosage changes in intrathecal baclofen during long-term treatment of patients with severe leg spasticity.

Methods: We performed a retrospective chart review of 49 patients treated with an intrathecal baclofen pump (ITB) because of severe leg spasticity, for a minimum of 7 years. Eight patients were excluded due to catheter/pump failure or factors aggravating spasticity.

Short-term prediction of secondary progression in a sliding window: A test of a predicting algorithm in a validation cohort.

Introduction: The Multiple Sclerosis Prediction Score (MSPS, www.msprediction.com) estimates, for any month during the course of relapsing-remitting multiple sclerosis (MS), the individual risk of transition to secondary progression (SP) during the following year.

Treatment of military acoustic accidents with N-Acetyl-L-cysteine (NAC).

Objective: To study if the antioxidant (AO) N-Acetyl-L-cysteine (NAC) reduces the risk of hearing loss after acoustic accidents in humans.

Design: A retrospective, observational study.

Study Sample: Personnel of the Swedish Armed Forces (SAF) exposed to military acoustic accidents during a 5 year period.

Clinical Assessment of Spasticity in People With Spinal Cord Damage: Recommendations From the Ability Network, an International Initiative.

A thorough assessment of the extent and severity of spasticity, and its effect on functioning, is central to the effective management of spasticity in persons with spinal cord damage (SCD). These individuals however do not always receive adequate assessment of their spasticity. Inadequate assessment compromises management when the effect of spasticity and/or need for intervention are not fully recognized.

Diffusion tensor imaging in multiple sclerosis at different final outcomes.

Objectives: Methods to evaluate the relative contributions of demyelination vs axonal degeneration over the long-term course of MS are urgently needed. We used magnetic resonance diffusion tensor imaging (DTI) to estimate degrees of demyelination and axonal degeneration in the corpus callosum (CC) in cases of MS with different final outcomes.

Materials And Methods: We determined DTI measures mean diffusivity (MD), fractional anisotropy (FA), and axial (AD) and radial (RD) diffusivities in the CC of 31 MS patients, of whom 13 presented a secondary progressive course, 11 a non-progressive course, and seven a monophasic course.

A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

Objective: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.

Design: The study was prospective and longitudinal, covering the period from reporting to military service to discharge.

Continuous prediction of secondary progression in the individual course of multiple sclerosis.

Background: Prediction of the course of multiple sclerosis (MS) was traditionally based on features close to onset.

Objective: To evaluate predictors of the individual risk of secondary progression (SP) identified at any time during relapsing-remitting MS.

Methods: We analysed a database comprising an untreated MS incidence cohort (n=306) with five decades of follow-up.

The outcome spectrum of multiple sclerosis: disability, mortality, and a cluster of predictors from onset.

Interest in the long-term natural history of multiple sclerosis (MS) is being revived, as disability endpoints become increasingly important with the advent of highly efficacious long range but potentially harmful drugs. MS had an increasingly benign course, probably due to better assessment and changing diagnostic criteria. Incidence cohorts reduce inclusion bias, capturing both extreme benign and severe cases.

Clinically isolated syndromes with no further disease activity suggestive of multiple sclerosis at the age of population life expectancy.

The proportion of patients with clinically isolated syndrome (CIS) reported to convert to clinically definite multiple sclerosis varied between 30 and 75%. We studied the lifetime probability of remaining in the "CIS only" condition. The study was based on the longitudinally followed Gothenburg 1950-1964 incidence cohort (n = 306).

Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs.

Background: It is currently unknown whether early immunomodulatory treatment in relapsing-remitting MS (RRMS) can delay the transition to secondary progression (SP).

Objective: To compare the time interval from onset to SP in patients with RRMS between a contemporary cohort, treated with first generation disease modifying drugs (DMDs), and a historical control cohort.

Methods: We included a cohort of contemporary RRMS patients treated with DMDs, obtained from the Swedish National MS Registry (disease onset between 1995-2004, n = 730) and a historical population-based incidence cohort (onset 1950-64, n = 186).

A representative cohort of patients with non-progressive multiple sclerosis at the age of normal life expectancy.

Multiple sclerosis may have a non-progressive symptomatology for decades; however, it is not clear whether the disease activity may abate completely. We identified a cohort of patients, resident in Gothenburg at the time of disease onset, between the years 1950-64 (n = 307). These geographical and temporal restrictions, along with favourable conditions for a 'spider' epidemiological study, were optimal for an unbiased selection; this 15-year incidence cohort was essentially followed prospectively for 37-59 years after onset.

A comparison of the effects of two antispastic drugs, tizanidine and baclofen, on synaptic transmission from muscle spindle afferents to spinal interneurones in cats.

The alpha 2-adrenergic agonist tizanidine was reported to be more efficient than baclofen in reducing muscle tone in some spastic patients. The aim of this study was to investigate if this might be due to more specific depressive actions of tizanidine on transmission from muscle afferents which contribute to muscle tone. This was done by comparing the effects of tizanidine and baclofen on amplitudes of monosynaptic spinal focal field potentials produced by stimulation of muscle nerves in the cat.

Dopaminergic control of transmission from group II muscle afferents to spinal neurones in the cat and guinea-pig.

The effects of dopamine and its agonists on transmission from muscle afferents to spinal neurones were investigated in the cat and guinea-pig spinal cord, by measuring the drug effects on the amplitude of monosynaptic field potentials evoked by electrical stimulation of group I and group II muscle afferents. Local iontophoretic application of dopamine, the dopamine D1/D5 agonist SKF-38393 and the D2/D3/D4 agonist quinpirole all depressed the group II field potentials evoked at the base of the dorsal horn. Group II field potentials in the intermediate zone were depressed by dopamine to a similar degree as the dorsal horn field potentials, whereas the dopamine agonists were without effect upon them.

Depression of transmission from group II muscle afferents by electrical stimulation of the cuneiform nucleus in the cat.

The effects of short trains of electrical stimuli applied within the cuneiform nucleus and the subcuneiform region were examined on transmission from group I and group II muscle afferents to first-order spinal neurons. Variations in the effectiveness of transmission from these afferents were assessed from changes in the sizes of the monosynaptic component of extracellular field potentials evoked following stimulation of muscle nerves. Field potentials evoked from group II muscle afferents in the dorsal horn of the midlumbar and sacral segments and in the intermediate zone of the midlumbar segments were reduced when the test stimuli applied to peripheral nerves were preceded by conditioning stimulation of the cuneiform nucleus or the subcuneiform region.

High molecular weight growth hormone (> 160 kD) in human serum characterized with monoclonal antibodies.

Human growth hormone (hGH) was analyzed by six monoclonal antibodies (Mabs) and a polyclonal antiserum (Pas) before and after molecular sieve chromatography of sera from healthy subjects. Their hGH levels were between < 0.2 and 0.

Gating of transmission to motoneurones by stimuli applied in the locus coeruleus and raphe nuclei of the cat.

1. Neuronal systems activated by stimulation in the region of the locus coeruleus/subcoeruleus (LC/SC) and raphe nuclei have previously been shown to depress transmission from group II muscle afferents in regions of the midlumbar spinal segments in which premotor interneurones are located. The aim of the present investigation was to determine the extent to which such depression is paralleled by depression of the reflex actions of group II afferents on motoneurones.

Do noradrenergic descending tract fibres contribute to the depression of transmission from group II muscle afferents following brainstem stimulation in the cat?

Two alpha 2 noradrenaline antagonists, idazoxan and yohimbine, were injected in midlumbar segments of the spinal cord to test whether they counteract depression of field potentials evoked by group II muscle afferents by conditioning stimuli applied in the brainstem. The tested field potentials were those evoked monosynaptically in the intermediate zone of midlumbar segments. Their depression reflected thus the depression of transmission between group II fibres and their first relay neurones.

Monoclonal antibodies reveal circulating growth hormone of high molecular weight not detectable by conventional assays.

A radioimmunoassay based on a monoclonal antibody. Mc-ab 1, which was raised against growth hormone but cross-reacted with human placental lactogen yielded higher GH immunoreactivity levels in serum than one based on a polyclonal antiserum. This discrepancy was noted in subjects with normal GH secretion as well as in patients with GH insufficiency.