There is a synergistic relationship between epilepsy and intellectual disability (ID), and the approach to managing people with these conditions needs to be holistic. Epilepsy is the main co-morbidity associated with ID, and clinical presentation tends to be complex, associated with higher rates of treatment resistance, multi-morbidity and premature mortality. Despite this relationship, there is limited level 1 evidence to inform treatment choice for this vulnerable population.
View Article and Find Full Text PDFBackground: Knowledge of the chemical composition of amyloid plaques and tau tangles at the earlier stages of Alzheimer's disease (AD) pathology is sparse. This is due to limited access to human brain during life and at the earlier stages of AD pathophysiology and technical limitations in quantifying amyloid and tau species at a subcellular level. Understanding the chemical composition of plaques and tangles, how rapidly they grow and what factors drive growth is important for developing and refining therapeutics.
View Article and Find Full Text PDFClimate-related disasters pose significant risks to mental health and well-being globally. Individuals from disaster-prone regions, such as Puerto Rico, are at even greater risk. The devastating effects of recurrent hurricanes, compounded with pre-existing structural disparities (e.
View Article and Find Full Text PDFIntroduction: Teclistamab, the first approved B-cell maturation antigen-directed bispecific antibody for treatment of triple-class exposed relapsed/refractory multiple myeloma, demonstrated deep, durable responses with a manageable safety profile in the pivotal MajesTEC-1 cohort (NCT03145181/NCT04557098). Efficacy, safety, and pharmacokinetics from the MajesTEC-1 China cohort are reported.
Methods: Patients received teclistamab 1.
Infertility is often thought of as a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular, unprotected sexual intercourse. However, as fertility rates rapidly decline worldwide, we observe that the inability to conceive and have children stems not only from anatomical, physiological, or genetic conditions within the body but also from social, structural, and environmental conditions in society. Drawing on a wide array of international and interdisciplinary scholarship, this article rethinks infertility by focusing on the social, structural, and environmental conditions hindering the ability of individuals and couples to have children and become parents.
View Article and Find Full Text PDFAmong the intrathecal inflammatory niches where compartmentalized inflammation persists and plays a pivotal role in progressive multiple sclerosis (MS), choroid plexus (CP) has recently received renewed attention. To better characterize the neuropathological/molecular correlates of CP in progressive MS and its potential link with other brain inflammatory compartments, such as perivascular spaces and leptomeninges, the levels, composition and phenotype of CP immune infiltration in lateral ventricles of the hippocampus were examined in 40 post-mortem pathologically confirmed MS and 10 healthy donors, using immunochemistry/immunofluorescence and in-situ sequencing. Significant inflammation was detected in the CP of 21 out of the 40 MS cases (52%).
View Article and Find Full Text PDFA male in his 20s was referred to the neurosurgical service with headaches, vomiting and personality changes. He had a previous history of bilateral ventriculoperitoneal (VP) shunts and bitemporal decompressive surgery for neonatal intraventricular haemorrhage. There were appearances of slit-ventricles on his CT head scan typically associated with adequate cerebrospinal fluid drainage and normal intracranial pressure (ICP), which ordinarily will have limited further investigation.
View Article and Find Full Text PDFPsoriasis is a chronic immune-mediated skin disorder characterized by intense local inflammation, epidermal hyperplasia, and leukocyte infiltration. Current treatment approaches for psoriasis aim to alleviate symptoms and prevent disease progression, including systemically administered drugs with whole body side effects. Despite some advances in psoriasis treatment, success has been quite limited.
View Article and Find Full Text PDFBackground: People with intellectual disability (PwID) and epilepsy have increased premature and potentially preventable mortality. This is related to a lack of equitable access to appropriate care. The Step Together guidance and toolkit, developed with patient, clinical, charity and commissioning stakeholders, allows evaluation and benchmarking of essential epilepsy service provision for PwID in eight key domains, at a care system level.
View Article and Find Full Text PDFThis study aimed to examine the rejection-identification model (RIM) within a community sample of undocumented Hispanic immigrants in the United States, a unique and vulnerable population who face distinct legal and sociopolitical challenges. The RIM posits that ethnic discrimination is associated with increased identification with one's ethnic group, which, in turn, is positively associated with well-being. Data were collected from a community sample of 140 undocumented Hispanic immigrants living in the South-Central United States during the height of the 2015 Trump presidential campaign.
View Article and Find Full Text PDFOver the past few decades, research has indicated that the buildup of waste proteins, like amyloid-β (Aβ), in the brain's interstitial spaces is linked to neurodegenerative diseases like Alzheimer's, but the details of how such proteins are removed from the brain are not well understood. We have developed a numerical model to investigate the aggregation and clearance mechanisms of Aβ in the interstitial spaces of the brain. The model describes the volume-averaged transport of Aβ in a segment of the brain interstitium modeled as a porous medium, oriented between the perivascular space (fluid-filled channel surrounding a blood vessel) of a penetrating arteriole and that of a venule.
View Article and Find Full Text PDFPurpose Of Review: We review prevalence, etiology, impact on treatment, and best practices for treatment of posttraumatic stress disorder (PTSD) in a substance use disorder (SUD) treatment setting. Recommendations are given related to screening, assessment, and symptom monitoring.
Recent Findings: PTSD and SUDs are highly comorbid.
Intracranial pressure (ICP) is a physiological parameter that conventionally requires invasive monitoring for accurate measurement. Utilising multivariate predictive models, we sought to evaluate the utility of non-invasive, widely accessible MRI biomarkers in predicting ICP and their reversibility following cerebrospinal fluid (CSF) diversion. The retrospective study included 325 adult patients with suspected CSF dynamic disorders who underwent brain MRI scans within three months of elective 24-h ICP monitoring.
View Article and Find Full Text PDFIntroduction: Accurately estimating bone perfusion and metabolism using [F]NaF kinetics from shorter scan times could help address concerns related to patient comfort, motion, and throughput for PET scans. We examined the impact of changing the PET scan duration on the accuracy of [F]NaF kinetic parameters in the knee.
Methods: Both knees of twenty participants with and without osteoarthritis were scanned using a hybrid PET-MRI system (53 ± 13 years, BMI 25.
Primary mitral regurgitation (MR) is a pathology that alters mechanical loading on the left ventricle, triggers an array of compensatory neurohormonal responses, and induces a distinctive ventricular remodeling response known as eccentric hypertrophy. Drug therapies may alleviate symptoms, but only mitral valve repair or replacement can provide significant recovery of cardiac function and dimensions. Questions remain about the optimal timing of surgery, with 20% of patients developing systolic dysfunction post-operatively despite being treated according to the current guidelines.
View Article and Find Full Text PDFObjective: Gait disturbance is one of the features of normal pressure hydrocephalus (NPH) and decompensated long-standing overt ventriculomegaly (LOVA). The timed-up-and-go (TUG) test and the timed-10-m-walking test (10MWT) are frequently used assessments tools for gait and balance disturbances in NPH and LOVA, as well as several other disorders. We aimed to make smart-phone apps which perform both the 10MWT and the TUG-test and record the results for individual patients, thus making it possible for patients to have an objective assessment of their progress.
View Article and Find Full Text PDFBackground: In the UK, one in four patients are in work at the time of their hip or knee replacement surgery. These patients receive little support about their return to work (RTW). There is a need for an occupational support intervention that encourages safe and sustained RTW which can be integrated into National Health Service practice.
View Article and Find Full Text PDFDementia is a leading cause of disability, and as the population ages, there will be a greater need for friends and family to care for people with Dementia. Unfortunately, informal care for a person with dementia is associated with poor psychological and physical health and lower quality of life of the caregiver. The aim of the present study was to understand how to best support caregivers within their communities by examining their experience of loneliness, isolation, and their relationship with well-being.
View Article and Find Full Text PDFPathological nociception arising from peripheral nerve injury impacts quality of life. Current therapeutics are generally ineffective. However, photobiomodulation therapy (PBMT) has shown promise in addressing this issue.
View Article and Find Full Text PDFBrain Behav Immun
October 2024
Introduction: There is increased focus on the negative impact of the overprescribing of medication, specifically psychotropic medication, including anti-seizure medications (ASM), in people with Intellectual Disability (ID). This is particularly important for the older adult population, where multi-morbidity and polypharmacy are more common. ASMs are associated with psychiatric and behavioral adverse effects.
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