Wibergoddershede1563
Our goal was to expand the spectrum of clinico-radiologic characteristics and the possible therapeutic choices in patients with tumefactive demyelinating lesions (TDLs).
A retrospective analysis of 50 patients with at least one TDL was performed at an academic neurology center (2008-2020).
Our cohort comprised mostly women (33/50) with a mean age of 38 years at TDL onset. The mean follow-up time was 76 months. The mean Expanded Disability Status Scale score at TDL onset and at the latest neurological evaluation was 3.7 and 2.3, respectively. We subcategorized the patients into seven groups based mainly on the clinical/radiological findings and disease course. Group A included patients presenting with a Marburg-like TDL (
= 4). Groups B and C comprised patients presenting with monophasic (
= 7) and recurrent TDLs (
= 12), respectively. Multiple sclerosis (MS) patients who subsequently developed TDL (
= 16) during the disease course were categorized as Group D. Group E comprised patients who initiphenotypes can establish more efficient treatment strategies, thus improving clinical outcomes in the future.
To investigate effectiveness and safety of teriflunomide (14 mg once daily) in association with age and pre-treatment in unselected MS patients.
Prespecified analysis of a non-interventional, prospective, real-world study in Germany.
A total of 558 (49.5%) patients were above 45 years old, and 593 patients (52.6%) had been pre-treated within 6 months prior to teriflunomide. Baseline Expanded Disability Status Scale (EDSS) was higher with older age, with lower number of relapses. Relapse rate decreased in all age groups, and in both treatment-naïve (0.82 ± 0.73 at baseline; 0.25 ± 0.55 under teriflunomide) and pre-treated (from 0.48 ± 0.76; 0.22 ± 0.50) patients after 12 months compared with the year before teriflunomide initiation. EDSS remained stable in patients of all age groups as well as in therapy-naïve and pre-treated patients over 24 months. The percentage of patients with adverse events (AEs) ranged between 29.2% (age group >25-35) and 38.9% (age group >55-65), with an increased discontinuation rate (most commonly due to diarrhoea, alopecia and nausea) in the higher age groups. AE rates were lower in pre-treated compared with treatment-naïve patients.
Overall, patients of all age groups including older patients, and irrespective of pre-treatment, benefit from teriflunomide treatment in routine clinical practice.
BfArM public study database number 2075.
BfArM public study database number 2075.Inflammatory bowel disease (IBD) frequently affects women of childbearing age and can have implications in pregnancy. Most women with IBD have comparable fertility with women in the general population. Fertility is reduced in women with active disease or previous ileal-pouch-anal anastomosis (IPAA) surgery and is temporarily reduced in men taking sulfasalazine. Women with IBD have an increased risk of preterm delivery, low birth weight, small-for-gestational-age infants and Cesarean section (CS) delivery, however, no increased risk of congenital abnormalities. These adverse outcomes are particularly prevalent for women with active IBD compared with those with quiescent disease. Conception should occur during disease remission to optimize maternal and fetal outcomes and reduce the risk of disease exacerbations during pregnancy. Pre-conception counseling is therefore pertinent to provide patient education, medication review for risk of teratogenicity and objective disease assessment. Most medications are safe during pregnancy and breastfeeding, with the exception of methotrexate, ciclosporin, allopurinol and tofacitinib. Delivery modality should be guided by obstetric factors in most cases; however, CS is recommended for women with active perianal disease and can be considered for women with inactive perianal disease or IPAA. In conclusion, most women with IBD have uncomplicated pregnancies. Active IBD is the predominant predictor of poor outcomes and disease exacerbations; therefore, maintenance of disease remission during and before pregnancy is crucial.
In this analysis we aimed to describe Brazilian inflammatory bowel disease (IBD) patients' knowledge and perceptions regarding biosimilars and compare with viewpoints from non-Brazilian patients.
An online survey consisting of 19 questions was made available by the European Federation of Crohn's and Ulcerative Colitis Associations between July 2018 and December 2018. Only respondents who had heard of biosimilars were asked to respond to all of the questions.
A total of 102 Brazilian IBD patients responded to the survey. The majority (78.4%) of patients had been exposed to anti-tumor-necrosis-factor drugs and 63.4% of them had heard of biosimilars. Brazilian respondents worried significantly more about biosimilars being less effective than the originator (62.5%
47.9%,
value 0.03) and molecular differences between biosimilars and originators (53.1%
31.8,
value 0.001) as compared with non-Brazilian IBD patients. The majority of Brazilian (75%) and non-Brazilian (64.1%) respondents thought that the management of their disease. With the recent approval of many biosimilars in Brazil and the imminent widespread use of these drugs, our data raise awareness for the need of providing patient education to prevent negative expectations toward switching to biosimilars.Plasma-based NO X synthesis via the Birkeland-Eyde process was one of the first industrial nitrogen fixation methods. However, this technology never played a dominant role for nitrogen fixation, due to the invention of the Haber-Bosch process. Recently, nitrogen fixation by plasma technology has gained significant interest again, due to the emergence of low cost, renewable electricity. We first present a short historical background of plasma-based NO X synthesis. Thereafter, we discuss the reported performance for plasma-based NO X synthesis in various types of plasma reactors, along with the current understanding regarding the reaction mechanisms in the plasma phase, as well as on a catalytic surface. Abemaciclib in vivo Finally, we benchmark the plasma-based NO X synthesis process with the electrolysis-based Haber-Bosch process combined with the Ostwald process, in terms of the investment cost and energy consumption. This analysis shows that the energy consumption for NO X synthesis with plasma technology is almost competitive with the commercial process with its current best value of 2.4 MJ mol N-1, which is required to decrease further to about 0.7 MJ mol N-1 in order to become fully competitive. This may be accomplished through further plasma reactor optimization and effective plasma-catalyst coupling.Hallux valgus (HV), which is mainly caused by the wearing of narrow-width and high-heeled shoes, disrupts gait behavior because it deforms lower limb joints. There is limited information regarding the relationship between the foot disease HV and lower limb joints. Previous studies evaluating abnormal gait patterns caused by deformity used spatiotemporal parameters; however, they failed to characterize the overall gait dynamics. To address this issue, this study is aimed at characterizing the gait stability of patients with HV and examining the joints that are critically affected by HV. To assess complex gait dynamics, we quantified the potential changes in gait stability by using the maximum Lyapunov exponent (MLE). Angular displacements of the ankle, knee, and hip in the sagittal plane during walking were investigated to calculate the MLE for gait stability based on foot conditions (i.e., barefoot, flat shoes, and high heels). During walking, a large MLE (P 0.05). Quantitative assessments of dynamic stability using the MLE may help clinicians assess the overall gait dynamics of HV patients and other people suffering from gait disturbances.The base fit between a removable partial denture (RPD) and the underlying soft tissue plays a significant role in its performance. The application of a denture adhesive is hypothesized to result in better retention of RPDs and, as a result, contribute to lower stress on the oral mucosa. The objectives of this study were to observe and compare the distribution of simulated bite forces applied to the RPD through the abutments and soft tissue for models with and without the use of a denture adhesive. Furthermore, we evaluated the possible benefit of using a denture adhesive in lowering stresses on the oral mucosa. The RPD, mandible, oral mucosa, abutment teeth supporting the RPD, and the corresponding abutment periodontal ligaments (PDLs) were modelled as 3D volumes based on computer tomography (CT) datasets. A viscoelastic adhesive layer between the RPD and oral mucosa was incorporated into this base model using Prony series approximation. The layer was developed as a volume extract using the denture surface. Finite element (FE) simulations were performed for the bite force on one of the RPD segments, with the resulting force and moments experienced by the dental structures and oral mucosa compared between the model with the adhesive layer and the base model without. As a result, the contact pressure on the oral mucosa for the model with the denture adhesive decreased to 0.15 MPa as compared to 0.25 MPa for the model without the adhesive. The potential role of denture adhesives in leading to a better fit between the RPD and oral mucosa as well as lowering contact pressures could be used to improve comfort in patients wearing RPDs.
Pseudostellariae Radix (PR) is an important traditional Chinese herbal medicine with vast clinical consumptions, which has two different dosage forms, PR decoction pieces and PR formula granules. However, these two forms are bound to have an impact on the accumulation of the effective components in PR, so the effectiveness of clinical use cannot be guaranteed.
To determine the effective composition of PR.
In this research, PR decoction pieces and formula granules were collected, and their composition was detected by HPLC-Q-Exactive Orbitrap/MS; multivariate statistical analysis was used to distinguish differential metabolites between PR decoction pieces and formula granules.
A clear cut difference in the composition of the two groups was observed. 98 differential chemical constituents could be identified in the positive mode, while 52 differential chemical compositions could be identified in the negative mode. The differential chemical compositions were mainly concentrated in flavonoids, organic acids, fatty acids, and amino acids and present different change rules, mainly involved in the isoquinoline alkaloid biosynthesis metabolic pathways.
This study provides basic information to reveal the influence law of different dosage forms on the metabolite synthesis and quality formation mechanism of PR.
This study provides basic information to reveal the influence law of different dosage forms on the metabolite synthesis and quality formation mechanism of PR.
Dingji Fumai Decoction (DFD), a traditional herbal mixture, has been widely used to ventricular arrhythmia (VA) in clinical practice in China. However, research on the bioactive components and underlying mechanisms of DFD in VA is still scarce.
Components of DFD were collected from TCMSP, ETCM, and literature. The chemical structures of each component were obtained from PubChem. Next, SwissADME and SwissTargetPrediction were applied for compounds screening and targets prediction of DFD; meanwhile, targets of VA were collected from DrugBank and Online Mendelian Inheritance in Man (OMIM). Then, the H-C-T-D network and the protein-protein interaction (PPI) network were constructed based on the data obtained above. CytoNCA was utilized to filter hub genes and VarElect was used to analyze the relationship between genes and diseases. At last, Metascape was employed for systematic analysis on the potential targets of herbals against VA, and AutoDock was applied for molecular docking to verify the results.
A total of 434 components were collected, 168 of which were qualified, and there were 28 shared targets between DFD and VA.
