389 research outputs found
Reply to Letter to the Editor: Intra-individual randomised comparison of gadobutrol 1.0 M versus gadobenate dimeglumine 0.5 M in patients scheduled for preoperative breast MRI
No full text[No abstract available
Reply to Letter to the Editor: Intra-individual randomised comparison of gadobutrol 1.0 M versus gadobenate dimeglumine 0.5 M in patients scheduled for preoperative breast MRI
No full textN
Supplemental material for Use and cost of disease-modifying therapies by Sonya Slifka Study participants: has anything really changed since 2000 and 2009?
No full textSupplemental Material for Use and cost of disease-modifying therapies by Sonya Slifka
Study participants: has anything really changed since 2000 and 2009? by Sarah L Minden, R
Philip Kinkel, Helene T Machado, Jonathan S Levin, Meredith B Rosenthal and Lisa I Iezzoni
in Multiple Sclerosis Journal – Experimental, Translational and Clinical</p
Intra-individual randomised comparison of gadobutrol 1.0 M versus gadobenate dimeglumine 0.5 M in patients scheduled for preoperative breast MRI
No full textTo demonstrate non-inferiority of gadobutrol versus gadobenate dimeglumine by intra-individually comparing 0.1 mmol/kg body weight doses for contrast-enhanced breast magnetic resonance imaging (MRI) and prospectively evaluating lesion detection and characterisation in a multicentre trial. Two identical breast MRI examinations were performed in 72 patients with biopsy-proven breast cancer, separated by 1-7 days. Gadobutrol 1.0 M or gadobenate 0.5 M were administered in a randomised order. Lesion detection and characterisation were performed by two independent blinded readers. Lesion tracking, which compared on-site readings and histology from surgery or biopsy, was performed by a third reader. Differences in lesion detection and characterisation were compared between the two contrast agents. Among 103 lesions, 96 were malignant and 7 were benign. No difference in lesion detection was identified between the contrast agents (82.33 % for gadobutrol, 81.60 % for gadobenate). Assessment of sensitivity in lesion characterisation and Breast Imaging Reporting and Data Systems showed no difference between gadobutrol (92.63 %) and gadobenate (90.53 %). Regarding morphology, there was more non-focal enhancement for gadobutrol than for gadobenate (P = 0.0057). Non-inferiority of gadobutrol compared with gadobenate was demonstrated for breast lesion detection and sensitivity in lesion characterisation in breast MRI. aEuro cent Contrast-enhanced magnetic resonance imaging is now widely used for breast problems. aEuro cent Lesion detection in breast MRI differs according to the contrast agent. aEuro cent Thus we compared gadobutrol 1 M with gadobenate dimeglumine 0.5 M. aEuro cent Gadobutrol was non-inferior to gadobenate dimeglumine for detecting and characterising malignant lesions
Post-natalizumab disease reactivation in multiple sclerosis: systematic review and meta-analysis
No full textBackground: Natalizumab (NTZ) is sometimes discontinued in patients with multiple sclerosis, mainly due to concerns about the risk of progressive multifocal leukoencephalopathy. However, NTZ interruption may result in recrudescence of disease activity. Objective: The objective of this study was to summarize the available evidence about NTZ discontinuation and to identify which patients will experience post-NTZ disease reactivation through meta-analysis of existing literature data. Methods: PubMed was searched for articles reporting the effects of NTZ withdrawal in adult patients (⩾18 years) with relapsing–remitting multiple sclerosis (RRMS). Definition of disease activity following NTZ discontinuation, proportion of patients who experienced post-NTZ disease reactivation, and timing to NTZ discontinuation to disease reactivation were systematically reviewed. A generic inverse variance with random effect was used to calculate the weighted effect of patients’ clinical characteristics on the risk of post-NTZ disease reactivation, defined as the occurrence of at least one relapse. Results: The original search identified 205 publications. Thirty-five articles were included in the systematic review. We found a high level of heterogeneity across studies in terms of sample size (10 to 1866 patients), baseline patient characteristics, follow up (1–24 months), outcome measures (clinical and/or radiological), and definition of post-NTZ disease reactivation or rebound. Clinical relapses were observed in 9–80% of patients and peaked at 4–7 months, whereas radiological disease activity was observed in 7–87% of patients starting at 6 weeks following NTZ discontinuation. The meta-analysis of six articles, yielding a total of 1183 patients, revealed that younger age, higher number of relapses and gadolinium-enhanced lesions before treatment start, and fewer NTZ infusions were associated with increased risk for post-NTZ disease reactivation ( p ⩽ 0.05). Conclusions: Results from the present review and meta-analysis can help to profile patients who are at greater risk of post-NTZ disease reactivation. However, potential reporting bias and variability in selected studies should be taken into account when interpreting our data
Targeted violence: a review of six school shootings and implications for school counselors
No full textIncludes bibliographical references
The relevance of multiple sclerosis cortical lesions on cortical thinning and their clinical impact as assessed by 7.0-T MRI.
No full textObjective: This study aimed to investigate at 7.0-T MRI a) the role of multiple sclerosis (MS) cortical lesions in cortical tissue loss b) their relation to neurological disability.
Methods: In 76 relapsing remitting and 26 secondary progressive MS patients (N = 102) and 56 healthy subjects 7.0-T T2*-weighted images were acquired for lesion segmentation; 3.0-T T1-weighted structural scans for cortical surface reconstruction/cortical thickness estimation. Patients were dichotomized based on the median cortical lesion volume in low and high cortical lesion load groups that differed by age, MS phenotype and degree of neurological disability. Group differences in cortical thickness were tested on reconstructed cortical surface. Patients were evaluated clinically by means of the Expanded Disability Status Scale (EDSS).
Results: Cortical lesions were detected in 96% of patients. White matter lesion load was greater in the high than in the low cortical lesion load MS group (p = 0.01). Both MS groups disclosed clusters (prevalently parietal) of cortical thinning relative to healthy subjects, though these regions did not show the highest cortical lesion density, which predominantly involved frontal regions. Cortical thickness decreased on average by 0.37 mm, (p = 0.002) in MS patients for each unit standard deviation change in white matter lesion volume. The odds of having a higher EDSS were associated with cortical lesion volume (1.78, p = 0.01) and disease duration (1.15, p < 0.001).
Conclusion: Cortical thinning in MS is not directly related to cortical lesion load but rather with white matter lesion volume. Neurological disability in MS is better explained by cortical lesion volume assessment
Oldinger, Oscar R. (Birth, 1875-09-29)
No full textAddress: 113 Sycamore St.4254/Pg. 169/1875/M W/Ger./Ger./Mrs. D. Kinkel, Mid.Original record filed in drawer labeled 'O'HEARN-O'NEEL'
The relevance of 7-Tesla paramagnetic rim lesions in patients with multiple sclerosis
No full textBackground: In multiple sclerosis (MS), chronic lesions harboring a paramagnetic rim were neuropathologically related with activated microglia, an expanding lesion pattern and a poor prognosis. However, while the presence of this feature differs between patients and it is present only in a subset of lesions, it is still uncertain how it relates with overall lesion load, stage or disease aggressiveness. Aim: We used ultra-high resolution 7T scans on a cohort of 91 subjects at different MS stages to: i) assess the presence and distribution of paramagnetic rims throughout MS stages ii) explore whether the presence of the paramagnetic rims is linked with overall lesion load, pathological changes in normal appearing white matter (NAWM), as well as with clinical disability and cortical tissue loss. Methods: Sixty-two relapsing remitting (RRMS) and 29 secondary progressive MS (SPMS) patients, underwent: 7T T2*-weighted scans (0.33x0.33x1.0 mm) yielding magnitude and phase images for cortical and white matter lesion segmentation; 3T 3D T1-weighted scans for surface reconstruction and cortical thickness estimation. Conventional diffusion metrics were acquired in a subset of 72 patients. Expanded Disability Status Scale and Symbol Digit Modality Test evaluated the clinical status. Paramagnetic rim was appreciated on phase images and patients were dichotomized based on its presence or absence. The differences between groups were assessed by nonparametric statistics and analysis of covariance. Results: Overall, 174 (median 1, range1-16) rim lesions were identified in 55 (60.4%) patients. Rim lesion load was the same across MS phenotypes though there were large individual differences (RRMS: median 1 range 0-14 vs. SPMS: median 1 range 1-16 lesions). Concurrently, both white matter (median 25 vs. 45 lesions, p=0.028) and cortical (median 5.5 vs. median 11 lesions, p=0.014) lesion load was higher in patients with rim lesions than in patients without rim lesions. The two groups did not differ from each other regarding age, disease duration, NAWM fractional anisotropy and mean diffusivity, cortical thickness and clinical measures. Conclusion: The presence of rim lesions might be linked to an accelerated phase of the disease in respect to the development of an increased number of MS lesions. Further longitudinal studies are needed to unveil their true significance
Mahonney, Kate (Birth, 1876-06-21)
No full textAddress: E. 5th St.2598/Pg.19/1876/F W/Mrs. D. Kinkel, Mid.Original record filed in drawer labeled 'MACK, R-MAIN'
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