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donderdag 23 februari 2017

The Lancet: [Articles] Safety and efficacy of a Nav1.7 selective sodium channel blocker in patients with trigeminal n...

[Articles] Safety and efficacy of a Nav1.7 selective sodium channel blocker in patients with trigeminal neuralgia: a double-blind, placebo-controlled, randomised withdrawal phase 2a trial
The primary endpoint of treatment failure was not significantly lower in the BIIB074 group than in the placebo group. However, our findings provide a basis for continued investigation of BIIB074 in patients with trigeminal neuralgia in future clinical trials.
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[Comment] Selective sodium channel blockers in trigeminal neuralgia
Trigeminal neuralgia (or tic douloureux) is characterised by short-lasting explosive attacks of pain in the facial region, and is often triggered by different stimuli inside or around the mouth and nose.1 The daily occurrence of often unexpected pain paroxysms might disrupt the lives of patients and causes fear. Treatment for trigeminal neuralgia can either be pharmacological or surgical.2 For patients with a vascular compression or distortion of the trigeminal root, surgical intervention with vascular decompression is effective.
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[Corrections] Corrections
Wachter R, Gröschel K, Gelbrich G, et al. Holter-electrocardiogram-monitoring in patients with acute ischaemic stroke (Find-AFRANDOMISED): an open-label randomised controlled trial. Lancet Neurol 2017; published online Feb 7. http://dx.doi.org/10.1016/S1474-4422(17)30002-9—In the discussion of this Article, the penultimate sentence of the second paragraph should read "A more thorough diagnostic work-up before randomisation might have led to a selection bias that could have affected the generalisability of the study results because patients with findings suggestive of a specific stroke cause (eg, hypokinetic left ventricular segment or persistent foramen ovale), but no option might have been excluded before the initiation of an intensified ECG monitoring." This correction has been made to the online version as of Feb 16, 2017.
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[Articles] Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin: a subgroup analysis of SOCRATES, a randomised, double-blind, controlled trial
In this prespecified exploratory analysis, ticagrelor was superior to aspirin at preventing stroke, myocardial infarction, or death at 90 days in patients with acute ischaemic stroke or transient ischaemic attack when associated with ipsilateral atherosclerotic stenosis. An understanding of stroke mechanisms and causes is important to deliver safe and efficacious treatments for early stroke prevention.
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[Personal View] The prion model for progression and diversity of neurodegenerative diseases
The neuropathology of different neurodegenerative diseases begins in different brain regions, and involves distinct brain networks. Evidence indicates that transcellular propagation of protein aggregation, which is the basis of prion disease, might underlie the progression of pathology in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and Huntington's disease. The prion model predicts specific patterns of neuronal vulnerability and network involvement on the basis of the conformation of pathological proteins.
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