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woensdag 8 februari 2017

The Lancet: [In Context] Encephalitis: time to understand

[In Context] Encephalitis: time to understand
How many people know about encephalitis? Probably not that many. It is relatively unknown in the public sphere and, because its complexity, requires a multidisciplinary collaboration for effective diagnosis and treatment. "So far we have reached about 20 million people since the launch of World Encephalitis Day (WED) in 2014, but we need to reach more", Ava Easton (Chief Executive of The Encephalitis Society, North Yorkshire, UK) announced at the press launch of #ShowYouKnow exhibition at the Saatchi Gallery, London, UK.
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[Articles] Safety and efficacy of ozanezumab in patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled, phase 2 trial
Ozanezumab did not show efficacy compared with placebo in patients with ALS. Therefore, Nogo-A does not seem to be an effective therapeutic target in ALS.
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[Comment] Blockade of the neurite outgrowth inhibitor Nogo-A in amyotrophic lateral sclerosis
In 2016, results from several promising clinical trials of amyotrophic lateral sclerosis (ALS) were published, including a preliminary report of a phase 3 study of edaravone1 and a report of a phase 2 trial of a symptomatic treatment for bulbar symptoms.2 However, disease-modifying therapy remains limited to riluzole, which has only modest efficacy.3 In The Lancet Neurology, Vincent Meininger and colleagues4 report the results of a large, randomised, placebo-controlled, phase 2 trial of ozanezumab, a monoclonal antibody against neurite outgrowth inhibitor A (Nogo-A) in ALS.
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[Corrections] Corrections
Anne-Marie Wills. Blockade of the neurite outgrowth inhibitor Nogo-A in amyotrophic lateral sclerosis. Lancet Neurol 2017; published online Jan 27. http://dx.doi.org/10.1016/S1474-4422(17)30009-1—In this Comment, reference 2 has been corrected. The correction has been made to the online version as of Jan 31, 2017.
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[Comment] The relevance of atrial fibrillation in stroke prevention
Cerebral infarction is one of the most common causes of morbidity and mortality worldwide. Although the identification of the cause of stroke can directly affect treatment and prognosis, almost a third of ischaemic stroke cases are of unknown cause or cryptogenic–ie, the stroke mechanism remains unknown after routine assessment. Results of EMBRACE1 and CRYSTAL-AF2 showed that undiagnosed atrial fibrillation, which can be paroxysmal and asymptomatic, might be the cause of a substantial number of cryptogenic strokes.
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