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vrijdag 17 maart 2017

The Lancet: [Comment] Solving the conundrum of insoluble protein aggregates

[Comment] Solving the conundrum of insoluble protein aggregates
A pathological hallmark of many neurodegenerative diseases is the aggregation of misfolded proteins.1 To prevent accumulation of misfolded protein, constant intracellular clearance through the proteasome and lysosomal and autophagic systems, and extracellular removal through the immune system are crucial,3 but these clearance mechanisms seem to fall short under pathological conditions. What triggers the disease cascade in the brain, why protein removal systems fail in some individuals and not others, and whether neurodegenerative diseases, apart from prion disorders like Creutzfeldt–Jakob disease, are communicable are questions that remain unanswered.
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[In Context] No past, no future: studies in the art and science of memory
For those with a functioning memory, amnesia is a condition that is almost impossible to conceptualise. Try to envisage the erasure of all past autobiographical memory. Remembering reactivates the pattern of neural activity originally generated, and replays the memory with an awareness of the present. Remembering is therefore an act of creative reimagination, and if this act is denied, the future is also unimaginable. Without the ability to remember, how can we place ourselves in the world around us, hold on to an understanding of self, recognise those we love, own any part of what we have experienced, and know who we have become? Memory is intrinsically connected to identity, and to a large extent, is what makes us truly human.
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[Comment] The long-term benefits of endovascular therapy
About 2 years have passed since the publication of five endovascular thrombectomy trials1–5 with positive findings and three subsequent trials have also reported similar positive results.6–8 In The Lancet Neurology, Antoni D├ívalos and colleagues9 now present the 1-year follow-up results of the REVASCAT trial of endovascular thrombectomy for ischaemic stroke.
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[Articles] Safety and efficacy of thrombectomy in acute ischaemic stroke (REVASCAT): 1-year follow-up of a randomised open-label trial
At 12 months follow-up, neurovascular thrombectomy reduced post-stroke disability and improved health-related quality of life, indicating sustained benefit. These findings have important clinical and public health implications for evaluating the cost-effectiveness of the intervention in the long term.
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[Comment] Can allogeneic stem cells improve outcomes after stroke?
Stroke is the second leading cause of death1 and the third leading cause of disability2 worldwide. Acute reperfusion therapies can improve outcomes but are only accessed by about one in 20 patients with ischaemic stroke in the USA. The need exists for additional therapies that are accessible and effective for most patients.3 One strategy in this regard is to develop new therapies that have a longer time window than the 3–6 h window of reperfusion therapies.
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