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vrijdag 29 september 2017

The Lancet: [Comment] Global burden of neurological disease: what's in a name?

[Comment] Global burden of neurological disease: what's in a name?
We are living in a rapidly changing landscape in terms of global public health. On one hand, the immense increase in and ageing of the world's population, mass migration of people from rural to urban areas, and unhealthy lifestyles—either by choice or by circumstance—are negatively affecting the overall health of the planet. On the other hand, medical advances such as vaccines, antibiotics, and new medications, and renewed emphasis on workplace safety, have benefitted global health. These balancing influences perhaps have the most effect on neurological diseases, which affect many different daily functions and therefore have a disproportionately large effect on global health.
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[Articles] Large-scale identification of clinical and genetic predictors of motor progression in patients with newly diagnosed Parkinson's disease: a longitudinal cohort study and validation
Our model ensemble confirmed established and identified novel predictors of Parkinson's disease motor progression. Improvement of existing prognostic models through machine-learning approaches should benefit trial design and evaluation, as well as clinical disease monitoring and treatment.
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[Comment] Predicting progression in patients with Parkinson's disease
A major challenge to patients, clinicians, family members, and scientists is the unpredictable future that accompanies a diagnosis of Parkinson's disease. When met with the question "what does my future hold?" it is difficult to give predictions that are likely to be useful to the patient. Some individuals will face features that rapidly and adversely affect their quality of life; others will experience a prolonged and fairly benign course, initially well managed by drugs and lifestyle changes. Variability between patients in core features of this multisystem disease—eg, motor decline, neuropsychiatric changes, mood disorders, dysautonomic signs, and fatigue—is the rule.
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[In Context] Vladimir Mikhailovich Bekhterev
Russian neurologist, psychiatrist, and founder of the Russian school of psychoneurology. Born in Sorali (now known as Bekhterevo), Russia, on Jan 20, 1857, he died on Dec 24, 1927, in Moscow, aged 70.
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[Articles] Risk of natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: a retrospective analysis of data from four clinical studies
Our risk estimates calculated from patient-level clinical data allow individualised annual prediction of risk of PML in patients receiving natalizumab for multiple sclerosis, supporting yearly benefit–risk re-evaluation in clinical practice. Further, our estimates are generally consistent with previously calculated estimates. Incorporating anti-JCV antibody index allows further risk stratification for anti-JCV antibody-positive patients who have not previously taken immunosuppressants.
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