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donderdag 8 maart 2018

The Lancet: [Articles] Cognitive and neuroimaging features and brain β-amyloidosis in individuals at risk of Alzheim...

[Articles] Cognitive and neuroimaging features and brain β-amyloidosis in individuals at risk of Alzheimer's disease (INSIGHT-preAD): a longitudinal observational study
Brain β-amyloidosis alone did not predict progression to prodromal Alzheimer's disease within 30 months. Longer follow-up is needed to establish whether this finding remains consistent.
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[Comment] White matter is what matters after cardiac arrest
Patients who are successfully resuscitated after cardiac arrest usually remain comatose thereafter. These patients are usually sedated and artificially ventilated during the first 1–2 days while their body temperature is regulated, further prolonging the period in a coma.
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[Comment] One step towards dementia prevention
Dementia prevention, which might have seemed unrealistic until a few years ago, now seems feasible, albeit still fraught with uncertainty and unknowns. In The Lancet Neurology, Bruno Dubois and colleagues1 present an assessment of associations between amyloid β deposition and cognitive decline in people with subjective memory complaints. The INSIGHT-preAD study offers interesting insights and highlights challenges that might be faced by clinicians in the future.
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[Articles] Stage at which riluzole treatment prolongs survival in patients with amyotrophic lateral sclerosis: a retrospective analysis of data from a dose-ranging study
We showed that riluzole prolongs survival in the last clinical stage of ALS; this finding needs to be confirmed in a prospective study, and treatment effects at stage 1 still need to be analysed. The ALS stage at which benefit occurs is important for counselling of patients before starting treatment. Staging should be used in future ALS clinical trials to assess the stage at which survival benefit occurs, and a similar approach could be used for other neurodegenerative diseases.
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[Comment] Riluzole, disease stage and survival in ALS
Following pivotal clinical trials in amyotrophic lateral sclerosis (ALS), approval of riluzole by the US Food and Drug Administration in 1995 was met with optimism. Despite being associated with a short survival benefit of 2–3 months equating to a 9% increase in 1-year survival,1,2 the subsequent adoption of riluzole as a treatment for ALS was perhaps reflective of a desperate need for therapeutic options in the face of this devastatingly progressive disease.3 More than two decades after riluzole was first approved for ALS, a more efficacious treatment is yet to be discovered.
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