European journal of neurology : the official journal of the European Federation of Neurological Societies
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Amyotrophic lateral sclerosis (ALS) is characterized by rapidly progressive paralysis of striated muscles due to the loss of upper and lower motor neurons. The disease leads to death within 2-5 years, mainly due to respiratory failure. The pathogenesis of ALS is still unexplained for the most part. In this study, we aimed to determine the prevalence of different cardiovascular, metabolic, and neuropsychiatric comorbidities in a large ALS cohort and to evaluate their influence on the disease course. ⋯ Persons with cardiovascular diseases or risk factors seem to be at lower risk of ALS. Although these diseases are apparently somehow protective regarding ALS susceptibility, their presence did not modify disease progression and survival in patients with ALS. Our study further confirms the well-known continuum between ALS and dementia. It also suggests a link with other neurodegenerative diseases such as Parkinson's disease.
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Meta Analysis
Nocebo as a potential confounding factor in clinical trials for Parkinson's disease treatment: a meta-analysis.
Nocebo refers to adverse events (AEs) generated by patient's negative expectations that medical treatment will likely harm instead of heal and can be assessed in placebo-controlled randomized controlled trials (RCTs). We examined AEs following placebo administration in RCTs for Parkinson's disease (PD). ⋯ Our analysis indicates a significant dropout rate related to nocebo in trials for PD treatment. Adherence and efficacy may be adversely affected with additional implications for clinical practice.
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This paper is meant to provide guidance to anyone wishing to write a neurological guideline for diagnosis or treatment, and is directed at the Scientist Panels and task forces of the European Federation of Neurological Societies (EFNS). It substitutes the previous guidance paper from 2004. It contains several new aspects: the guidance is now based on a change of the grading system for evidence and for the resulting recommendations, and has adopted The Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). ⋯ Thus, the outcomes chosen will be more critical, more patient-oriented and easier to translate into simple recommendations. This paper also provides updated practical recommendations for planning a guideline task force within the framework of the EFNS. Finally, this paper hopes to find the approval also by the relevant bodies of our future organization, the European Academy of Neurology.
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Review Meta Analysis
The efficacy of temozolomide for recurrent glioblastoma multiforme.
The efficacy of temozolomide (TMZ) in recurrent glioblastoma multiforme (GBM) has been evaluated by several clinical trials. A meta-analysis to assess the overall efficacy of TMZ in the treatment of recurrent GBM was carried out by the authors. ⋯ Temozolomide is effective for recurrent GBMs, and its efficacy may be increased with metronomic schedule and high average daily dose (>100 mg/m(2) ).
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The aim of the study was to compare the incidence, causes, severity and mortality of traumatic spinal cord injury (TSCI) in Western Norway and Estonia from 1997 to 2001. ⋯ Although the two cohorts had similar demographic, injury and clinical characteristics, the age profile of the victims was different. The incidence rate was 1.5 times higher and SMR was 2.7 times higher in Estonia. Probable explanations for the different outcomes of the two European countries are socioeconomic differences, lower physical activity level, lower life expectancy and insufficient injury prevention programmes in Estonia.