The Neurobiology of Depression (Dr Imran Waheed)Imran Waheed
A lecture delivered in the West Midlands by Dr Imran Waheed, Consultant Psychiatrist, on The Neurobiology of Depression. For further information visit www.bhampsych.com
This presentation gives an over view: of the depression, its symptoms, prevalence, and patho-physiology. It then reviews various treatment options for depression, first starting with medication, and then moving to neuro-modulation. Focus is then on the similarities and differences of ECT and TMS. And finally information is provided about PineWood TMS.
The Neurobiology of Depression (Dr Imran Waheed)Imran Waheed
A lecture delivered in the West Midlands by Dr Imran Waheed, Consultant Psychiatrist, on The Neurobiology of Depression. For further information visit www.bhampsych.com
This presentation gives an over view: of the depression, its symptoms, prevalence, and patho-physiology. It then reviews various treatment options for depression, first starting with medication, and then moving to neuro-modulation. Focus is then on the similarities and differences of ECT and TMS. And finally information is provided about PineWood TMS.
Treating Treatment Refractory Depression With TMS, Transcranial Magnetic Stimulation. TMS is for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant treatment. These slides show research and anecdotes taken from actual results of patients who've tried TMS.
New Developments in the Treatment of Mood DisordersS'eclairer
Roger F Haskett MD
University of Pittsburgh School of Medicine Western Psychiatric Institute and Clinic
Medicine, Culture, and Spirituality Conference
September 9, 2011
Recent advances in the treatment of psychosesKarun Kumar
This presentation deals with atypical antipsychotics & new drugs in the pipeline (Clozapine, Risperidone, Olanzapine, Quetiapine, Ziprasidone, Aripiprazole, Second generation antipsychotics, atypical antipsychotics, Aspirin, Minocycline, Raloxifene, Estrogen, N-acetylcysteine). Introduction
Major psychiatric disorders Psychoses & affective disorders
Psychoses Disorders in which patients exhibit gross disturbances in their comprehension of reality as evidenced by false perception (hallucinations), false beliefs (delusions) and loss of contact with reality; schizophrenia most common form of psychosis (+ve n –ve symptoms)
Mostly concerned Abt –ve because poor prognosis , more difficult to treat, persist after positive symptoms have resolved
Mesolimbic Dopamine travels from the midbrain tegmental area to the nucleus accumbens. Increased activity in this pathway may cause delusions, hallucinations, and other so-called positive symptoms of schizophrenia.
Mesocortical pathways Decreased activity in the pathway that goes from the midbrain to the prefrontal lobe cortex can cause apathy, withdrawal, lack of motivation and pleasure, and other so-called negative symptoms of schizophrenia. Mesocortical dysfunction also disinhibits the mesolimbic pathway.
Nigrostriatal pathway from the substantia nigra to the striatum is involved in the coordination of body movements. Inhibition of this pathway causes the extrapyramidal side effects of antipsychotic drugs.
Tuberoinfundibular pathway from the hypothalamus to the pituitary inhibits the release of prolactin. Inhibition of this pathway leads to elevated serum prolactin levels.
2nd generation antipsychotics Clozapine, Risperidone, Olanazapine, Quetiapine, Ziprasidone, Aripiprazole (MOA, Dose, Brand name & A/E and receptor affinities)
Why do 1st gen. antipsychotics cause EPS & 2nd gen. do not? “Hit and run” hypothesis
Inflammation & schizophrenia
New drugs in pipeline Aspirin, Minocycline, Raloxifene, Estrogen, N-acetylcysteine (MOA and rationale of use)
Potential future targets of schizophrenia
Schizophrenia is a chronic and disabling mental illness affecting millions of people worldwide. The symptoms of schizophrenia are classified into positive, negative and cognitive symptoms. New receptor targets and drugs have being evaluated for addressing the multifaceted syndrome of schizophrenia.
is a chronic and disabling mental illness affecting millions of people worldwide. The symptoms of schizophrenia are classified into positive, negative and cognitive symptoms. New receptor targets and drugs have being evaluated for addressing the multifaceted syndrome of schizophrenia.
Pharmacotherapies for neurodegenerative disordersBrian Piper
This seminar was presented to 2nd year pharmacy students enrolled in a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 22.
Treating Treatment Refractory Depression With TMS, Transcranial Magnetic Stimulation. TMS is for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant treatment. These slides show research and anecdotes taken from actual results of patients who've tried TMS.
New Developments in the Treatment of Mood DisordersS'eclairer
Roger F Haskett MD
University of Pittsburgh School of Medicine Western Psychiatric Institute and Clinic
Medicine, Culture, and Spirituality Conference
September 9, 2011
Recent advances in the treatment of psychosesKarun Kumar
This presentation deals with atypical antipsychotics & new drugs in the pipeline (Clozapine, Risperidone, Olanzapine, Quetiapine, Ziprasidone, Aripiprazole, Second generation antipsychotics, atypical antipsychotics, Aspirin, Minocycline, Raloxifene, Estrogen, N-acetylcysteine). Introduction
Major psychiatric disorders Psychoses & affective disorders
Psychoses Disorders in which patients exhibit gross disturbances in their comprehension of reality as evidenced by false perception (hallucinations), false beliefs (delusions) and loss of contact with reality; schizophrenia most common form of psychosis (+ve n –ve symptoms)
Mostly concerned Abt –ve because poor prognosis , more difficult to treat, persist after positive symptoms have resolved
Mesolimbic Dopamine travels from the midbrain tegmental area to the nucleus accumbens. Increased activity in this pathway may cause delusions, hallucinations, and other so-called positive symptoms of schizophrenia.
Mesocortical pathways Decreased activity in the pathway that goes from the midbrain to the prefrontal lobe cortex can cause apathy, withdrawal, lack of motivation and pleasure, and other so-called negative symptoms of schizophrenia. Mesocortical dysfunction also disinhibits the mesolimbic pathway.
Nigrostriatal pathway from the substantia nigra to the striatum is involved in the coordination of body movements. Inhibition of this pathway causes the extrapyramidal side effects of antipsychotic drugs.
Tuberoinfundibular pathway from the hypothalamus to the pituitary inhibits the release of prolactin. Inhibition of this pathway leads to elevated serum prolactin levels.
2nd generation antipsychotics Clozapine, Risperidone, Olanazapine, Quetiapine, Ziprasidone, Aripiprazole (MOA, Dose, Brand name & A/E and receptor affinities)
Why do 1st gen. antipsychotics cause EPS & 2nd gen. do not? “Hit and run” hypothesis
Inflammation & schizophrenia
New drugs in pipeline Aspirin, Minocycline, Raloxifene, Estrogen, N-acetylcysteine (MOA and rationale of use)
Potential future targets of schizophrenia
Schizophrenia is a chronic and disabling mental illness affecting millions of people worldwide. The symptoms of schizophrenia are classified into positive, negative and cognitive symptoms. New receptor targets and drugs have being evaluated for addressing the multifaceted syndrome of schizophrenia.
is a chronic and disabling mental illness affecting millions of people worldwide. The symptoms of schizophrenia are classified into positive, negative and cognitive symptoms. New receptor targets and drugs have being evaluated for addressing the multifaceted syndrome of schizophrenia.
Pharmacotherapies for neurodegenerative disordersBrian Piper
This seminar was presented to 2nd year pharmacy students enrolled in a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 22.
Dietary Administration of Diquat for 13 Weeks Does Not Result in a Loss of Do...EPL, Inc.
Dietary Administration of Diquat for 13 Weeks Does Not Result in a Loss of Dopaminergic Neurons in the Substantia Nigra Pars Compacta (SNpc) of C57BL/6J Mice
KDM5 epigenetic modifiers as a focus for drug discoveryChristopher Wynder
A summary presentation of my scientific work.
My laboratory focused on an enzyme KDM5b (aka PLU-1, JARID1b) that was widely expressed during development and played a key role in progression of breast cancer through HER-2.
My lab focused on understanding the key biochemical activity of the enzyme through dissecting the proteomic and genomic interactors.
Our results were confirmed through the use of ES cells, adult stem cells and mouse models.
Much of this work remains unpublished, please contact me for more information and/or access to any reagents that I still have as part of this work.
crwynder@gmail.com
Altered proliferation and networks in neural cells derived from idiopathic au...Masuma Sani
Autism Spectrum Disorders; heterogeneous nature of genetic and brain pathology in ASD– which makes it difficult to produce relevant animal and cell models
The dance between Glia and Neurons is critical to the development and maintenance to CNS. Did you know: • up to 90% of the cells in the vertebrate nervous system are “not neurons” • make > 50% of the brain volume. This is a great overview to anyone that wants to learn more.
Optic Neuritis and OCT in Multiple Sclerosis neurophq8
This talk was given in the MS preceptorship day in Dasman Institute . It discusses the advances in the diagnosis of optic neuritis and value of optical coherence tomography in MS patients.
Current recreational drugs: RX462 Drug Abuse & Society, Spring 2015 Class pre...Brian Piper
These are the presentations from 2nd and 3rd year pharmacy students from semester long projects on a recreational drug of their choosing. Each presentations contains what was currently known (as of spring, 2015) about the history, epidemiology, pharmacokinetics, and pharmacodynamics of a recreational drug of their choosing.
Drug Abuse & Society (RX 462) Presentations-Spring 2014Brian Piper
This includes end of the semester presentations made by 2nd and 3rd year pharmacy students as part of an elective course. Each student was asked to provide information about history, epidemiology, pharmacodynamics, pharmacokinetics, and toxicology. Older "classic" (psilocybin, ayahuasca, crack), newer (JWB-018, mephedrone, MDA) drugs were covered as well as agents that have appreciable use outside the U.S. (desomorphine, areca nut, kava).
Overview of electronic cigarettes including history, components, safety and adverse events, efficacy in smoking cessation, pharmacokinetics and epidemiology. This presentation was originally delivered to 2nd year pharmacy students as part of a two semester class on pharmacology and toxicology.
Examination of Sexually Dimorphic Behavior on the Novel-Image Novel-Location ...Brian Piper
Objectives: Sex differences in object location memory favoring females appear to be a replicable phenomenon but may also depend on the task demands. This investigation evaluated if females outperformed males at both a short (immediate) and long (half-hour) interval between the learn and test condition using a recently developed version of the Novel-Image Novel-Location (NINL) test (Piper et al. 2011, Physiology & Behavior,
103, 513 - 522). Methods: Young-adults (N = 184) completed a standardized handedness inventory and the NINL. Results: Participants assigned to the Immediate and Delayed conditions did not differ in age, sex, or handedness. The NINL total score was higher among females at the Immediate, but not Delayed, interval. However, within the Delayed condition, females excelled at correctly identifying the unchanged items with a similar pattern for the Novel-Location (NL) scale. Conclusions: These findings are consistent with the view that sexually dimorphic performance favoring females in neurocognitive function can also extend to tasks that have a spatial component.
Drug abuse and society drug presentations: Spring 2013Brian Piper
This presentation is on recreational drugs as part of a elective course for 2nd and 3rd year pharmacy students. The instructions were to include what is known about history, pharmacodynamics, pharmacokinetics including common routes of administration, overdose potential, and recent epidemiology.
The class chose some older agents (peyote, LSD, mushrooms, cocaine), others that have only become more popular recently (bath sats, synthetic cannabinoids), and some medical drugs (methylphenidate, oxycontin).
Pharmacotherapies for parkinsons diseaseBrian Piper
This seminar was delivered to 2nd year pharmacy students as part of 2 lectures for a pharmacology & toxicology class. This material accompanies Goodman & Gilman's (12e) chapter 22.
This is an overview of drugs used to treat migraine with an emphasis on serotonergic drugs. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46. A bit of general background on 5-HT is also included.
This is an overview of drugs used to control nausea and vomiting. This presentation was for 2nd year pharmacy students as part of a pharmacology & toxicology course and accompanies Goodman & Gilman's (12e) chapter 46.
This presentation was delivered over two days to second year pharmacy students enrolled in a course in pharmacology & toxicology. This lecture is designed to accompany Goodman & Gilman's (12e) chapter 11.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Objectives
• Pharmacy students should be:
– familiar with pharmacotherapies for Multiple
Sclerosis (see also DiPiro chapter 64)
– able to evaluate the role of anti-inflammatory
agents in other neurodegenerative diseases (AD).
3. Cells in Brain Compared
Neurons Glia
size large small
action potential yes no
# few many
Santiago division in
Ramon y
adulthood
no* yes
Cajal
types pyramidal (cortex) oligodendrocytes (CNS)
Purkinje (cerebellum) Schwann cells (PNS)
*except hippocampus & olfactory nerve
5. Microglia
• Frequency: 10% of all glia
• States
– scanning: evaluate environment for sick cellular
elements
– activated:
• divide
• move
• phagocytose
• Release pro-inflammatory cytokines (IL-1α, IL-1β, TNF- α)
Brodal, P. (2010). The central nervous system. Chapter 2.
Humorous Overview: http://www.scq.ubc.ca/creeping-into-your-head-a-brief-introduction-to-microglia/
6. Multiple Sclerosis
• neurodegenerative disorder of CNS
• autoimmune
• Women = 1/200; Men = 1/400
• myelin > neurons
Jean Martin Charcot
“father of neurology”
1825 - 1893
7. Expanded Disability Status Scale
• Neurologist rates various functional systems (FS)
(visual, cerebral, cerebellar, sensory, pyramidal)
• Total
– 0: normal neurological exam
– 1: minimal disability on 1 FS
– 2.5: minimal disability on 2 FS
– 4.5: able to walk without aid for 300 m
– 6.5: constant bilateral support
– 8.5: bedridden but some self-care maintained
– 9.5: unable to communicate/eat/swallow
– 10: death due to MS
Kurtzke, J. F. (1983). Neurology, 33(11), 1444-1452.
16. MOA of Natalizumab (Tysabri)
• Humanized mouse antibody (-zumab)
• Binds to α4 integrins
Selewski et al. (2010). American Journal of Neuroradiology, 31, 1588-1590.
18. Natalizumab Evaluation
• RRMS with score < 5 on EDSS randomized to
natalizumab (300 mg, i.v. 1x/month; N=627) or
placebo (N=315) for two years
29%
# of new T2 Hyperintense Lesions
Placebo Natalizumab
17%
1 Year 6.1 1.2
2 Year 11.0 1.9*
* P < .0001
Polman et al. (2006). New England Journal of Medicine, 354(9), 899-910.
20. Neuroinflammation & AD
• COX1: ↑ in activated microglia
• COX2: high levels in pyramidal neurons
McGreer & McGreer (2007). Neurobiology of Aging, 28, 639-647.
21. Do COX Inhibitors Prevent AD?
• Non-demented older
-----------------------------------------------------
(55+) adults (N=6,989)
were followed for 7
years
• Prescriptions of
NSAIDs were examined
Veld et al. (2001). New England Journal of Medicine, 346(21), 1515-1521.
22. Summary
• Interferon β1A/B & Glatiramer Acetate are 1st
line treatments followed by Natalizumab for
MS.
• Blocking inflammation has been useful to
prevent, but not treat, Alzheimer’s Disease.
Antibodies, which the immune system uses to attack foreign substances in the periphery, don’t cross the BBB.
Classical signs of inflammation (redness, swelling, heat, and pain) don’t work in the brain. The immune response is much slower in brain than periphery.
Original Disability Status Scale was published in 1955, the expansion was later. Pyramidal refers to whether person is paralyzed; cerebellar = ataxia; brain stem = eye movements & ability to swallow; sensory = response to pain; visual = extent of visual impairment; cerebral = mood/cognition;
The clinical definition of multiple sclerosis requires two or more episodes of symptoms and signs. There are no FDA approved agents for PP MS.
Interferons (IFNs) are naturally occurring cytokines possessing a wide range of anti-inflammatory properties.Glycosylation refers to the joining of a glycan to a protein. 1a is glycosylated but the glycosylation is different from humans. 1b is not glycosylated as bacteria don’t glycosylate proteins. Glycosylation decreases immunogenicity but also decreases potency.Interferon B decreases leakiness of BBB by increasing the function of endothial cells.Elevations in NGF have been reported from astrocytes and endothelial cells.Good general description of 1st line therapies for MS: http://www.youtube.com/watch?v=OwanqcI4mHY
Denominator of Cohen’s d is pooled Standard Deviation.
All patients had had one relapse of symptoms but the 2nd was the key criteria to be clinically definite.
For MRI, T1 is the longitudinal relaxation time. It indicates the time required for a substance to become magnetized after first being placed in a magnetic field or, alternatively, the time required to regain longitudinal magnetization following an RF pulse.T2 is the "transverse" relaxation time. It is a measure of how long transverse magnetization would last in a perfectly uniform external magnetic field.
http://www.howjsay.com/index.php?word=glatiramer&submit=SubmitGlitiramer is a polymer of four amino acids that are found in myelin basic protein: glutamic acid, lysine, alanine, & tyrosine. Copaxone is FDA approved to reduce the frequency of relapses but not for reducing progression of disability.Injection site reactions are described by the National MS organization as “fairly common”
Black holes represent lesions where severe tissue disruption has occurred.Gadolinium is a dye used with MRI to identify areas of active inflammation.T2 scan is shown.
The currently predominant hypothesis of MS states that auto-reactive T lymphocytes cross the BBB and trigger inflammatory events which results in axonal demylination & neuronal damage.
Pronounced:natiliz uh mab. Humanized antibodies are antibodies from non-human species whose protein sequencs have been modified to increase their similarity to antibody variants produced naturally in humans.
With anti-natalizumab, there is a corresponding reduction in drug concentration and efficacy. Allergic reactions occur in the first 2 hours after drug administration but can occur weeks afterwards. Usual symptoms include fever, headache, neck pain, itching, general malaise, and joint pain.John Cunningham (1933-1970) from Milwaukee, WI had Hodgkin’s disease. He died of PML. Source: http://bmartinmd.com/2012/01/who-the-hell-was-john-cunningham.htmlThe JC Virus is a polyomavirus and is dormant in the majority of the adult population.
EDSS=Expanded Disability Status Scale. Progression of Disability = sustained increase in disability for > 3 months on EDDS. The range of new lesions was 0 to 191! Image is from an 80 year old patient with extensive hyperintensities in the peri-ventricular region.
The reduced risk was specific to Alzheimer’s and did not apply to vascular dementia. Ibuprofen, naproxen, and diclofenac accounted for the vast majority of prescription NSAIDs.