1. Brain atrophy occurs across all stages of multiple sclerosis (MS), with around 40% of cortical neurons being lost over a lifetime without intervention. Early treatment with disease-modifying therapies (DMT) can help reduce disability and protect brain health.
2. Both inflammatory lesions and neurodegeneration are associated with disability progression in MS. Gadolinium-enhancing lesions are not fully indicative of disease phenotypes and inflammation may be present even without new lesions.
3. DMT have been shown to reduce disability accrual even at advanced stages of MS. While early treatment is important, evidence suggests that people with progressive forms may also benefit. Interventions should focus on outcomes beyond just lesion activity.
Introduction of Autoimmune encephalitis for Non medical professionals and mental health professionals work in neurology. Reference provided in last slide and prepared of self learning purpose not for any commercial purpose.
Over the past few decades, the prognosis of neonatal seizures has experienced considerable enhancement due to the improvement in neonatal and infant care. The mortality rate of neonatal seizures has fallen from 40% to 20%, and the relationship between electro encephalogram (EEG) and prognosis has become quite clear. The underlying cause of seizures is a major determinant of the outcome of the disease. For example, patients with secondary seizures and hypoxic-ischemic encephalopathy have only 50% chance of normal development and total recovery, while newborns with secondary seizures and subarachnoid hemorrhage or better hypocalcemia have higher chances of recovery. Searches were conducted by two independent researchers in international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID and Magiran) databases for related studies from the inception of the databases to September 2017 (without time limitation) in English and Persian languages. It is possible to achieve accurate diagnosis through checking the history before birth and performing a thorough physical examination in some rare cases. Depending on the case, tests or additional actions can be done. EEG is the primary means for diagnosis and may exhibit paroxysmal activity in the difference between seizures or may produce electrographic seizures in cases where seizure is hidden or latent. One of the most important points in the treatment of neonatal seizures is the diagnosis of underlying cause (such as hypoglycemia, meningitis, drug deprivation, and trauma) because such diagnosis facilitates different approaches to control neonatal seizures. Most experts agree to control all clinical and electrographic seizures. Some others focus merely on clinical seizures. Most centers prefer the first approach. An important point before starting an anticonvulsant drug is to decide if the patient needs intravenous and luteinizing treatment with an initial bolus dose, or it can be easy to start treatment with a prescription for a long-acting medication based on the severity of seizure, duration, and frequency.
Mini-mental state examination in patients with hepatic encephalopathy and liv...Enrique Moreno Gonzalez
Mini-Mental State Examination (MMSE) is one of the most commonly used methods in the assessment of cognitive mental status. MMSE has been used in hepatology but its usefulness in the evaluation of hepatic encephalopathy (HE) has never been properly assessed. The aim of the study was to investigate the value of MMSE in detection of HE in atients with cirrhosis.
Professor Carolyn Sue, Professor University of Sydney / Director of the Department of Neurogenetics at Royal North Shore Hospital / Director of the National Centre for Adult Stem Cell Research (Sydney Node). http://www.garvan.org.au/news-events/leaders-in-science-and-society
Needle reflexology in the treatment of neurological changes in ischemic strokeSubmissionResearchpa
In recent years, the problem of diagnosis and preventive treatment of cerebrovascular diseases has become increasingly relevant. Stroke is the most common cause of permanent disability (E. I. Gusev, 2007). The leading role in the diagnosis and prognosis of stroke, as well as the choice of further treatment and rehabilitation tactics is assigned to non-invasive ultrasound research methods, which make it possible to assess the parameters of cerebral hemodynamics. (I. D. Stulin, 2006). by I.T. Tuhtaev and D. T. Khodjaeva 2020. Needle reflexology in the treatment of neurological changes in ischemic stroke. International Journal on Integrated Education. 3, 11 (Nov. 2020), 51-52. DOI:https://doi.org/10.31149/ijie.v3i11.823. https://journals.researchparks.org/index.php/IJIE/article/view/823/789 https://journals.researchparks.org/index.php/IJIE/article/view/823
Neurocritical Care Triad - Focused Neurological Examination, Brain Multimodal...Apollo Hospitals
Intensive care is rightly described as “an art of managing intense intricacy” and this situation is further complicated in the care of patients with critical neurological illness. Brain
damage directly related to an insult is primary brain injury (PBI). The cascade of pathobiological events following PBI is known as secondary brain injury (SBI). PBI is most often
irreversible so, the focus of neurocritical care is to prevent, detect and manage SBI.
Objective: To describe cognitive disorders in patients with epilepsy attending neurology consultations in the city of Ouagadougou. Methodology: This was a prospective cross-sectional multicenter study carried on patients with epilepsy during the period from 1erJanuary 2018 to 30 April 2019. All the patients were screened using mini-mental state examination (MMSE). Results: The study included 102 patients with a mean age of 33.28 ± 15.55 years. The sample was consisted of 54 (52.9%) men and 48 (47.1%) women. The majority of patients had secondary level (55.7 %). Generalized seizures were more common (74.5%). The most common causes of epilepsy was head trauma (24.5%). A great number of patients were treated by phenobarbital (49%). The overall mean MMSE score was 25.65 ± 5.07. The frequency of cognitive disorders was 61.8%, including cognitive impairment (25.5%), mild dementia (25.5%), moderate dementia (7.8%) and severe dementia (3%). The domains most affected were calculation and attention
deficit (48%) followed by memory disorders (27.5%) and copying (12.8%). Head trauma and phenobarbital were signifi cantly associated to cognitive. Cognitive disorders were less frequent in young adult aged of 26-35 years.
Dr. James C. Johnston is a board-certified neurologist and founder of the 501(c)(3) non-profit organization Global NeuroCare. James Johnston, MD, JD, and his colleague Mehila Zebenigus, MD serve as Directors to this NGO which is accredited by the World Health Organization and holds Special Consultative Status with United Nations ECOSOC.
Introduction of Autoimmune encephalitis for Non medical professionals and mental health professionals work in neurology. Reference provided in last slide and prepared of self learning purpose not for any commercial purpose.
Over the past few decades, the prognosis of neonatal seizures has experienced considerable enhancement due to the improvement in neonatal and infant care. The mortality rate of neonatal seizures has fallen from 40% to 20%, and the relationship between electro encephalogram (EEG) and prognosis has become quite clear. The underlying cause of seizures is a major determinant of the outcome of the disease. For example, patients with secondary seizures and hypoxic-ischemic encephalopathy have only 50% chance of normal development and total recovery, while newborns with secondary seizures and subarachnoid hemorrhage or better hypocalcemia have higher chances of recovery. Searches were conducted by two independent researchers in international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID and Magiran) databases for related studies from the inception of the databases to September 2017 (without time limitation) in English and Persian languages. It is possible to achieve accurate diagnosis through checking the history before birth and performing a thorough physical examination in some rare cases. Depending on the case, tests or additional actions can be done. EEG is the primary means for diagnosis and may exhibit paroxysmal activity in the difference between seizures or may produce electrographic seizures in cases where seizure is hidden or latent. One of the most important points in the treatment of neonatal seizures is the diagnosis of underlying cause (such as hypoglycemia, meningitis, drug deprivation, and trauma) because such diagnosis facilitates different approaches to control neonatal seizures. Most experts agree to control all clinical and electrographic seizures. Some others focus merely on clinical seizures. Most centers prefer the first approach. An important point before starting an anticonvulsant drug is to decide if the patient needs intravenous and luteinizing treatment with an initial bolus dose, or it can be easy to start treatment with a prescription for a long-acting medication based on the severity of seizure, duration, and frequency.
Mini-mental state examination in patients with hepatic encephalopathy and liv...Enrique Moreno Gonzalez
Mini-Mental State Examination (MMSE) is one of the most commonly used methods in the assessment of cognitive mental status. MMSE has been used in hepatology but its usefulness in the evaluation of hepatic encephalopathy (HE) has never been properly assessed. The aim of the study was to investigate the value of MMSE in detection of HE in atients with cirrhosis.
Professor Carolyn Sue, Professor University of Sydney / Director of the Department of Neurogenetics at Royal North Shore Hospital / Director of the National Centre for Adult Stem Cell Research (Sydney Node). http://www.garvan.org.au/news-events/leaders-in-science-and-society
Needle reflexology in the treatment of neurological changes in ischemic strokeSubmissionResearchpa
In recent years, the problem of diagnosis and preventive treatment of cerebrovascular diseases has become increasingly relevant. Stroke is the most common cause of permanent disability (E. I. Gusev, 2007). The leading role in the diagnosis and prognosis of stroke, as well as the choice of further treatment and rehabilitation tactics is assigned to non-invasive ultrasound research methods, which make it possible to assess the parameters of cerebral hemodynamics. (I. D. Stulin, 2006). by I.T. Tuhtaev and D. T. Khodjaeva 2020. Needle reflexology in the treatment of neurological changes in ischemic stroke. International Journal on Integrated Education. 3, 11 (Nov. 2020), 51-52. DOI:https://doi.org/10.31149/ijie.v3i11.823. https://journals.researchparks.org/index.php/IJIE/article/view/823/789 https://journals.researchparks.org/index.php/IJIE/article/view/823
Neurocritical Care Triad - Focused Neurological Examination, Brain Multimodal...Apollo Hospitals
Intensive care is rightly described as “an art of managing intense intricacy” and this situation is further complicated in the care of patients with critical neurological illness. Brain
damage directly related to an insult is primary brain injury (PBI). The cascade of pathobiological events following PBI is known as secondary brain injury (SBI). PBI is most often
irreversible so, the focus of neurocritical care is to prevent, detect and manage SBI.
Objective: To describe cognitive disorders in patients with epilepsy attending neurology consultations in the city of Ouagadougou. Methodology: This was a prospective cross-sectional multicenter study carried on patients with epilepsy during the period from 1erJanuary 2018 to 30 April 2019. All the patients were screened using mini-mental state examination (MMSE). Results: The study included 102 patients with a mean age of 33.28 ± 15.55 years. The sample was consisted of 54 (52.9%) men and 48 (47.1%) women. The majority of patients had secondary level (55.7 %). Generalized seizures were more common (74.5%). The most common causes of epilepsy was head trauma (24.5%). A great number of patients were treated by phenobarbital (49%). The overall mean MMSE score was 25.65 ± 5.07. The frequency of cognitive disorders was 61.8%, including cognitive impairment (25.5%), mild dementia (25.5%), moderate dementia (7.8%) and severe dementia (3%). The domains most affected were calculation and attention
deficit (48%) followed by memory disorders (27.5%) and copying (12.8%). Head trauma and phenobarbital were signifi cantly associated to cognitive. Cognitive disorders were less frequent in young adult aged of 26-35 years.
Dr. James C. Johnston is a board-certified neurologist and founder of the 501(c)(3) non-profit organization Global NeuroCare. James Johnston, MD, JD, and his colleague Mehila Zebenigus, MD serve as Directors to this NGO which is accredited by the World Health Organization and holds Special Consultative Status with United Nations ECOSOC.
This project was developed for a competitive intelligence company by mining data from the various information sources e.g. Company (News, Investor Section, SEC filings, Annual Reports, Presentations etc), Universities/Medical Schools/Organizations, Medical Affairs Companies, Non- Profit Medical Agency, Government Agencies, Drug Delivery Companies, Contract Manufacturing Organizations, Contract Research Organizations, Consultancies and Financial Institutions. The complete information available there complied into a single MS word document, listed in MS Excel and then by using MS publisher it was converted into the report which finally converted into PDF.
In his Master of Science in Osteopathy (M.Sc.O) thesis for London College of Osteopathy and Health Sciences (LCO), Dr. Arun Vijayan explores the potential benefits of osteopathic treatment techniques on symptoms related to Multiple Sclerosis.
My presentation delivered at the MS Symposium of the Jewish Hospital Berlin (https://www.juedisches-krankenhaus.de/home.html) held on 29 Nar 2023 at the Centrum Judaicum, Oranienburger Strasse, Berlin
Analyze the Molecular Genetics of a Solitary Causative Genetic Material behin...ijtsrd
Muscular dystrophy is a genetic disorder characterized by progressive muscle weakness and degeneration. Duchenne muscular dystrophy DMD is the most common X linked disorder muscular dystrophy. It is caused by an absence of the protein named as dystrophin, which helps to keep muscle cells intact. In my research on this topic, I will emphasis on a complete analysis of molecular gene behind muscular dystrophy. According to a survey with few hospitals labs in my region with 40 50 patients, we had identified the ratio of around 90 of male and 10 of the female victim with the muscular dystrophy disorder. The lifespan of people having this disorder decreases unconditionally and it majorly effect the youngsters. Main concern for the treatment methodology or medical interventions are limited to treating symptoms. Nishtaa Modi ""Analyze the Molecular Genetics of a Solitary Causative Genetic Material behind Muscular Dystrophy"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020, URL: https://www.ijtsrd.com/papers/ijtsrd29850.pdf
Paper Url : https://www.ijtsrd.com/biological-science/cell-biology/29850/analyze-the-molecular-genetics-of-a-solitary-causative-genetic-material-behind-muscular-dystrophy/nishtaa-modi
Eukaryotic cells have their genetic material in the nucleus, in the other side, prokaryotes have it dispersed in the cytoplasm.
From this DNA will be synthesized RNA, which will act as an intermediary, carrying genetic information from the nucleus to the ribosomes located in the cytoplasm to carry out protein synthesis.
genetic code consists of 64 triplets (codons) of nucleotides, each codon encodes for one of the 20 amino-acids used in the synthesis of proteins.
The study of the genetic code, allow s us identify mutations in specific genes, to detect diseases or predispositions to some pathologies such as those proposed by the articles, and with tan information, implement a PREVENTIVE MEDICINE.
Knowing the sequence of genes that cause certain genetic diseases, is essential for GENE THERAPY branch. In brief it consist in introduce a correct copy of the defective gene that was visualized into the cells, by some vectors, previously studied.
With the knowledge of genetic information, can be provided counseling before and after pregnancy to future parents (Give information about the diseases to which it is susceptible and existing treatments), having always instilled an ethical principle: THE HUMAN LIFE RESPECT.
Promote investigation in medicine basic areas, such as cell biology, molecular biology, biochemistry and pharmacology, with the aim of implement humanity solutions .
This presentation by Gavin Giovannoni looks at the new treatment paradigm for MS. It includes: arguments for early treatment in multiple sclerosis, the effect of MS on quality of life and whether highly-effective treatments stabilise MS.
It was presented at the MS Trust Annual Conference in November 2013.
Information, consent sheet, safety checklist, and Litak summary of medical product characteristics concerning the use of cladribine in people with multiple sclerosis, who are not eligible for disease modifying treatment under the commissioning policies of NHS England.
Disclaimer of liability:
The material and information contained in this document is for general information purposes only. You should not rely upon the material or information on the website as a basis for making any medical, legal or any other decisions. Whilst we endeavour to keep the information up to date and correct, neither the author Klaus Schmierer, his primary employer Queen Mary University of London, or Barts Health NHS Trust, make any representations or warranties of any kind, express or implied about the completeness, accuracy, reliability, suitability or availability with respect to the information contained in this document for any purpose. Any reliance you place on such material is therefore strictly at your own risk.
Klaus Schmierer, Queen Mary University of London, and Barts Health NHS Trust will not be liable for any false, inaccurate, inappropriate or incomplete information presented in this document.
Although every effort is made to keep this document up and running smoothly, due to the nature of the Internet and the technology involved, Klaus Schmierer, Queen Mary University of London, or Barts Health NHS Trust take no responsibility for, and will not be liable for the website being temporarily unavailable due to technical issues (or otherwise) beyond its control or for any loss or damage suffered as a result of the use of or access to, or inability to use or access this website whatsoever.
To the extent not prohibited by law, in no circumstances shall Klaus Schmierer, Queen Mary University of London, or Barts Health NHS Trust be liable to you or any other third parties for any loss or damage (including, without limitation, damage for loss of health, business or loss of profits) arising directly or indirectly from your use of or inability to use, this document or any of the material contained in it.
Outline of a trial for people with advanced (deteriorating, worsening, progressive) multiple sclerosis using cladribine to maintain/improve upper limb function.
Response (Nov 2011) by the Neuroinflammation & Multiple Sclerosis Subcommittee of the Association of British Neurologists to NICE Interventional Procedures Programmes (IPG) 420, and reply by NICE (Mar 2012).
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
the IUA Administrative Board and General Assembly meeting
Never stop k_sv1.4
1. Never stop trying to stop MS
Klaus Schmierer
Blizard Institute, Barts and the London School of Medicine and Dentistry
2. Klaus Schmierer, MB BS PhD FRCP
Reader in Clinical Neurology & Consultant Neurologist
Never stop trying to stop MS
@KlausSchmierer
3. Disclosures
PI of trials sponsored by Novartis, Roche, Teva, Medday.
Involved in trials sponsored by Biogen, Genzyme, BIAL, Cytokinetics,
Canbex.
Speaking honoraria from, and/or served in an advisory role for, Biogen,
Merck, Merck Inc., Novartis, Roche, Teva
Supported for attendance of meetings by Genzyme and Novartis.
Research grant support from Novartis, Biogen, National MS Society (US),
MS Society of Great Britain & Northern Ireland, Royal College of
Radiologists, and Barts Charity.
4. 8 y 20 y 30 y
Disability accrual in MS: The EDSS
5. Brain atrophy: across all stages
n= 963 pwMS
De Stefano N, et al. Neurology 2010;74:1868-76.
10. Grey matter volume loss and disability
Fisniku L, et al. Ann Neurol 2008;64:247-54.
n= 73 patients with initial diagnosis CIS, followed up for 20 years
12. 1. Raise awareness of the global burden of MS
2. Speed up referral and diagnosis
3. Intervene early to maximize lifelong brain health
4. Monitor disease activity and treat to a target
5. Act swiftly on the evidence of disease activity
6. Take a comprehensive economic approach to
evaluating treatment cost-effectiveness
Recommendations
http://msbrainhealth.org/perch/resources/time-matters-in-ms-report-may16.pdf
13. 7. Never stop trying to stabilize/improve brain health
Recommendation?
14. Only one “window of
therapeutic opportunity”?
n= 718 pwMS who reached both DSS 3 and DSS 6
Leray E, et al. Brain 2010; 133:1900-13; Coles A, et al. J Neurol 2006;253:98-108.
n= 22
Disease duration=
2.7 years (2.9)
EDSS: 4.8 (2)
Relapsing MS
n= 36
Disease duration=
11.2 years (6.1)
EDSS: 5.8 (0.8)
SPMS
15.
16. Length dependency and neuroanatomy
55% of cortico-
spinal tract
axons terminate
at the cervical
level.
Kurtzke JF. Mult Scler Relat Disord 2015;4:95–103. Schieber MH. J Neurophysiol 2001;86:2125–43.
18. • 38 years old woman of Afro-Caribbean
extraction
• Diagnosed with primary progressive MS in 2009
• Enrolled in trial of fingolimod (INFORMS) in 2011
• Examination at baseline: brain stem signs
(bilateral INO), hemiparesis on right, walking
range 100-200m. EDSS= 5.5.
Case study – treating progressive MS
Alvarez-Gonzalez C, et al. Ann Clin Trans Neurol 2017 DOI: 10.1002/acn3.410
20. May 2011 Dec 2014
EQ-5D
May 2011 Dec 2014
EDSS
May 2011 Dec 2014
9-HPT
Case study – treating progressive MS
Alvarez-Gonzalez C, et al. Ann Clin Trans Neurol 2017 DOI: 10.1002/acn3.410
Dec 2014
21. Alvarez-Gonzalez C, et al. Ann Clin Trans Neurol 2017 DOI: 10.1002/acn3.410
Case study – treating progressive MS
EDSS= 8 EDSS= 7
22. “A highly significant association between
inflammation and axonal injury was seen in the
global multiple sclerosis population as well as in
progressive multiple sclerosis alone… [suggesting] a
close association between inflammation and
neurodegeneration in all lesions and disease stages
of multiple sclerosis.”
Brain 2009;132:1175-89.
24. 1. Without intervention ~40% of cortical neurons are being lost over a lifetime
with MS. The start of this loss from the earliest disease stages can be inferred
from indices of brain volume, notably the cortical ribbon.
2. Gd+ lesions do not define primary progressive versus other phenotypes of MS.
3. Absence of new/Gd+ lesions does not necessarily mean there is no
inflammation.
4. To establish efficacy in advanced MS, outcomes need to be used that are
sensitive to functions which can be protected/recovered, such as upper limb
dexterity, swallowing, speech, cognition.
5. Whilst “early” DMT promises a life relatively unaffected by MS over many
years, evidence suggests DMT are effective in reducing disability accrual at
more advanced stages of MS too.
6. When shifting the focus on “early DMT” a trade-off against people with more
advanced disease, who may also benefit from DMT, needs to be avoided.
Start DMT as early as possible
