Six guidelines to navigate the Aduhelm controversy and (hopefully) help patients with Mild Cognitive Impairment and early-stage Alzheimer ’s Disease
The approval of a controversial new drug for Alzheimer’s disease, Aduhelm, is shining a spotlight on mild cognitive impairment — problems with memory, attention, language or other cognitive tasks that exceed changes expected with normal aging. After initially indicating that Aduhelm could be prescribed to anyone with dementia, the Food and Drug Administration now specifies that the prescription drug be given to individuals with mild cognitive impairment or early-stage Alzheimer’s, the groups in which the medication was studied. Yet this narrower recommendation raises questions. What does a diagnosis of mild cognitive impairment mean? Is Aduhelm appropriate for all people with mild cognitive impairment, or only some? And who should decide which patients qualify for treatment: dementia specialists or primary care physicians? Controversy surrounds Aduhelm because its effectiveness hasn’t been proved, its cost is high (an estimated $56,000 a year, not including expenses for imaging and monthly infusions), and its potential side effects are significant (41% of patients in the drug’s clinical trials experienced brain swelling and bleeding). Furthermore, an FDA advisory committee strongly recommended against Aduhelm’s approval, and Congress is investigating the process leading to the FDA’s decision. Medicare is studying whether it should cover the medication, and the Department of Veterans Affairs has declined to do so under most circumstanc...
ConclusionsWomen experiencing moderate or severe antenatal depression and/or who self-perceive as having poor health should be identified and targeted for additional support to access and utilize maternal health services.
Anxiety and depression symptoms increased in adults last winter as COVID-19 surged in the United States but declined in the spring as COVID activity approached its nadir.Medscape Medical News
A joint experiment-theory investigation is conducted to unveil the fracture mechanics of grain boundaries (GBs) in low-symmetry monolayer rhenium disulfide at the single-atom level. GBs having different Re chain alignment with respect to the GB orientation display disparate crack behaviors, indicating the GB type-dependent mechanical failure in anisotropic 2D polycrystals, which gives fundamental insights into GB engineering. AbstractGrain boundaries (GBs) play a central role in the fracture of polycrystals. However, the complexity of GBs and the difficulty in monitoring the atomic structure evolution during fracture great...
Given a suitable delivery system, one that localizes to the desired target tissues to a far greater degree than to all other undesirable off-target tissues, the big advantage of a gene therapy is it precisely achieves the manipulation desired. It dials up or dials down expression for selected genes, alters the amount of proteins produced from those genes, and thereby changes cell behavior as a consequence - and that is all it does. One doesn't have the endless concern about off-target effects that characterize small molecule drug development. There are, of course, different challenges. Setting aside some adventurous...
Alzheimer's risk and susceptibility to severe COVID-19 share a common genetic mechanism; the new findings that could lead to novel treatments to slow progression and severity of both diseases.Medscape Medical News
DEMENTIA is a destructive set of symptoms associated with progressive brain decline. Research continues to shed light on the contributing risk factors, raising the possibility of early intervention to forestall it. According to a study published in the journal Nature, a particular sleep pattern puts you at a 30 percent higher risk of dementia.
Computer and imaging technologies led to the development of digital pathology and the capture and storage of pathological specimens as digitally formatted images. The use of artificial intelligence (AI) in digital pathology, such as in three-dimensional (3D) reconstruction, requires analyses of high volumes of data. This resulted in increased demands for processing and acquisition of digital images of pathology samples. Increased usage cannot be met by the time-consuming, manual, and laborious methods currently used. Therefore, there is a need for automation of the techniques used in processing of pathology samples and acq...
We describe a patient who developed recto-sigmoidal ischaemia after embolization of the haemorrhoidal arteries, known as the “emborrhoid” technique, with persistence of rectal bleeding and progressive rectal stenosis.
ConclusionsThe utility of anticoagulant reversal agents in GI bleeding is recognized in guidelines; however, such agents should be reserved for use in truly life-threatening scenarios.
ConclusionNighttime mean glucose level has a comparable effect size to HSSV in association with fetal growth, suggesting that endogenous hyperglycemia might drive the association between maternal hyperglycemia and birth weight. Further studies need to examine the effect of lowering nighttime glucose level and/or HSSV on preventing fetal overgrowth in GDM women.
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