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for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association , MD, MSc, FRCPC, FAHA, Chair , MD, FAHA, Vice-Chair , MD, MS, FAHA , MD , DO , MD , MD, MS, FAHA , MD, MBA, FAHA , PhD , MD, MS, FAHA , MD, MSc, FAHA , and MD, FAHA MD, MPH, FAHAon behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention Bart M. Demaerschalk , Dawn O (...) . Kleindorfer , Opeolu M. Adeoye , Andrew M. Demchuk , Jennifer E. Fugate , James C. Grotta , Alexander A. Khalessi , Elad I. Levy , Yuko Y. Palesch , Shyam Prabhakaran , Gustavo Saposnik , Jeffrey L. Saver , and Eric E. Smith and on behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention Originally published 22 Dec 2015 Stroke. 2016;47:581–641 You are viewing the most recent version of this article. Previous versions: Abstract Purpose— To critically review
Investigational New Drug (Application) iNHL indolent non-Hodgkin lymphoma IRC independent review committee ITT intent-to-treat KM Kaplan-Meier LDH lactate dehydrogenase LPL lymphoplasmacytic lymphoma m module mAb monoclonal antibody MALT mucosa-associated lymphoid tissue MCL mantle cell lymphoma MedDRA Medical Dictionary for Regulatory Activities MID minimally important difference MM multiple myeloma MR minor response MRI magnetic resonance imaging MST medical search term MZL marginal zone lymphoma N or n (...) spectroscopy, ultraviolet absorption (UV) and x-ray diffraction. The molecular formula is confirmed by elemental analysis. Manufacture, characterisation and process controls The active substance is synthesised in five steps using commercially available and well defined starting materials. The final active substance is purified by crystallisation. According to the synthetic process described the active substance is consistently obtained as the S-enantiomer. The manufacturing development of the active
Management of Thyroid Cancer CLINICAL ENDOCRINOLOGY VOLUME 81 SUPPLEMENT 1 JULY 2014 THE CLINICAL JOURNAL OF THE SOCIETY FOR ENDOCRINOLOGY AND THE ENDOCRINE SOCIETY OF AUSTRALIA British Thyroid Association Guidelines for the Management of Thyroid CancerGuidelines for the management of thyroid cancer Third edition British Thyroid Association July 2014 Perros P, Colley S, Boelaert K, Evans C, Evans RM, Gerrard GE, Gilbert JA, Harrison B, Johnson SJ, Giles TE, Moss L, Lewington V , Newbold KL (...) Cathy Sturgeon for her contribution on calcitonin, Dr Alan Dodd for his contribution in grading some of the evidence and the patient leaders who worked on the patient information lea? ets: Judith Tay- lor (British Thyroid Foundation), Kate Farnell (Butter? y Thyroid Cancer Trust), Liz Glenister (Hypopara UK), Jo Grey (Association for Multiple Endocrine Neoplasia Disorders – AMEND), Janis Hickey (British Thyroid Foundation) and Helen Hobrough (Thyroid Cancer Support Group – Wales). The authors also
during pregnancy can lead to fetal alcohol syndrome and other harms such as spontaneous abortion, stillbirth, low birthweight, prematurity and birth defects. Use of alcohol and other drugs can also severely impair an individual’s functioning as a parent, spouse or partner, and trigger gender-based and domestic violence, thus significantly affecting the physical, mental and emotional development of children. Injecting drug use is also associated with an increased risk of transmission of HIV and viral (...) for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Design and layout: L ’IV Com Sàrl, Villars-sous-Yens, Switzerland. Printed by the WHO Document Production Services, Geneva, Switzerland.i Acknowledgements iii Glossary of terms used in these guidelines v Acronyms & abbreviations viii Executive summary x Introduction 1 Why these guidelines were developed 1 Existing relevant guidelines on related problems
– A GUIDE FOR PRIMARY HEALTH CARE iii HIV , VIRAL HEPATITIS & STIs A GUIDE FOR PRIMARY CARE 2014 EDITION EXPERT REFERENCE GROUP (EDITORIAL OVERSIGHT) Dr Michael Burke Nepean Sexual Health & HIV Clinic Ms Tracey Cabrie Victorian Infectious Diseases Service, Melbourne Health Associate Professor Ben Cowie Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, University of Melbourne Professor Greg Dore The Kirby Institute, UNSW Australia Dr Seamus Duffy Tuggerah Medical Centre Dr (...) Gail Matthews The Kirby Institute, UNSW Australia Dr Ronald McCoy Royal Australian College of General Practitioners Dr Anna McNulty Sydney Sexual Health Centre Dr Catriona Ooi Western Sydney Sexual Health Centre and University of Sydney Associate Professor Simone Strasser Royal Prince Alfred Hospital, University of Sydney Mr David Youds Gladstone Road Medical Centre Dr Iryna Zablotska The Kirby Institute, UNSW Australiaiv HIV, VIRAL HEPATITIS AND STIs – A GUIDE FOR PRIMARY HEALTH CARE HIV, VIRAL
Noncoding CGG repeat expansions in neuronal intranuclear inclusion disease, oculopharyngodistal myopathy and an overlapping disease. Noncoding repeat expansions cause various neuromuscular diseases, including myotonic dystrophies, fragileXtremor/ataxiasyndrome, some spinocerebellar ataxias, amyotrophic lateral sclerosis and benign adult familial myoclonic epilepsies. Inspired by the striking similarities in the clinical and neuroimaging findings between neuronal intranuclear inclusion (...) disease (NIID) and fragileXtremor/ataxiasyndrome caused by noncoding CGG repeat expansions in FMR1, we directly searched for repeat expansion mutations and identified noncoding CGG repeat expansions in NBPF19 (NOTCH2NLC) as the causative mutations for NIID. Further prompted by the similarities in the clinical and neuroimaging findings with NIID, we identified similar noncoding CGG repeat expansions in two other diseases: oculopharyngeal myopathy with leukoencephalopathy and oculopharyngodistal
%]), and phenytoin (17 [1.4%]). MAO inhibitors were disallowed as concomitant medications in all of the sponsor’s clinical studies, because of the possibility that they may have produced serotonin syndrome when administered in combination with DM. Nevertheless, a total of 3 subjects received MAO inhibitors during the sponsored clinical trials (protocol violations); all were PBA patients enrolled in Study 02-AVR-107, 2 receiving selegeline, and one receiving phenelzine. No association between the above (...) pharmacodynamics of dextromethorphan hydrobromide (DM) and quinidine sulfate (Q) have been previously evaluated and are well-documented in the literature. There is also extensive clinical experience with DM and Q. Therefore a limited pharmacology package was submitted to support the fixed dose combination, which was acceptable. The etiology of PBA is not completely understood; however, the neurologic insults that are associated with PBA are thought to increase the activity of the excitatory glutamate pathways
that describe the evidence on each topic. Inheritance and Risk More than 100 types of tumors are clinically apparent on the skin; many are known to have familial and/or inherited components, either in isolation or as part of a syndrome with other features. and , which are known collectively as nonmelanoma skin cancer, are two of the most common malignancies in the United States and are often caused by sun exposure, although several hereditary syndromes and genes are also associated with an increased risk (...) of developing these cancers. is less common than nonmelanoma skin cancer, but 5% to 10% of all melanomas arise in multiple-case families and may be inherited in an autosomal dominant fashion. Associated Genes and Syndromes Several genes and hereditary syndromes are associated with the development of skin cancer. (BCNS, caused by pathogenic variants in and ) is associated with an increased risk of BCC, while syndromes such as , , , and are associated with an increased risk of SCC. The major tumor suppressor
with von Hippel-Lindau disease. (Refer to the section in the PDQ summary on for more information.) Associated Genes and Syndromes MEN1, which is primarily associated with the development of , (NETs), and , is caused by germline pathogenic variants in the gene. The primary endocrine features of MEN2, which is subdivided into and , include (MTC); its precursor, ; ; and . MEN2 is caused by germline pathogenic variants in the gene. MEN4 is a rare syndrome with clinical features that overlap with the other (...) , in accordance with treatment for other familial syndromes such as MEN1. are also treated surgically. Preoperative management aimed at preventing catecholamine-induced complications of the surgery is common. The mainstay of is complete surgical resection of the tumor. The timing of the operation correlates with the presentation of the tumor. Thyroid cancers associated with FNMTC are also , commonly with a total thyroidectomy. Patients who undergo a total thyroidectomy must receive lifelong thyroid hormone
The Spectrum of Neurological and White Matter Changes and Premutation Status Categories of Older Male Carriers of the FMR1 Alleles Are Linked to Genetic (CGG and FMR1 mRNA) and Cellular Stress (AMPK) Markers The fragileX premutation (PM) allele contains a CGG expansion of 55-200 repeats in the FMR1 gene's promoter. Male PM carriers have an elevated risk of developing neurological and psychiatric changes, including an approximately 50% risk of the fragileX-associatedtremor/ataxiasyndrome (...) the lowest end of the PM repeat range, and non-syndromic carriers assumed an intermediate position. The size of the CGG expansion was significantly correlated, across all three categories, with infratentorial and total wmhs and with all motor scores, and the FMR1 mRNA levels with all the wmh scores, whilst AMPK activity showed considerable elevation in the non-FXTAS combined group, decreasing in the FXTAS group, proportionally to increasing severity of the wmhs and tremor/ataxia. We conclude
Pathological Study of a FMR1 Premutation Carrier With Progressive Supranuclear Palsy Dual pathology in fragileX mental retardation 1 (FMR1) premutation carriers and fragileX-associatedtremor/ataxiasyndrome (FXTAS) patients is an emerging phenomenon. Although it includes atypical parkinsonism, neuropathological confirmation is very scarce. Here, we describe neuropathological findings for a female who suffered a severe parkinsonian syndrome with apraxia and supranuclear palsy. She died (...) , and neurons. This is, to best of our knowledge, the first report describing a pathologically confirmed progressive supranuclear palsy - corticobasal syndrome (PSP-CBS) variant case in a FMR1 premutation carrier.
such as Autism Spectrum Disorder(s), including those who may also have an ADHD (Attention-deficit/hyperactivity disorder) diagnosis, Asperger's Syndrome, Alzheimer's Disease, and/or FragileXsyndrome Condition or disease Autistic Disorders Spectrum Adhd Asperger Syndrome Alzheimer Disease Parkinson Tremor Essential Dementia, Alzheimer Type Lewy Body Dementia With Behavioral Disturbance (Disorder) Dementia With Lewy Bodies Dementia Frontal Detailed Description: What is the study for? The goal of this study (...) the inherent properties of the biorhythms of each person in order to build a proper neurotypical scale and measure the departure of several groups of subjects from this typical ranges. These include Autism Spectrum Disorder(s), ADHD (Attention-deficit/hyperactivity disorder) , Asperger's Syndrome, Alzheimer's Disease, and/or FragileXsyndrome. This study does not provide any recommendations of diagnosis or treatment. It is merely a characterization of the person's biorhythms across these conditions. What
Acute Stroke in Middle Cerebellar Peduncle in a Patient With FXTAS Background: Fragile-Xassociatedtremor/ataxiasyndrome (FXTAS) is commonly associated with T2 hyperintensity in the middle cerebellar peduncles (MCP) on magnetic resonance imaging (MRI). However, ischemic stroke in the MCP in a patient with FXTAS has not previously been described. Case Description: A 61-year-old man with hypertension, sleep apnea, obesity, and FXTAS presented to the emergency department with 2 days of worsening (...) balance and nausea which began 2 days after chiropractic neck manipulation. Examination revealed new nystagmus and worsening dysmetria. Workup revealed an acute infarct in the left MCP, atherosclerotic narrowing of the V4 segment of the left vertebral artery, inadequately controlled hypertension, and a LDL of 127. Conclusion: Isolated MCP infarcts are rare and typically associated with hypoperfusion in the setting of vertebral artery disease and neck manipulation. We suspect that underlying
Middle Cerebellar Peduncle Widthâ€”A Novel MRI Biomarker for FXTAS? FragileX-associatedtremor/ataxiasyndrome (FXTAS) is a severe neurodegenerative movement disorder affecting over 40% of male and 16% of female FMR1 premutation carriers over the age of 50. However, there is a lack of prognostic biomarkers to aid early diagnosis and treatment planning. Therefore, this study aimed to assess the utility of the Magnetic Resonance Parkinson Index (MRPI) as a potential MRI biomarker for FXTAS
Quantitative Evaluation of Toxic Polyglycine Biosynthesis and Aggregation in Cell Models Expressing Expanded CGG Repeats FragileX-associatedtremor/ataxiasyndrome (FXTAS) is a late-onset neurodegenerative disorder caused by expanded CGG (CGGexp) trinucleotides in the 5'UTR of the FMR1 gene encoding fragileX mental retardation protein (FMRP). The patients, with the number of the repeats ranging from 55 to 200, show specific manifestation of clinical symptoms that include intention tremor (...) , gait ataxia, cognitive deficits, and brain atrophy. Accumulation of toxic polyglycine (FMRpolyG), a by-product of the CGGexp repeat-associated non-ATG (RAN) translation, is considered to be one of the main factors triggering neurodegenerative processes in FXTAS patients. Nevertheless, the nature of the FMRpolyG-induced cell damage, especially in the context of its soluble and inclusion-associated forms, is still elusive. Targeting either biosynthesis, cellular stability or aggregation capacity
Microglial cell activation and senescence are characteristic of the pathology FXTAS. FragileX-associatedtremor/ataxiasyndrome (FXTAS) is a late-onset neurodegenerative disorder associated with premutation alleles of the FMR1 gene. Expansions of more than 200 CGG repeats give rise to fragileXsyndrome, the most common inherited form of cognitive impairment. FragileX-associatedtremor/ataxiasyndrome is characterized by cerebellar tremor and ataxia, and the presence of ubiquitin-positive (...) inclusions in neurons and astrocytes. It has been previously suggested that fragileX-associatedtremor/ataxiasyndrome is associated with an inflammatory state based on signs of oxidative stress-mediated damage and iron deposition.Determine whether the pathology of fragileX-associatedtremor/ataxiasyndrome involves microglial activation and an inflammatory state.Using ionized calcium binding adaptor molecule 1 and cluster differentiation 68 antibodies to label microglia, we examined the number
Clinical implication of FMR1 intermediate alleles in a Spanish population. FMR1 premutation carriers (55-200 CGGs) are at risk of developing FragileX-associated primary ovarian insufficiency as well as FragileX-associatedtremor/ataxiasyndrome. FMR1 premutation alleles are also associated with a variety of disorders, including psychiatric, developmental, and neurological problems. However, there is a major concern regarding clinical implications of smaller CGG expansions known (...) as intermediate alleles (IA) or gray zone alleles (45-54 CGG). Although several studies have hypothesized that IA may be involved in the etiology of FMR1 premutation associated phenotypes, this association still remains unclear. The aim of this study was to provide new data on the clinical implications of IA. We reviewed a total of 17 011 individuals: 1142 with primary ovarian insufficiency, 478 with movement disorders, 14 006 with neurodevelopmental disorders and 1385 controls. Similar IA frequencies were
dementia, fragileXsyndrome and other neurological disorders), and emerging data suggest that tandem repeat polymorphisms (TRPs) can also regulate gene expression in healthy individuals. TRPs in human genomes may also contribute to the missing heritability of polygenic disorders. A better understanding of tandem repeats and their associated repeatome, as well as their capacity for genetic plasticity via both germline and somatic mutations, is needed to transform our understanding of the role of TRPs (...) Tandem repeats mediating genetic plasticity in health and disease. Accumulating evidence suggests that many classes of DNA repeats exhibit attributes that distinguish them from other genetic variants, including the fact that they are more liable to mutation; this enables them to mediate genetic plasticity. The expansion of tandem repeats, particularly of short tandem repeats, can cause a range of disorders (including Huntington disease, various ataxias, motor neuron disease, frontotemporal
Frequency of SCA8, SCA10, SCA12, SCA36, FXTAS and C9orf72 repeat expansions in SCA patients negative for the most common SCA subtypes. Spinocerebellar ataxia (SCA) subtypes are often caused by expansions in non-coding regions of genes like SCA8, SCA10, SCA12 and SCA36. Other ataxias are known to be associated with repeat expansions such as fragileX-associatedtremorataxiasyndrome (FXTAS) or expansions in the C9orf72 gene. When no mutation has been identified in the aforementioned genes next (...) of the fragileX mental retardation 1 gene (FMR1) revealed one patient with a premutation (>50 CGG repeats) and seven patients with alleles in the grey zone (41 to 54 CGG repeats).Altogether five patients showed 92 or more SCA8 CTA/CTG combined repeats. Our results support the assumption that smaller FMR1 gene expansions could be associated with the risk of developing neurological signs. The results do not support genetic testing for C9orf72 expansion in ataxia patients.