Noticias

Lower N-acetylhexosamine levels in plasma correlated with worse clinical outcomes.
Early studies suggest that N-glycosylation is altered in multiple sclerosis (MS). N-acetylglucosamine (GlcNAc) is a metabolic precursor to N-glycosylation. Investigators studied GlcNAc via its stereoisomer mix, N-acetylhexosamine (HexNAc), among different MS subtypes and clinical outcomes.

PP-CNS-GLB-1927

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The questions of whom to treat for hypertension and how aggressively to treat have received con-siderable recent attention, with at least some partial answers. A recent analysis of the final results of the landmark SPRINT study published in the New England Journal of Medicine confirmed that treat-ment of patients at high risk for cardiovascular (CV) disease (but without prevalent diabetes or stroke) to a systolic blood pressure (BP) goal of 120 mm Hg leads to substantial benefits compared with treating to 140 mm Hg.

PP-CVP-GLB-0514

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In a retrospective study, researchers examined associations between laryngeal disorders and fibromyalgia, irritable bowel, and chronic fatigue.
Fibromyalgia, irritable bowel, and chronic fatigue are syndromes that share chronic pain and other unexplained symptoms among their clinical manifestations. Otolaryngologists from a voice disorders clinic at a U.S. academic medical center anecdotally observed a high prevalence of these syndromes  in patients with voice and airway symptoms; 

PP-PPF-GLB-0446

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In cognitively intact individuals with late-life depression, cortical amyloid burden predicted poor antidepressant response.
Accumulation of cortical amyloid-β (Aβ) has been associated with greater depressive symptoms in cognitively intact older adults. Higher cortical Aβ burden and late-life depression (LLD) are indepen-dently associated with risks for cognitive decline and Alzheimer disease. 

PP-CNS-GLB-1852

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Plasma neurofilament light chain concentrations may inform phenoconversion and disease progression in familial frontotemporal lobar degeneration.
In this study, researchers analyzed whether plasma neurofilament light chain (NfL) levels, a sensitive biomarker for neurodegeneration, could predict individuals with familial frontotemporal lobar degen-eration (FTLD) who were at risk for clinical phenoconversion or disease progression from an original (n=277) and validation (n=297) cohort.

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In an observational study, the optimal prostate-specific-antigen level increases that predicted disease progression differed in Black and white men.
In the continuing search for ways to identify progression of prostate cancer in patients who are managed by active surveillance, researchers used the U.S. 

PP-MHP-GLB-0246

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Six mutations are associated with an increased risk for cancer-associated thrombosis, independent of cancer type.
The etiology of cancer-associated thrombosis (CAT) is multifactorial, with influence from cancer stage, chemotherapy, postoperative state/immobility, prior thrombosis history, and presence of vascular access.

PP-IMU-GLB-0151

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Almost 75% of patients in a meta-analysis sustained silent brain infarcts after the procedure.
Transcatheter aortic-valve implantation (TAVI) is one of the great recent advances in cardiovascular medicine. However, postprocedure stroke is a hazard of the procedure, perhaps occurring in as many as 10% of patients.

PP-CVP-GLB-0484

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In a longitudinal study, baseline ganglion cell layer thickness was associated with disability 10 years later.
Optical coherence tomography (OCT) is a noninvasive retinal scan that is used increasingly in neuro-logic practice. Prior studies have shown that risk of future disability is higher for those with decreased retinal nerve fiber layer (RNFL) thickness (NEJM JW Neurol May 2016 and Lancet Neurol 2016; 15:574).

PP-UOP-GLB-0177

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The Centers for Disease Control and Prevention reported that in 2016 the national prevalence of  gestational diabetes mellitus (GDM) was 6% among women with live births. Based on this estimate, among the 3.75 million births in the United States in 2019, there were approximately 225,000 preg-nancies complicated by GDM.

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A randomized trial showed that a more-restrictive strategy was noninferior.
In previous large randomized trials, restrictive transfusion strategies benefited patients with anemia, but those trials excluded patients with acute myocardial infarction (MI). 

PP-CVP-GLB-0470

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Vitamins E and C may be associated with risk, but the evidence remains limited.
To determine whether risk for future Parkinson disease (PD) diagnosis was reduced with increased  dietary antioxidant intake and total nonenzymatic antioxidant capacity (NEAC), researchers examined data from 43,865 men and women (aged 18–94 at baseline) in the Swedish National March Cohort linked to the National Health Registries.

PP-CNS-GLB-1808

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Obesity is associated with increases in life-threatening diseases and premature mortality. Bariatric surgery leads to durable weight loss and reduces the risk for cardiovascular disease, type 2 diabetes, cancer, and all-cause death. The effect of bariatric surgery on life expectancy, however, has not been well defined.

PPP-IMU-GLB-0112

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Major advances in the care of cardiac arrest patients have been reported in the literature over the past decade, including better data on pharmacologic and airway management during the intra-cardiac arrest period and after return of spontaneous circulation. The collection of articles presented here highlights some of those advances.

PP-IMU-GLB-0115

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Short-term psychodynamic psychotherapy focusing on awareness and processing of emotionally laden material can be helpful for somatization.
Is psychodynamic psychotherapy still relevant? Researchers addressed this question in a meta-analysis of 17 randomized, controlled trials involving 2004 patients (mean age, 43) with disorders characterized by functional somatic complaints such as irritable bowel syndrome, fibromyalgia, and chronic pain disorders.

PP-CNS-GLB-1778

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A quality-improvement intervention was associated with outcome successes.
Fragility hip fractures, often caused by a fall from standing height, portend substantial morbidity and mortality. Yale researchers implemented a multidisciplinary, multicomponent intervention designed to improve hip-fracture outcomes. 

PP-PPF-GLB-0379

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Data from the Framingham Study suggest that modern medical treatment helps.
Transient ischemic attacks (TIAs) are a well-recognized precursor to a potential ischemic stroke.

PP-CNS-GLB-1768

The treatment of rheumatoid arthritis is fraught with unknowns. It is not always certain how active the patient’s arthritis may be, even while they are engaged in an effective treatment regimen. What factors may predict a flare of the disease and how to confirm that the patient remains in remission are unknown.

PP-PPF-GLB-0342

A plethora of studies comparing the metabolic benefits of bariatric surgery with usual medical management of obese patients has increased the focus on surgical management — either Roux-en-Y gastric bypass or, increasingly often, sleeve gastrectomy. 

PP-IMU-GLB-0085

A strong relationship was seen in both women and men, irrespective of the presence of PFO.
Previous studies have evaluated some of the complex relationships among cryptogenic stroke, migraine, and patent foramen ovale (PFO) and suggested the following: Migraine is associated with ischemic stroke, migraine with aura is associated with the presence of PFO, and the association between mi-graine and cryptogenic ischemic stroke is stronger among patients with PFO than without. 

PP-CNS-GLB-1694

In cognitively intact individuals with late-life depression, cortical amyloid burden predicted poor antidepressant response. 
Accumulation of cortical amyloid-β (Aβ) has been associated with greater depressive symptoms in cognitively intact older adults. 

PP-CNS-GLB-1627

A 45-year longitudinal study shows that mental illness is astonishingly common and that it’s better to be a “lumper” than a “splitter” when thinking diagnostically.
Cross-sectional epidemiological surveys have documented high rates of lifetime psychiatric disorders (about 40%–50%) and substantial comorbidity,

PP-CNS-GLB-1625