Risultati per: Scoperte le cause biologiche della depressione

Sindrome Vexas, al San Raffaele di Milano ambulatorio dedicato

Findings from a large cohort suggest the answer is yes.

Stroke, Ahead of Print. BACKGROUND:Chronic cerebellar lesions of presumed ischemic origin are frequently found in patients with ischemic stroke and as incidental findings. However, the differentiation of embolic lesions from lesions caused by cerebral small vessel disease (SVD) is unclear. We aimed to investigate whether the location of chronic cerebellar ischemic lesions (deep versus cortical) indicates the underlying cause (embolic versus SVD).METHODS:This study was a post hoc data analysis from the multinational ELAN trial (Early Versus Late Initiation of Direct Oral Anticoagulants in Patients With Postischemic Stroke With Atrial Fibrillation), which included patients with acute ischemic stroke and atrial fibrillation cohort between 2017 and 2022. For comparison, data from 2 cohorts (DiViNAS [Disease Variability in NOTCH3-Associated SVD] and VASCAMY [Vascular and Amyloid Predictors of Neurodegeneration and Cognitive Decline in Nondemented Subjects]) consisting of participants with hereditary cerebral SVD (ie, Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) were analyzed (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy cohort). Brain magnetic resonance imaging scans were evaluated for presence and location of chronic cerebellar ischemic lesions. The association between these lesions and the severity of supratentorial SVD was analyzed using univariable and multivariable models, adjusting for key covariables.RESULTS:In the atrial fibrillation cohort (N=790), 278 (35%) patients had chronic cerebellar ischemic lesions (cortical: n=242; deep: n=36). In multivariable analyses, features of cerebral SVD were associated with deep cerebellar ischemic lesions (summary SVD score; odds ratio per point, 2.5 [95% CI, 1.5–3.5];P

Mapping human behavior to brain circuits has long been a goal for behavioral neurologists and neuropsychologists. Many discoveries were based on detailed psychological and anatomical studies of a single case. A famous example is Henry Gustav Molaison, better known as H.M.

This case-control study analyzes published cases of lesion-induced psychosisTo assess whether lesions that cause secondary psychosis have functional connections to a common brain circuit

Test clinici la promuovono. L’esperto: ‘Mai come sostitutivo del medico’

Objectives
A previous cohort study of male Norwegian Navy submariners showed higher overall cancer incidence and lower all-cause mortality than the general Norwegian population. We have extended the follow-up and show more precise estimates through seven decades.

Design
Historical cohort study using outcome data from Norwegian cancer incidence and cause-of-death registries.

Setting
Linkage with the outcome registries was performed by means of unique national identification numbers given to all Norwegian citizens.

Participants
2663 military men who ever served aboard a Navy submarine between 1942 and 2005.

Outcome measures
Standardised incidence ratios for cancer and mortality ratios were calculated from national period-specific, gender-specific and age-specific rates. Poisson regression was used to compare cancer incidence in groups with different length of submarine service ( >2 years vs ≤2 years).

Results
The overall cancer incidence was 15% higher than expected from the national rates, with colon, lung, skin (melanoma and non-melanoma) and urinary tract contributing 90% of the excess number of cases. Most of the excess was confined to those with shorter-time service, who also showed elevated risk of alcohol-related cancers. Excess non-melanoma skin cancer was most clearly seen among submariners with >2 years of service. Mortality from all causes combined was lower among submariners than in the general population, due to a markedly low mortality from non-neoplastic diseases and external causes.

Conclusions
Increased risk of non-melanoma skin cancer was found among submariners with long-term service, and skin exposure to carcinogens in petroleum products was hypothesised as an explanation. Less support for occupational risks was found for other cancers, although the lack of specific exposure data and limited statistical power reduced the possibility of identifying such associations. A ‘healthy soldier effect’ appeared in the mortality data, mainly restricted to low mortality from non-neoplastic diseases and external causes.

Più comuni in femmine, a scapito di sostanze neuroprotettive

Esperto, problemi combinati a mucose e muscoli della fonazione

Objective
To clarify whether the high-density lipoprotein cholesterol/C reactive protein (HDL-C/CRP) ratio can be used as a new prognosticator of all-cause mortality in patients with chronic heart failure (CHF) (New York Heart Association (NYHA) cardiac class III/IV).

Design
Retrospective study.

Background
Several papers have revealed that HDL-C and CRP can act as anti-inflammatory and pro-inflammatory factors, respectively, to affect disease progression in patients with heart failure, and the balance of the two has been shown to affect the prognosis of patients with heart failure with preserved ejection fraction (HFpEF), but none of the above studies involved patients with the more severe forms of heart failure with mildly reduced ejection fraction and heart failure with reduced ejection fraction; therefore, the present study is to extend the balance of HDL-C and CRP to the whole range of types of patients CHF to further confirm its importance.

Setting
This study is from a single centre in Yunnan Province, China.

Participants
After excluding ineligible patients, we finally included 1192 patients with CHF from January 2017 to October 2021.

Primary and secondary measures
The primary outcome was all-cause mortality in patients with CHF between January 2017 and October 2021. No secondary outcome measures were performed.

Results
All patients were divided into four groups according to the quartiles of the HDL-C/CRP ratio. Using the Kaplan-Meier analysis, the risk of all-cause mortality was always the highest for Q1 (HDL-C/CRP

Stroke, Ahead of Print. The 2024 Guidelines for the Primary Prevention of Stroke, recently updated by the American Heart Association and the American Stroke Association, serve as an essential resource for clinicians aiming to reduce the growing impact of cerebrovascular disease. These guidelines emphasize modifiable risk factors and population-specific considerations, covering a range of cardiovascular conditions, including hypertension, diabetes, atherosclerotic disease, and genetic predispositions to stroke. However, a notable omission in these guidelines is the absence of specific recommendations for patients with thrombotic thrombocytopenic purpura. Indeed, these patients are particularly susceptible to stroke, which can be the sole manifestation of the disease. Given the established association between thrombotic thrombocytopenic purpura and ischemic stroke and the effectiveness of preventive interventions, future guidelines should include specific recommendations for patients with thrombotic thrombocytopenic purpura to avert thrombotic events, including stroke. In that regard, ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13) activity measurement should be considered in the workup of cryptogenic stroke.

Gli esperti, ‘anche i medici responsabili, colmare il divario’