Search

With an ageing global population, there is an urgent need to identify effective strategies to maintain brain health across the life course and therein minimise the risk of age‐related neurodegenerative disorders reaching a severe stage which may manifest as dementia. An increasing body of evidence indicates that nutrition is a modifiable lifestyle factor that can promote healthy brain ageing and reduce dementia risk. However, at present, little is known about which dietary patterns, foods and food bioactives influence brain function during ageing, and more research is required to identify at‐risk individuals and population subgroups who are most likely to benefit from future nutritional intervention intended to promote healthier brain ageing. This article introduces the newly established Medical Research Council‐funded NuBrain consortium, the vision of which is to provide a step change in research in the area by developing novel approaches and techniques to further understand the complex interactions between diet and brain health and how we can support appropriate behaviour changes in the population. NuBrain will form a new, sustainable and internationally field‐leading research consortium with multidisciplinary and complementary areas of expertise to address the fundamental research challenges in this area. [ABSTRACT FROM AUTHOR]

Introduction To enhance interprofessional learning outcomes, The School of Dentistry at The University of Queensland redesigned first-year curricula. Courses for Bachelor of Oral Health ( OHT) and Bachelor of Dental Science ( DS) students were combined, and learning content created to support the development of skills, knowledge and attitudes required for the oral healthcare team to work effectively in providing the best possible care for patients. Methods Over a 2-year period, all commencing OHT and DS students were invited to participate in this study. One cohort ( n = 93) was enrolled into a traditional, discipline-specific programme ( TRAD), whereas the other cohort ( n = 93) experienced an integrated learning programme ( INT) with combined courses for OHT and DS students. The Readiness for Interprofessional Learning Scale ( RIPLS) and a modified dental and dental care professional roles and responsibilities ( DRR) survey were completed to determine students' awareness of dental professionals' roles and responsibilities, and their attitudes to interprofessional education and teamwork. Results Following completion of 1 year of learning, both INT and TRAD cohorts showed similar levels of readiness for shared learning. At the commencement of the second year of the study programme, however, there was a significantly better understanding of shared care amongst INT students. Conclusions This study provides initial support for the integrated learning approach adopted by this university. The INT cohort had significantly improved understandings of the roles and responsibilities of dentists and oral health therapists. The results of this study have been used to refine ongoing curriculum developments. [ABSTRACT FROM AUTHOR]

Over a period of 11 years, 33 sheep or goat holdings lost their maedi-visna or caprine arthritis-encephalitis accredited status (mean 2.8 per year [0.09 per cent] of the accredited holdings in Great Britain). Of these, 22 sheep flocks and two goat herds eradicated the infection and regained their accredited status. In addition, 10 sheep flocks and two goat herds managed to eradicate infection, having joined the scheme with infected animals. In flocks and herds with a high initial prevalence of infection, the adoption of an indirect ELISA, with greater sensitivity than the agar gel immunodiffusion test, improved success rates. A strategy was devised to interpret the ELISA results depending upon the prevalence of infection at the time. Eighteen of the 33 flocks/herds (54.5 per cent) that had introductions of infection also owned non-accredited stock. [ABSTRACT FROM PUBLISHER]

Objective: Although the evidence base for the use of antipsychotics in older people with schizophrenia is generally of low quality, it tends to support the use of atypical antipsychotics. Only limited information regarding longer term adherence to these apparently more effective drugs is available. The aim of this study was to determine predictors of adherence to risperidone or olanzapine in patients over 60. Methods: Patients receiving care from old age psychiatrists for their schizophrenia were randomised to treatment with olanzapine or risperidone and were followed for up to SV2 years. Kaplan—Meier curves were generated to assess the univariate effect of randomisation drug on long-term adherence and Cox regression adjusted for baseline variables which may have affected adherence. Results: In total, 60.6% of the 66 patients in the study were still taking their randomised drug by the end of the interval in which they remained under observation (64.7% olanzapine and 56.3% risperidone). This difference was non-significant. No baseline variable was associated with an increased risk of non- adherence, though the delivery form of pre-randomisation drug (oral or depot) was weakly (p — 0.054) associated with patients originally on depot being less likely to be adherent to an atypical drug. Conclusions: Overall adherence with atypical medication was good with almost two-thirds of the patients remaining on their randomisation drug for the interval in which they were under observation. Patients taken off depot were less likely to be adherent but there was no significant difference in adherence between olanzapine and risperidone. Scrutiny of the survival curves suggested that non-adherence is an early event in treatment and patients adherent at 6 months were likely to remain adherent over a longer time period. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

KVALE E.A., CLAY O.J., ROSS-MEADOWS L.A., MCGEE J.S., EDWARDS J.D., UNVERZAGT F.W., RITCHIE C.S. & BALL K.K. (2009) European Journal of Cancer Care 19, 110–117 Cognitive speed of processing and functional declines in older cancer survivors: an analysis of data from the ACTIVE trial It has been suggested that chemotherapy treatment for cancer may contribute to cognitive decline in older cancer survivors. This issue is particularly important given that subtle cognitive impairment, particularly in cognitive processing speed, can affect functional status and quality of life for older adults. Multivariate regression of data from a longitudinal randomized controlled trial of older adults revealed a trend towards decreased performance after cancer treatment with chemotherapy on several functional measures associated with processing speed (as compared with matched individuals who did not have cancer). Additional analyses revealed that a subset of the chemotherapy-treated adults demonstrated a reliable negative change on several measures of processing speed. While inconclusive, this hypothesis generating work suggests that cognitive dysfunction following cancer treatment may contribute to disability observed in older cancer survivors. Further research is needed to determine the significance of the relationship between cognitive and functional impairment in older cancer survivors. [ABSTRACT FROM AUTHOR]

There has been a large increase in the amount of research seeking to define or diagnose Alzheimer's disease before patients develop dementia. If successful, this would principally have clinical benefits both in terms of treatment as well as risk modification. Moreover, a better method for diagnosing predementia disease would assist research which seeks to develop such treatments and risk modification strategies. The evidence-based definition of a diagnostic test's accuracy is fundamental to achieve the above goals and to address this, the Cochrane Collaboration has established a Diagnostic Test Accuracy group dedicated to examining the utility and accuracy of proposed tests in dementia and cognitive impairment. We present here the assumptions and observations underpinning the chosen methodology as well as the initial methodological approach decided upon. [ABSTRACT FROM AUTHOR]

Background Following an earlier study in which elderly patients with schizophrenia had their typical antipsychotic medication changed to olanzapine or risperidone, the 61 patients were followed for up to a further six months to see if either treatment was superior in terms of efficacy or side effects. Aims To determine whether either olanzapine or risperidone was superior in terms of efficacy or side effects when treating schizophrenia in late life. Methods Psychiatric symptoms, side effects and quality of life were rated every six weeks for 24 weeks of open label comparative treatment using standard measures. Group differences were examined using analysis of covariance and within-group changes over time were assessed using paired t-tests. Results There were 34 olanzapine and 32 risperidone patients who entered the study, but intention to treat data was only available for 61 of the 66 patients. There were no clinical or demographic differences between the groups. Parkinsonism, positive and negative symptoms of schizophrenia improved in both groups both from baseline switch to olanzapine or risperidone and during the six month follow-up after completion of crossover. No significant differences were seen between groups on most measures. However, patients treated with olanzapine showed a significantly greater improvement in quality of life from baseline compared to risperidone patients. Conclusions Both drugs were well tolerated and their use was associated with fewer symptoms of schizophrenia and less adverse effects than were seen when the patients were taking a typical antipsychotic at baseline. Olanzapine appears to have particular benefit with regard to quality of life. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BackgroundAtypical antipsychotics are commonly used in the management of schizophrenia in late life with evidence suggesting they induce lower rates of motor disturbance, but have similar efficacy to conventional antipsychotics. Trials in the elderly have been either retrospective, small, of short duration or of a single-arm design. AimsTo demonstrate the effects upon motor side-effects, efficacy, safety and quality of life (QOL) of switching elderly patients with schizophrenia from conventional antipsychotics to olanzapine or risperidone. MethodsElderly patients with schizophrenia were randomly allocated to olanzapine or risperidone and followed through an open-label crossover period. Between and within group intention to treat analyses were conducted. Results66 patients were randomised (mean age 69.6 [SD ± 6.2]). Four (11.8%) patients on olanzapine and 8 (26.7%) patients on risperidone failed to complete the crossover because of treatment failure [Odds Ratio (OR) = 2.73[0.73–10.2] p = 0.14]. The mean doses upon completion of switching in each arm were 9.9 mg (SD = 4.2) and 1.7 mg (SD = 1.2) for olanzapine and risperidone respectively. In both arms there was improvement in Parkinsonism, though only olanzapine was associated with a reduction in dyskinetic symptoms. The Brief Psychiatric Rating Scale, Scale for the assessment of Negative Symptoms and Montgomery and Asberg Depression Rating Scale scores all improved through the crossover period in both arms with no between group differences. Treatment with olanzapine was associated with a better response over risperidone on the psychological domain of the World Health Organisation—Quality Of Life [Brief] (WHO-QOL-BREF) scale ( p = 0.02). Patients in the olanzapine arm also demonstrated improvement from baseline in the WHO-QOL-BREF physical, psychological and health satisfaction domains, but risperidone had no effect on any Quality of Life (QOL) measure. ConclusionsAfter switching from a conventional antipsychotic, olanzapine and risperidone were associated with improvement in core symptoms of schizophrenia and motor side effects. Subjects switched to olanzapine were more likely to complete the switching process and show an improvement in psychological QOL. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article presents several case studies of dogs suffering from dirofilarial heloptytic expectoration. The adulticide treatment proved to be successful for dogs, but one died during the treatment. The article discusses the manifestations of canine heartworm disease due to adult dirofilaria immitis worms that reside in the pulmonary artery.

Background Objective Methods Results Conclusion Long‐term data on the effectiveness and safety of omalizumab for chronic inducible urticaria (CIndU) in large populations are lacking.To evaluate the effectiveness, safety, estimated omalizumab treatment duration and its predictors, as well as differences between CIndU subtypes, in a large long‐term CIndU cohort.A multinational multicenter study was conducted at 14 specialized urticaria centres (UCAREs), including all CIndU patients ever treated with omalizumab from 2009 until July 2022. Kaplan–Meier survival and regression analyses were performed.Across 234 CIndU patients (55% female; mean age 37 years), 76% (n = 178) had standalone CIndU and 24% (n = 56) had predominant CIndU plus minor CSU, with an observation period up to 13 years. Most CIndU patients (73%, n = 145/200 with available data on response) had complete/good response to omalizumab treatment, without significant differences between CIndU subtypes. Sixty‐two (26%) patients discontinued omalizumab; due to well‐controlled disease (47%, n = 29), ineffectiveness (34%, n = 21), side effects (3%, n = 2), combination of ineffectiveness and side effects (3%, n = 2) and other reasons (13%, n = 8). The median estimated omalizumab treatment duration exceeded 5 years (54% drug survival at 5 years) and was mostly determined by well‐controlled disease. Higher age predicted a lower chance to discontinue omalizumab due to well‐controlled disease (HR 0.969, 95%CI 0.945–0.995). CIndU subtype and presence of minor CSU were not related to response and time until omalizumab discontinuation for any reason.Omalizumab is highly effective and safe in CIndU patients, with long estimated treatment duration mainly reflecting long disease duration. Our data show omalizumab's high potential as treatment in any subtype of CIndU and support its clinical use for these patients. [ABSTRACT FROM AUTHOR]

A biomarker associated with cognition in neurodegenerative dementias would aid in the early detection of disease progression, complement clinical staging and act as a surrogate endpoint in clinical trials. The current systematic review evaluates the association between cerebrospinal fluid protein markers of synapse loss and neuronal injury and cognition. We performed a systematic search which revealed 67 studies reporting an association between cerebrospinal fluid markers of interest and neuropsychological performance. Despite the substantial heterogeneity between studies, we found some evidence for an association between neurofilament-light and worse cognition in Alzheimer's diseases, frontotemporal dementia and typical cognitive ageing. Moreover, there was an association between cerebrospinal fluid neurogranin and cognition in those with an Alzheimer's-like cerebrospinal fluid biomarker profile. Some evidence was found for cerebrospinal fluid neuronal pentraxin-2 as a correlate of cognition across dementia syndromes. Due to the substantial heterogeneity of the field, no firm conclusions can be drawn from this review. Future research should focus on improving standardization and reporting as well as establishing the importance of novel markers such as neuronal pentraxin-2 and whether such markers can predict longitudinal cognitive decline., (© 2022 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Background: Cold urticaria (ColdU), that is, the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU., Methods: An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest ® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms., Results: Of 551 ColdU patients, 75% (n = 412) had a positive CST and ColdA occurred in 37% (n = 151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n = 40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs. 39%, p = .003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes., Conclusion: ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector., (© 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)