scholarly journals Dapsone is an anticatalysis for Alzheimer’s disease exacerbation

Author(s):  
Jong Hoon Lee ◽  
Badar Kanwar ◽  
Chul Joong Lee ◽  
Consolato Sergi ◽  
Michael Coleman

Abstract This study investigated leprosy patients with Alzheimer's disease (AD) treated with dapsone (4,4’-diaminodiphenyl sulfone, DDS) as a cytosolic DNA sensor cyclic-GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway and neuroinflammasome competitor. We searched the Sorokdo National Hospital medical records and the National Health Insurance Service in South Korea with the International Classification of Diseases (ICD)-10 code and Electronic Data Interchange (EDI) from January 2005 to June 2020. Four groups were defined: Treatment (T) 1: DDS prescription (+) AD prevalence (+), T 2: DDS (+) AD nondiagnosed (-), T 3: DDS nonprescription (-) AD (+), T 4: DDS (-) AD (-). The T1:T3 tests demonstrate that the incidence of AD is significantly reduced in the presence of dapsone among AD patients. The T1:T3 tests demonstrate that the incidence of AD is significantly reduced in the presence of dapsone among AD patients. T1 (M = 0.18, SD = 0.074):T2 (M = 0.55, SD = 0.14) and T3 (M = 0.18, SD = 0.074):T4 (M = 0.55, SD = 0.14) explain that dapsone effects on AD can be clearly distinguished according to its presence or absence.The T1:T4 and the T2:T3 test demonstrate a causal relationship in which the presence or absence of dapsone determines the onset of AD. The T1:T3 test proved that the incidence of AD was significantly reduced by dapsone. (The t-value is -23.1, p-value is < .00001, significant at p < .05) The T2:T3 test proved that the prevalence of AD was significantly high without dapsone, and without AD was increased with dapsone. (The t-value is -6.38, p-value is < .00001, significant at p < .05) AD is increased in the absence of dapsone. Our study has demonstrated that dapsone has the potential for the prevention of AD. This study indicates that dapsone is a valid preventive therapeutic for AD. KEYWORD: Neuroinflmmasome, Alzheimer's disease, Dapsone

Author(s):  
M. Rochoy ◽  
E. Chazard ◽  
S. Gautier ◽  
R. Bordet

INTRODUCTION: Alzheimer’s disease (AD) is the first cause of dementia. Diagnostic criteria have evolved: proposals to revise the NINCDS–ADRDA criteria were published in 2007. Our aim was to analyze the evolution in the coding of AD in the French nationwide exhaustive hospital discharge database (PMSI) between 2007 and 2017. METHODS: We analyzed evolution of International Classification of Diseases and Related Health Problems, 10th edition (ICD-10) coding for AD and AD dementia in the PMSI database from 2008 to 2017 (285,748,938 inpatient stays). RESULTS: We observed a 44% decrease in the number of inpatient stays with a principal diagnosis of AD or AD dementia from 2007 (46,313 inpatient stays) to 2017 (25,856 inpatient stays) in France. Over the same period, we observed a 49% increase in the number of inpatient stays with a principal diagnosis of related dementias (other organic mental disorders or other degenerative disorders). Overall, the number of inpatient stays for dementia remained stable despite the increase in the total number of inpatient stays: 95,377 in 2007 (0.409% of inpatient stays) and 99,190 in 2017 (0.344%). CONCLUSION: We therefore note a shift from AD and AD dementia to other dementia diagnoses since 2007. This study suggests a more accurate use of AD related ICD-10 codes since the revised criteria in 2007.


2021 ◽  
Vol 9 (3) ◽  
pp. 213-218
Author(s):  
Patricio Garcia-Espinosa ◽  
Edgar Botello-Hernández ◽  
Gabriela Torres-Hernández ◽  
Clarissa Guerrero-Cavazos ◽  
Estefania Villareal-Garza ◽  
...  

Background: Arteriovenous Malformations (AVMs) are abnormalities in intracranial vessels between the arterial and venous systems. This study aimed to identify the predictors of mortality in patients that presented to our hospital with AVMs, ruptured or unruptured, and correlate them to those available in the literature. Methods: An analytical, observational, retrospective study was performed to review data of patients with cerebral AVMs in the University Hospital “Dr José Eleuterio González” from January 2016 to December 2020. Clinical files were reviewed based on AVMs diagnosis according to the  International Classification of Diseases 10th Revision, ICD-10. Variables were subjected to a univariate analysis and those found significant (p-value < 0.05) were subjected to a logistic regression. Results: A total of 80 patients were included in our study. Most of the participants were females (56.3%) and three were pregnant. The most common presenting symptom was holocranial headache (34 cases) occurring between the hours of 22:00 to 7:00. The most significant predictors of mortality were a total bleeding volume greater than 9.18 cm3 (p = 0.010), the presence of more than one symptom (p = 0.041), and a history of previous cerebral intraparenchymal hemorrhage (p = 0.014). Conclusion: Results demonstrated an important association between intracranial bleeding and mortality. Ultimately, more prospective studies are needed to determine predictor factors for mortality in AVMs patients.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18306-e18306
Author(s):  
Michael Gallaway ◽  
Nimi Idaikkadar

e18306 Background: Cancer patients are increasingly likely to visit an emergency department (ED) for acute care compared to the general population. Cancer patients who visit the ED often have long wait times, increased exposure to infection, and lesser quality treatment. The Centers for Medicare & Medicaid Services (CMS) is encouraging efforts to decrease survivor acute care visits. The purpose of this study was to examine cancer-related ED visits using a national population-based sample to understand why they are seeking care in an ED. Methods: A retrospective cohort study of U.S. patients who visited EDs between June 1, 2017 and May 31, 2018 was conducted using the National Syndromic Surveillance Program (NSSP) BioSense Platform. Cancer patients were identified using International Classification of Diseases, 10th Revision (ICD-10) codes for any cancer type and specifically for cancers of the bladder, female breast, cervix, colon and rectum, kidney, liver, lung, ovary, pancreas, prostate, or uterus. Symptoms were identified using syndromic definitions and key-word queries. Significance testing (p-value ≤0.01), was used to assess differences in the prevalence of symptoms by cancer type. Results: There were 97 million visits to EDs during the study period, 710,297 (0.8%) were among cancer survivors. Slightly more were female (50.1%) than male (49.5%); more were aged 65 or older (53.6%) than 18-64 (1.4-35.3%). The most common symptoms were pain (19%), gastrointestinal (14%), respiratory (12%), neurologic (5%), fever (5%), and injury (4%). Prevalence of symptoms differed significantly by cancer type. Some symptoms were higher among those with specific cancer types compared to all cancers in aggregate: pain (cervical, liver, pancreas); gastrointestinal (pancreas, liver, colorectal); respiratory (lung); neurologic (liver, lung), fever (pancreas, liver), injury (prostate), and bleeding (colorectal, liver). Conclusions: Use of NSSP data enabled a descriptive characterization of more than half of the U.S. ED visits among cancer patients. These comprehensive findings inform best practices to reduce unplanned acute care and help inform possible modifications in treatment and care protocols among survivors of specific cancers.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
MUHAMMAD ZUBAIR Z KHAN ◽  
Kirtenkumar Patel ◽  
Ashwani Gupta ◽  
Jordesha Hodge ◽  
Krunalkumar Patel ◽  
...  

Introduction: Atrial fibrillation (Afib) is a common cardiac manifestation of hyperthyroidism. The data regarding outcomes of A fib with and without hyperthyroidism are lacking. Hypothesis: We hypothesized that patients with Afib and hyperthyroidism have better clinical outcomes, compared with Afib patients without hyperthyroidism. Methods: We queried National Inpatient Sample database for years 2015 - 2017 using Validated International Classification of Diseases and Clinical Modification (ICD-10-CM) codes for atrial fibrillation and hyperthyroidism. Patients were separated into 2 groups- A fib with hyperthyroidism and A fib without hyperthyroidism. Results: Study was conducted on 68,095,278 pateints. A total of 9,727,295 Afib patients were identified, out of which 90,635(0.9%) had hyperthyroidism. The prevalence of hyperthyroidism was higher in patients with Afib (0.9% vs 0.4%, p value <0.001), compared with patients without A fib. Using multivariate regression analysis after adjusting for various confounding factors, the odds ratio of Afib with hyperthyroidism was 2.08 (CI 2.07 - 2.10 P<.0001). Afib patients with hyperthyroidism were younger, (70.9 vs75.1 years, p<0.0001) and more likely to be female (63.9% vs 47% p<0.0001) as compared with Afib patients without hyperthyroidism. Afib patients with hyperthyroidism had lower prevalence of CAD (36.4% vs 43.8%,p<0.0001), cardiomyopathy(24.1% vs 25.9%,p<0.0001), valvular disease (6.9% vs 7.4%,p<0.0001), hypertension(60.7% vs 64.4%,p<0.0001) , and diabetes mellitus (28.9% vs 31.8%,p<0.0001). Afib with hyperthyroidism group had lower all-cause mortality (3.3% vs 4.8%, p<0.0001), shorter mean length of stay (5.7 ±6.6 vs 5.9±6.6 days,p<0.0001) and hospitalization cost ($14968±21871 vs $15955±22233, p<0.0001). The disposition to home was higher in Afib with hyperthyroidism patients (50.6% vs 41.8 p<0.0001). Conclusions: Presence of hyperthyroidism is associated with Afib in both univariate and multivariate analysis. Afib patients with hyperthyroidism have better clinical outcomes, compared with Afib patients without hyperthyroidism.


2020 ◽  
Vol 13 ◽  
pp. 175628642093567
Author(s):  
Olaf Stuve ◽  
Rick A. Weideman ◽  
Danni M. McMahan ◽  
David A. Jacob ◽  
Bertis B. Little

Background: Our aim was to determine whether specific nonsteroidal anti-inflammatory (NSAID) agents are associated with a decreased frequency of Alzheimer’s disease (AD). Materials and methods: Days of drug exposure were determined for diclofenac, etodolac, and naproxen using US Department of Veterans Affairs (VA) pharmacy transaction records, combined from two separate VA sites. AD diagnosis was established by the International Classification of Diseases, ninth revision (ICD-9)/ICD-10 diagnostic codes and the use of AD medications. Cox regression survival analysis was used to evaluate the association between AD frequency and NSAID exposure over time. Age at the end of the study and the medication-based disease burden index (a comorbidity index) were used as covariates. Results: Frequency of AD was significantly lower in the diclofenac group (4/1431, 0.28%) compared with etodolac (328/14,646, 2.24%), and naproxen (202/12,203, 1.66%). For regression analyses, naproxen was chosen as the comparator drug, since it has been shown to have no effect on the development of AD. Compared with naproxen, etodolac had no effect on the development of AD, hazard ratio (HR) 1.00 [95% confidence interval (CI): 0.84–1.20, p = 0.95]. In contrast, diclofenac had a significantly lower HR of AD compared with naproxen, HR 0.25 (95% CI: 0.09–0.68, p <0.01). After site effects were controlled for, age at end of the study (HR = 1.08, 95% CI: 1.07–1.09, p <0.001) was also found to influence the development of AD, and the medication-based disease burden index was a strong predictor for AD, HR 5.17 (95% CI: 4.60–5.81) indicating that as comorbidities increase, the risk for AD increases very significantly. Conclusion: Diclofenac, which has been shown to have active transport into the central nervous system, and which has been shown to lower amyloid beta and interleukin 1 beta, is associated with a significantly lower frequency of AD compared with etodolac and naproxen. These results are compelling, and parallel animal studies of the closely related fenamate NSAID drug class.


2021 ◽  
Vol 1 (2) ◽  
pp. 46
Author(s):  
Wiwit Ida Chahyani ◽  
Murni Sri Hastuti

Latar Belakang: Prevalensi demensia saat ini semakin meningkat, mengenai usia diatas 65 tahun dan risikonya meningkat 2 kali setiap penambahan usia 5 tahun. Salah satu bentuk demensia adalah mixed dementia. Diagnosis mixed dementia sangat sulit dan memberikan tantangan tersendiri bagi para klinisi. Pada artikel ini, penulis ingin membahas mengenai tinjauan diagnosis dan tatalaksana mixed dementia. Hasil: Diagnosis mixed dementia dapat menggunakan beberapa kriteria yaitu International Classification of Diseases and Health Related Problems 10th Revision (ICD-10), the Alzheimer’s Disease Diagnostic and Treatment Centers (ADDTC), dan the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l’Enseignement en Neurosciences (NINDS-AIREN). Tatalaksana mixed dementia berupa terapi farmakologi untuk gejala gangguan kognitif dengan pemberian golongan inhibitor kolinesterase dan antagonis NMDA. Terapi farmakologi untuk gangguan psikis dan perilaku dengan antipsikotik atau antidepresan. Managemen faktor risiko hipertensi, konsumsi nutrisi yang sehat, dan olah raga teratur sebagai upaya preventif dan mencegah progresivitas mixed dementia. Kesimpulan: Diagnosis mixed dementia meliputi gejala demensia Alzheimer dan demensia pada penyakit serebrovaskuler. Tatalaksana mixed dementia meliputi terapi gangguan kognitif, psikis, dan perilaku, serta tatalaksana faktor risiko penyakit serebrovaskuler. Dibutuhkan penelitian lebih lanjut serta adanya konsensus diagnosis dan tatalaksana mixed dementia baik nasional maupun internasional agar tercapai tatalaksana secara komprehensif.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


Author(s):  
Philip Cowen

This chapter discusses the symptomatology, diagnosis, and classification of depression. It begins with a brief historical background on depression, tracing its origins to the classical term ‘melancholia’ that describes symptoms and signs now associated with modern concepts of the condition. It then considers the phenomenology of the modern experience of depression, its diagnosis in the operational scheme of ICD-10 (International Classification of Diseases, tenth edition), and current classificatory schemes. It looks at the symptoms needed to meet the criteria for ‘depressive episode’ in ICD-10, as well as clinical features of depression with ‘melancholic’ features or ‘somatic depression’ in ICD-10. It also presents an outline of the clinical assessment of an episode of depression before concluding with an overview of issues that need to be taken into account when addressing approaches to treatment, including cognitive behavioural therapy and the administration of antidepressants.


Genes ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 825
Author(s):  
Iacopo Ciampa ◽  
Grégory Operto ◽  
Carles Falcon ◽  
Carolina Minguillon ◽  
Manuel Castro de Moura ◽  
...  

This study investigated whether genetic factors involved in Alzheimer’s disease (AD) are associated with enlargement of Perivascular Spaces (ePVS) in the brain. A total of 680 participants with T2-weighted MRI scans and genetic information were acquired from the ALFA study. ePVS in the basal ganglia (BG) and the centrum semiovale (CS) were assessed based on a validated visual rating scale. We used univariate and multivariate logistic regression models to investigate associations between ePVS in BG and CS with BIN1-rs744373, as well as APOE genotypes. We found a significant association of the BIN1-rs744373 polymorphism in the CS subscale (p value = 0.019; OR = 2.564), suggesting that G allele carriers have an increased risk of ePVS in comparison with A allele carriers. In stratified analysis by APOE-ε4 status (carriers vs. non-carriers), these results remained significant only for ε4 carriers (p value = 0.011; OR = 1.429). To our knowledge, the present study is the first suggesting that genetic predisposition for AD is associated with ePVS in CS. These findings provide evidence that underlying biological processes affecting AD may influence CS-ePVS.


2021 ◽  
Vol 8 (1) ◽  
pp. e000759
Author(s):  
Daniel Higbee ◽  
Raquel Granell ◽  
Esther Walton ◽  
Roxanna Korologou-Linden ◽  
George Davey Smith ◽  
...  

RationaleLarge retrospective case-control studies have reported an association between chronic obstructive pulmonary disease (COPD), reduced lung function and an increased risk of Alzheimer’s disease. However, it remains unclear if these diseases are causally linked, or due to shared risk factors. Conventional observational epidemiology suffers from unmeasured confounding and reverse causation. Additional analyses addressing causality are required.ObjectivesTo examine a causal relationship between COPD, lung function and Alzheimer’s disease.MethodsUsing two-sample Mendelian randomisation, we used single nucleotide polymorphisms (SNPs) identified in a genome wide association study (GWAS) for lung function as instrumental variables (exposure). Additionally, we used SNPs discovered in a GWAS for COPD in those with moderate to very severe obstruction. The effect of these SNPs on Alzheimer’s disease (outcome) was taken from a GWAS based on a sample of 24 807 patients and 55 058 controls.ResultsWe found minimal evidence for an effect of either lung function (OR: 1.02 per SD; 95% CI 0.91 to 1.13; p value 0.68) or liability for COPD on Alzheimer’s disease (OR: 0.97 per SD; 95% CI 0.92 to 1.03; p value 0.40).ConclusionNeither reduced lung function nor liability COPD are likely to be causally associated with an increased risk of Alzheimer’s, any observed association is likely due to unmeasured confounding. Scientific attention and health prevention policy may be better focused on overlapping risk factors, rather than attempts to reduce risk of Alzheimer’s disease by targeting impaired lung function or COPD directly.


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