scholarly journals Keep S’Myelin: World Brain Day 2021 Editorial for Residents and Junior Doctors Page—Neurology International MDPI

2021 ◽  
Vol 13 (3) ◽  
pp. 402-403
Author(s):  
Lakshini Gunasekera ◽  
Tissa Wijeratne
Keyword(s):  
Multiple Sclerosis ◽  
Junior Doctors ◽  
The World ◽  
World Brain

Every five minutes someone in the world is diagnosed with multiple sclerosis [...]

scholarly journals Ethical use of off-label disease-modifying therapies for multiple sclerosis

2021 ◽  
pp. 135245852110302
Author(s):  
Joanna Laurson-Doube ◽  
Nick Rijke ◽  
Anne Helme ◽  
Peer Baneke ◽  
Brenda Banwell ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
World Health ◽  
World Federation ◽  
Off Label ◽  
Disease Modifying Therapies ◽  
The World ◽  
Disease Modifying ◽  
Health Organization

Background: Off-label disease-modifying therapies (DMTs) for multiple sclerosis (MS) are used in at least 89 countries. There is a need for structured and transparent evidence-based guidelines to support clinical decision-making, pharmaceutical policies and reimbursement decisions for off-label DMTs. Objectives/Results: The authors put forward general principles for the ethical use of off-label DMTs for treating MS and a process to assess existing evidence and develop recommendations for their use. Conclusion: The principles and process are endorsed by the World Federation of Neurology (WFN), American Academy of Neurology (AAN), European Academy of Neurology (EAN), Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Middle-East North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS) and Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS), and we have regularly consulted with the Brain Health Unit, Mental Health and Substance Use Department at the World Health Organization (WHO).

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

2021 ◽  
pp. 104990912110069
Author(s):  
Ariane Lewis ◽  
Andrew Kumpfbeck ◽  
Jordan Liebman ◽  
Sam D. Shemie ◽  
Gene Sung ◽  
...  
Keyword(s):  
Brain Death ◽  
Legal Framework ◽  
Developing Regions ◽  
Healthcare Facilities ◽  
Life And Death ◽  
The World ◽  
Religious Perspectives ◽  
World Brain ◽  
The Creation ◽  
Death By Neurologic Criteria

There are varying medical, legal, social, religious and philosophical perspectives about the distinction between life and death. Death can be declared using cardiopulmonary or neurologic criteria throughout much of the world. After solicitation of brain death/death by neurologic criteria (BD/DNC) protocols from contacts around the world, we found that the percentage of countries with BD/DNC protocols is much lower in Africa than other developing regions. We performed an informal review of the literature to identify barriers to declaration of BD/DNC in Africa. We found that there are numerous medical, legal, social and religious barriers to the creation of BD/DNC protocols in Africa including 1) limited number of healthcare facilities, critical care resources and clinicians with relevant expertise; 2) absence of a political and legal framework codifying death; and 3) cultural and religious perspectives that present ideological conflict with the idea of BD/DNC, in particular, and between traditional and Western medicine, in general. Because there are a number of unique barriers to the creation of BD/DNC protocols in Africa, it remains to be seen how the World Brain Death Project, which is intended to create minimum standards for BD/DNC around the world, will impact BD/DNC determination in Africa.

scholarly journals World Brain Day 2021: a call to stop multiple sclerosis

2021 ◽  
Author(s):  
Tissa Wijeratne ◽  
Wolfgang Grisold ◽  
Peer Baneke ◽  
Anne Helme ◽  
Rachel King ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
World Brain

scholarly journals The internet racing ahead of the scientific evidence: the case of "liberation treatment" for multiple sclerosis

2011 ◽  
Vol 69 (3) ◽  
pp. 525-527 ◽  
Author(s):  
Yára Dadalti Fragoso
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Disease ◽  
Venous Insufficiency ◽  
Scientific Evidence ◽  
The Internet ◽  
Evidence Based ◽  
The World ◽  
Internet Discussion ◽  
The Central Nervous System ◽  
The Subject

Multiple sclerosis (MS) is a chronic neurological disease that typically affects young adults. A recent publication suggested that MS might originate from insufficient blood drainage in certain areas of the central nervous system. The condition was named chronic cerebrospinal venous insufficiency (CCSVI). Other papers have not confirmed these findings and, therefore, the matter remains controversial. Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter. No clinical trials have been carried out on the subject and there is no evidence-based indication to perform surgical vascular procedures in MS patients. However, over the same nineteen-month period, the internet discussion on the subject of CCSVI and MS has led to countless websites advertising treatment using vascular surgery for patients with MS all over the world. The treatment based on the CCSVI theory has appealingly been called "liberation treatment", thus making it difficult to explain to patients why a treatment that has been highly praised (on the internet) cannot be recommended based on partial medical results that await confirmation.

scholarly journals Epidemiological Evidence of the Recent Surge in MS in Asia and Australia: A Systematic Review

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Sharareh Eskandarieh ◽  
Mohammad Ali Sahraian
Keyword(s):  
Multiple Sclerosis ◽  
New Zealand ◽  
Incidence Rate ◽  
United Arab Emirates ◽  
Literature Search ◽  
Systematic Literature Search ◽  
Epidemiological Evidence ◽  
Male Ratio ◽  
The World ◽  
Lower Incidence Rate

Context: Recently, the incidence and prevalence of multiple sclerosis (MS) have increased drastically in different regions of the world, including Asia. The present study aimed to systematically review the recent MS epidemiology in Asia, New Zealand, and Australia. Methods: A systematic literature search was performed in Medline and Embase databases to retrieve the available studies regarding MS epidemiology in Asia, New Zealand, and Australia. Results: Most of the studies were performed in hospital settings. The female-to-male ratio in the sample populations varied from 1.5:1 in Turkey to 5:1 in Malaysia. The total mean age at the onset of MS varied from the minimum of 28 years in Hong Kong to the maximum of 36 years in the United Arab Emirates. Among 16 pertinent studies in this regard, seven addressed the incidence rate of MS, and 13 addressed the prevalence of the disease. The highest prevalence rate was reported to be respectively 124.2 and 148.06 in Australia and Iran versus 2.73 in Malaysia (06 per 100,000 population), while a higher incidence rate was estimated at 6.88 and 6.7 per 100,000 population in Kuwait and Australia, respectively compared to the lower incidence rate per 100,000 population in China (0.2 in females, 0.12 in males). Conclusions: According to the results, the prevalence of MS has increased in Asia, while the prevalence of MS in this continent is lower compared to the rates reported in Australia, Europe, and North America.

scholarly journals Clinical efficacy and safety of alemtuzumab in postmarketing practice

2019 ◽  
pp. 56-62
Author(s):  
N. V. Khachanova
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Events ◽  
Drug Efficacy ◽  
Safety Monitoring ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Treatment Benefit ◽  
Dosing Schedule ◽  
The World ◽  
Multiple Sclerosis Treatment

Clinical trials confirm alemtuzumab efficacy for multiple sclerosis treatment in terms of both conventional measures and combined criteria such as NEDA (no evidence of disease activity). However, established drug efficacy and convenient dosing schedule are balanced by the risk of serious adverse events. Therefore, it is necessary to inform physicians about the benefits of alemtuzumab therapy along with the pattern of its safety profile.The present review provides the analysis of alemtuzumab real-world studies in Europe, USA and other parts of the world. The information obtained can help physicians to prescribe and administer the drug properly and to perform effective safety monitoring for early detection of adverse events and saving the maximum treatment benefit for the patient.

scholarly journals Clinical audit on possible causes of hospital initiated clinic cancellations and recommendation to improve the service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S324-S324
Author(s):  
Tanzida Haque ◽  
Mosab Mohammed Jodat Ibrahim ◽  
Bapu Ravindranath
Keyword(s):  
Inner City ◽  
Clinical Audit ◽  
Significant Loss ◽  
Junior Doctors ◽  
Time Period ◽  
Cancellation Rate ◽  
The World ◽  
Patient Appointment ◽  
Training Opportunities ◽  
Changeover Period

AimsThe aim of this audit is to explore the possible causes of clinic cancellation in an inner city CMHT and the recommendation to reduce the burden.BackgroundCancellations of planned appointments have been a major and long-standing problem for healthcare organisations across the world. It represents a significant loss of revenue and waste of resources, have significant psychological, social and financial implications for patients and their families and represent a significant loss of training opportunities for trainees. Re-scheduling appointment is one of the major issues of inconvenience to the patients. It also increases workload for the patient appointment team.MethodData have been collected retrospectively from patient appointment booking team regarding clinic cancellation with causes of cancellation recorded in the system (01/07/2019–30/09/2019). The investigators have investigated if the cancellation has been made when it was absolutely necessary to cancel the clinic (Unavailability of doctors due to leave/on calls) and if patients have been informed at least 8 weeks prior to the appointed clinic as per trust protocol.ResultTotal number of 193 clinics were booked at the CMHT from July 2019 – September 2019. About 54% clinics were cancelled during the time period. The Clinic Cancellation rate was higher in September (68%) and was lowest in August (30.30%). As the month of July is the changeover period for trainees, the number of clinics booked during August was relatively less than normal. 72% clinics were cancelled by junior doctors and 28% clinics were cancelled by consultants at the CMHT. The major cause of clinic cancellation was unavailability of the junior doctors due to on call (31.58%) which was not communicated to the patient appointment booking team. Due to annual leave, 25% clinics were cancelled and 21% clinics were cancelled due to study leave. In both cases it is evident that, lack of communication between clinicians and patient appointment team are primarily responsible for hospital-initiated clinic cancellations. As per Patient Appointment booking team, around 50% cases, patients were informed 8 weeks in advance before cancelling the clinics.ConclusionThis is evident from this audit that the number of hospital-initiated clinic cancellations can be reduced by improving communication between Patient Appointment booking service, Medical staffing department and clinicians. The findings of the audit have been shared locally with CMHT managers, clinicians and with the patient appointment booking team.

Copernican Revolution in Physics and Cosmology: Vantage Point from beyond Earth

2018 ◽  
pp. 351-376
Author(s):  
Georg Northoff
Keyword(s):  
Philosophy Of Mind ◽  
Body Problem ◽  
Vantage Point ◽  
Logical Space ◽  
Copernican Revolution ◽  
The World ◽  
Pulling Forces ◽  
World Brain ◽  
Mind Body Problem ◽  
The Mind

Why do we so stubbornly cling to the assumption of mind? Despite the so far presented empirical, ontological, and conceptual-logical evidence against mind, the philosopher may nevertheless reject the world-brain problem as counter-intuitive. She/he will argue that we need to approach the question for the existence and reality of mental features in terms of the mind-body problem as it is more intuitive than the world-brain problem. Our strong adherence to mind is thus, at least in part, based on what philosophers describe as “intuition”, the “intuition of mind” as I say. How can we resist and escape the pulling forces of our “intuition of mind”? The main focus in this chapter and the whole final part is on the “intuition of mind” and how we can avoid and render it impossible. I will argue that we need to exclude the mind as possible epistemic option from our knowledge, i.e., the “logical space of knowledge”, as I say. The concept of “logical space of knowledge” concerns what we can access in our knowledge, i.e., our possible epistemic options that are included in the “logical space of knowledge”, as distinguished from what remains inaccessible to us, i.e., impossible epistemic options, as they are excluded from the “logical space of knowledge”. For instance, the “logical space of knowledge” presupposed in current philosophy of mind and specifically mind-body discussion includes mind as possible epistemic option while world-brain relation is excluded as impossible epistemic option. This, as I argue, provides the basis for our “intuition of mind” and the seemingly counterintuitive nature of world-brain relation. How can we modify and change the possible and impossible epistemic options in our “logical space of knowledge”? I argue that this is possible by shifting our vantage point or viewpoint - that is paradigmatically reflected in the Copernican revolution in cosmology and physics. Copernicus shifted the “vantage point from within earth” to a “vantage point beyond earth”; this enabled him to take into view that the earth (rather than the sun) moves by itself which provided the basis for his shift from a geo- to a helio-centric view of the universe. Hence, the shift in vantage point modified his epistemic options and thus expanded the presupposed “logical space of knowledge”. I conclude that we require an analogous shift in the vantage point we currently presuppose in philosophy of mind. This will expand our “logical space of knowledge” in such way that makes possible to include world-brain relation as possible epistemic option while, at the same time, excluding mind as impossible epistemic option. That, in turn, will render the world-brain problem more intuitive while the mind-body problem will then be rather counter-intuitive. Taken together, this amounts to nothing less than a Copernican revolution in neuroscience and philosophy – that shall be the focus in next chapter.

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