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Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial
Among older men in Denmark, the incidence of death from any cause at a median follow-up of 5.6 years was not significantly lower among those randomly invited to undergo screening for subclinical cardiovascular disease.
Journal Article
Alzheimer's disease : a difficult diagnosis
An introduction to the medical background and effects of Alzheimer's disease.
Book
New evidence on the management of Lewy body dementia
Dementia with Lewy bodies and Parkinson's disease dementia, jointly known as Lewy body dementia, are common neurodegenerative conditions. Patients with Lewy body dementia present with a wide range of cognitive, neuropsychiatric, sleep, motor, and autonomic symptoms. Presentation varies between patients and can vary over time within an individual. Treatments can address one symptom but worsen another, which makes disease management difficult. Symptoms are often managed in isolation and by different specialists, which makes high-quality care difficult to accomplish. Clinical trials and meta-analyses now provide an evidence base for the treatment of cognitive, neuropsychiatric, and motor symptoms in patients with Lewy body dementia. Furthermore, consensus opinion from experts supports the application of treatments for related conditions, such as Parkinson's disease, for the management of common symptoms (eg, autonomic dysfunction) in patients with Lewy body dementia. However, evidence gaps remain and future clinical trials need to focus on the treatment of symptoms specific to patients with Lewy body dementia.
Journal Article
Handbook of atypical parkinsonism
\"Improved diagnostic sophistication is increasingly enabling neurologists to differentiate between Parkinson's disease and other atypical parkinsonism (AP), such as multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies. The Handbook of Atypical Parkinsonism is a comprehensive survey of all diseases of this category, providing an authoritative guide to the recognition, diagnosis and management of these disorders. Each chapter follows a common structure, commencing with the full basic science of the disorder under consideration, followed by descriptions of the clinical picture and differential diagnosis. Subsequent chapters discuss current and future therapeutic approaches to these difficult conditions. Written and edited by leading practitioners in the field, clinicians in neurology and other specialties will find this book essential to the understanding and diagnosis of this complex group of disorders\"--Provided by publisher.
Book
Diagnosis and Therapeutic Management of Extra-Intestinal Manifestations of Inflammatory Bowel Disease
Extra-intestinal manifestations (EIMs) are reported frequently in patients with inflammatory bowel disease (IBD) and may be diagnosed before, concurrently or after the diagnosis of IBD. EIMs in IBD may be classified based on their association with IBD disease activity. The first group has a direct relationship with the activity of the bowel disease and includes pauciarticular arthritis, oral aphthous ulcers, erythema nodosum and episcleritis. The second group of EIMs appears to follow an independent course from the underlying bowel disease activity and include ankylosing spondylitis and uveitis. The third group includes EIMs that may or may not be related to intestinal inflammation, such as pyoderma gangrenosum and probably primary sclerosing cholangitis (PSC). Genetic susceptibility, aberrant self-recognition and immunopathogenic autoantibodies against organ-specific cellular antigens shared by the colon and extra-colonic organs may contribute to the pathogenesis and development of these EIMs. The use of biological agents in the IBD armamentarium has expanded the treatment options for some of the disabling EIMs and these agents form the cornerstone in managing most of the disabling EIMs. PSC is one of the most common hepatobiliary manifestations associated with IBD in which no clear treatment options exist other than endoscopic therapy and liver transplantation. Future research targeting the pathogenesis, early diagnosis and treatment of these EIMs is required.
Journal Article
Intelligent computing applications for COVID-19 : predictions, diagnosis, and prevention
\"Accurate estimation, diagnosis, and prevention of COVID-19 is a global challenge for healthcare organizations. Innovative measures can introduce and implement AI, and Mathematical Modeling applications. This book provides insight into the recent advances of applications, statistical methods, and mathematical modeling for the healthcare industry. This book covers the state-of-the-art applications of AI and Machine Learning in past epidemics, pandemics, and COVID-19. It offers recent global case studies, and discusses how AI and statistical methods, initiatives, and applications such as Machine Learning, Deep Learning, Correlation and Regression Analysis play a major role in the prediction, diagnosis, and prevention of a pandemic. It will also focus on how AI and statistical applications can facilitate and restructure the healthcare system. This book is written for Researchers, Students, Professionals, Executives, and the general public\"-- Provided by publisher.
Book
Testing and controlling for horizontal pleiotropy with probabilistic Mendelian randomization in transcriptome-wide association studies
Integrating results from genome-wide association studies (GWASs) and gene expression studies through transcriptome-wide association study (TWAS) has the potential to shed light on the causal molecular mechanisms underlying disease etiology. Here, we present a probabilistic Mendelian randomization (MR) method, PMR-Egger, for TWAS applications. PMR-Egger relies on a MR likelihood framework that unifies many existing TWAS and MR methods, accommodates multiple correlated instruments, tests the causal effect of gene on trait in the presence of horizontal pleiotropy, and is scalable to hundreds of thousands of individuals. In simulations, PMR-Egger provides calibrated type I error control for causal effect testing in the presence of horizontal pleiotropic effects, is reasonably robust under various types of model misspecifications, is more powerful than existing TWAS/MR approaches, and can directly test for horizontal pleiotropy. We illustrate the benefits of PMR-Egger in applications to 39 diseases and complex traits obtained from three GWASs including the UK Biobank.
Transcriptome-wide association studies integrate GWAS and transcriptome data to examine the molecular mechanisms underlying disease etiology. Here the authors present PMR-Egger, a powerful TWAS method based on probabilistic Mendelian Randomization.
Journal Article
Bitten : the secret history of lyme disease and biological weapons
\"A riveting thriller reminiscent of The Hot Zone, this true story dives into the mystery surrounding one of the most controversial and misdiagnosed conditions of our time--Lyme disease--and of Willy Burgdorfer, the man who discovered the microbe behind it, revealing his secret role in developing bug-borne biological weapons, and raising terrifying questions about the genesis of the epidemic of tick-borne diseases affecting millions of Americans today. While on vacation on Martha's Vineyard, Kris Newby was bitten by an unseen tick. That one bite changed her life forever, pulling her into the abyss of a devastating illness that took ten doctors to diagnose and years to recover: Newby had become one of the 300,000 Americans who are afflicted with Lyme disease each year. As a science writer, she was driven to understand why this disease is so misunderstood, and its patients so mistreated. This quest led her to Willy Burgdorfer, the Lyme microbe's discoverer, who revealed that he had developed bug-borne bioweapons during the Cold War, and believed that the Lyme epidemic was started by a military experiment gone wrong. In a superb, meticulous work of narrative journalism, Bitten takes readers on a journey to investigate these claims, from biological weapons facilities to interviews with biosecurity experts and microbiologists doing cutting-edge research, all the while uncovering darker truths about Willy. It also leads her to uncomfortable questions about why Lyme can be so difficult to both diagnose and treat, and why the government is so reluctant to classify chronic Lyme as a disease. A gripping, infectious page-turner, Bitten will shed a terrifying new light on an epidemic that is exacting an incalculable toll on us, upending much of what we believe we know about it\"-- Provided by publisher.
Book
Thyroid Function Affects the Risk of Stroke via Atrial Fibrillation: A Mendelian Randomization Study
Abstract
Context
Observational studies suggest that variations in normal range thyroid function are associated with cardiovascular diseases. However, it remains to be determined whether these associations are causal or not.
Objective
To test whether genetically determined variation in normal range thyroid function is causally associated with the risk of stroke and coronary artery disease (CAD) and investigate via which pathways these relations may be mediated.
Design, Setting, and Participants
Mendelian randomization analyses for stroke and CAD using genetic instruments associated with normal range thyrotropin (TSH) and free thyroxine levels or Hashimoto’s thyroiditis and Graves’ disease. The potential mediating role of known stroke and CAD risk factors was examined. Publicly available summary statistics data were used.
Main Outcome Measures
Stroke or CAD risk per genetically predicted increase in TSH or FT4 levels.
Results
A 1 standard deviation increase in TSH was associated with a 5% decrease in the risk of stroke (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.91-0.99; P = 0.008). Multivariable MR analyses indicated that this effect is mainly mediated via atrial fibrillation. MR analyses did not show a causal association between normal range thyroid function and CAD. Secondary analyses showed a causal relationship between Hashimoto’s thyroiditis and a 7% increased risk of CAD (OR, 1.07; 95% CI, 1.01-1.13; P = 0.026), which was mainly mediated via body mass index.
Conclusion
These results provide important new insights into the causal relationships and mediating pathways between thyroid function, stroke, and CAD. We identify variation in normal range thyroid function and Hashimoto’s thyroiditis as risk factors for stroke and CAD, respectively.
Journal Article