The "Gender factor" in wearing-off among patients with Parkinson’s disease: a post hoc analysis of DEEP study

Background. The early detection of wearing-off in Parkinson disease (DEEP) observational study demonstrated that women with Parkinson’s disease (PD) carry an increased risk (80.1%) for wearing-off (WO). This post hoc analysis of DEEP study evaluates gender differences onWO and associated phenomena. Methods. Patients on dopaminergic treatment for ≥1 year were included in this multicenter observational cross-sectional study. In a single visit, WO was diagnosed based on neurologist assessment as well as the use of the 19-item wearing-off questionnaire (WOQ-19);WO was defined for scores ≥2. Post hoc analyses were conducted to investigate gender difference for demographic and clinical features with respect toWO. Results. Of 617 patients enrolled, 236 were women and 381 were men. Prevalence of WO was higher among women, according to both neurologists’ judgment (61.9% versus 53.8%, P = 0.045) and theWOQ-19 analysis (72.5% versus 64.0%, P = 0.034). In patients withWO (WOQ-19), women experienced ≥1 motor symptom in 72.5% versus 64.0% in men and ≥1 nonmotor symptom in 44.5% versus 36.7%, in men. Conclusions. Our results suggestWO as more common among women, for both motor and nonmotor symptoms. Prospective studies are warranted to investigate this potential gender-effect

Hematopoietic stem cell transplantation for multiple sclerosis

Hematopoietic stem cell transplantation (HSCT) was proposed as a treatment for multiple sclerosis (MS) in 1995 based on favorable results in animal models including experimental autoimmune encephalomyelitis. These initial or first-generation trials were developed by medical oncology subspecialists, used malignancy-specific myeloablative transplantation regimens, and selected patients with secondary progressive MS with rapid progression of disability. In general, these trials suffered from higher than anticipated toxic reactions including treatment-related and disease-related mortality, continued loss of brain volume as seen on magnetic resonance imaging (MRI), and, at least in some patients, continued progressive disability despite marked attenuation or absence of gadolinium-enhancing lesions on MRI. Learning from these experiences, second-generation transplantation trials for MS are using MS-specific nonmyeloablative transplantation regimens and selecting for active relapses despite the use of interferon treatment in patients with less accumulated disability. While still preliminary, results using second-generation nonmyeloablati

Rajeunissement du sourire en orthodontie

Les adultes entreprennent de plus en plus souvent un traitement orthodontique dans le but de retrouver le sourire de leur 20 ans et d’atténuer les signes de vieillissement plus ou moins avancés et prononcés en fonction des dysmorphoses présentes. Les critères esthétiques dentaires recherchés et retrouvés chez les patients traités sont principalement : l’alignement dentaire, la blancheur et l’aspect lisse des dents et de leurs contours, la prédominance des incisives maxillaires, la ligne du sourire régulière et tangente à la lèvre inférieure, la largeur du sourire. Il faut ajouter à tous ces guides dentaires, l’impression de volume au niveau facial et de tension au niveau cutané. Le traitement d’orthodontie, en corrigeant les différentes malocclusions plus ou moins sévères, s’associe de manière efficace à d’autres disciplines pour reconstruire un sourire jeune et effacer les signes de vieillissement

Creating a younger smile through orthodontic treatment

More and more adults are beginning orthodontic treatment because they want to regain the smile they had when they were 20 years-old and to diminish the signs of aging their faces present to degrees that depend upon the severity of their dento-facial deformity. The dental esthetic criteria that are sought after and regained with treatment are, primarily straightening and whitening of teeth, and a smooth appearance of the teeth and their mutual contours, predominantly in the upper incisor area as well as a regular, broad smile line in harmony with the lower lip. In addition to these dental guide lines, additional important consideration should be taken of the relationship of the size and bulk of the teeth with respect to facial type and the absence of any strain in lip posture. Orthodontic treatment, in correcting malocclusions of varying severity, can effectively join with other specialties in creating a younger smile line for patients and eliminating many signs of aging

Efficacy and safety of laquinimod in multiple sclerosis: Current status

Laquinimod is a novel immunomodulatory agent, in development as a potential disease-modifying treatment for multiple sclerosis (MS). Structurally related to linomide, its pharmacological predecessor, laquinimod combines anti-inflammatory and possibly clinically relevant neuroprotective effects with the convenience of oral administration. In this review we aim to highlight the immunomodulatory and neuroprotective effects of laquinimod, and to describe its effects in animal models of MS. Furthermore, we focus on current results of clinical studies in MS. Randomized, controlled clinical trials in relapsing MS demonstrate a dose–response effect on disease activity, measured by reduced clinical relapse rate, reduced number of brain MRI active lesions, as well as on sustained disability and brain atrophy. Laquinimod has a favourable tolerability and safety profile. A new phase III study, recently completed, will soon provide further details on the therapeutic potential of this drug. Laquinimod is a promising emerging treatment for relapsing–remitting MS that may provide a new therapeutic option in the near future

Drugs in clinical development for multiple sclerosis: focusing on anti-CD20 antibodies

Introduction: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), traditionally considered to be an autoimmune disease. Despite the standard of care for patients with MS is significantly improved in recent years, there is still room for improvement in terms of effectiveness and also compliance.Areas covered: The continuous improvements of our understanding of the pathophysiological changes that occur in MS have translated into many novel therapeutic agents at different stages of development. A number of therapies for MS are in advanced development and likely to be available soon. Along with these, we have also seen the appearance of a group of drugs considered together as a consequence of their similar design: the monoclonal antibodies (mAbs). Here, the focus will be on reviewing results that have emerged from a better clarification of MS pathogenesis to clinical trials of different anti-CD20 mAbs.Expert opinion: The decision to switch established patients from well-known drugs to either new formulations or new agents will be made on balancing efficacy and tolerability of the existing treatments. Safety seems increasingly likely to become a key factor