Treatment Of MD Research Articles

The genomic landscape of Ménière's disease: a path to endolymphatic hydrops

BackgroundMénière's disease (MD) is a disorder of the inner ear that causes episodic bouts of severe dizziness, roaring tinnitus, and fluctuating hearing loss. To date, no targeted therapy exists. As such, we have undertaken a large whole genome sequencing study on carefully phenotyped unilateral MD patients with the goal of gene/pathway discovery and a move towards targeted intervention. This study was a retrospective review of patients with a history of Ménière's disease. Genomic DNA, acquired from saliva samples, was purified and subjected to whole genome sequencing.ResultsStringent variant calling, performed on 511 samples passing quality checks, followed by gene-based filtering by recurrence and proximity in molecular interaction networks, led to 481 high priority MD genes. These high priority genes, including MPHOSPH8, MYO18A, TRIOBP, OTOGL, TNC, and MYO6, were previously implicated in hearing loss, balance, and cochlear function, and were significantly enriched in common variant studies of hearing loss. Validation in an independent MD cohort confirmed 82 recurrent genes. Pathway analysis pointed to cell–cell adhesion, extracellular matrix, and cellular energy maintenance as key mediators of MD. Furthermore, the MD-prioritized genes were highly expressed in human inner ear hair cells and dark/vestibular cells, and were differentially expressed in a mouse model of hearing loss.ConclusionBy enabling the development of model systems that may lead to targeted therapies and MD screening panels, the genes and variants identified in this study will inform diagnosis and treatment of MD.

Intestinal obstruction secondary to perforation of Meckel’s diverticulum caused by dentures: a case report and review of literature

BackgroundMeckel’s diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. However, MD is rare in clinical practice, and perforation of a MD by a foreign body is even rarer. Preoperative diagnosis is difficult because there is often insufficient information; therefore it is usually diagnosed intraoperatively. Although rare, it should be considered as a differential diagnosis in patients who have ingested foreign bodies.Case presentationThe following is the case of a 52-year-old female patient who was admitted because of generalized abdominal pain for 5 days, related to nausea and vomiting. She also stopped passing gas. Inflammatory indicators were elevated, and computed tomography (CT) revealed gas–liquid levels in the small intestine and high-density objects in the ileum. Based on the patient’s condition, laparotomy was performed instead because the laparoscopic procedure was difficult to perform. Intraoperatively, a foreign body perforated the diverticulum of the terminal ileum, resulting in the development of an abdominal abscess. Finally, we performed resection of the ileal diverticula and partial resection of the ileum. After the surgery, it was confirmed that the foreign bodies were two dentures accidentally eaten by the patient.ConclusionA thorough understanding of the clinical presentation, imaging features, and treatment of MD and its complications will assist clinicians in making prompt and accurate diagnoses and providing symptomatic treatment.

ANALYSIS OF SURGICAL TREATMENT OF CRYPTORCHIDISM IN EARLY AGE CHILDREN

ANALYSIS OF SURGICAL TREATMENT OF CRYPTORCHIDISM IN EARLY AGE CHILDREN Iurii Danilenko Md, children surgeon, tutor of S.Tentishev memorial Asian Medical Institute Kant city, Kyrgyzstan, Surgery department, Kyrgyzstan, Bishkek Anara Abdr

Arresting the pain syndrome after biopsy collection in oral mucosal diseases

Relevance. Diagnosis of oral mucosa diseases is very difficult. Heterogeneity of the oral mucosa disease manifestation often requires invasive diagnostic methods, which cause the pain syndrome. Timely and complete pain syndrome relief and the impact on all phases of the w ound healing process allow faster patient rehabilitation. The study aimed to examine the effect of Ketanov MD and Cifran CT on the wound process and the pain syndrome intensity after incisional and excisional biopsies to verify the oral mucosa pathology. Materials and methods. The study surveyed 30 people with oral mucosal diseases. The patients (30 subjects) formed two groups: excisional (10 people) and incisional biopsy (20 people). In these groups, we clinically evaluated the course of the wound process, the pain syndrome intensity, oedema phenomena, hyperemia, and the exudate presence. We analysed the quality of life of such patients using a validated Russian v ersion of the questionnaire.Results. On the 3rd day after the biopsy, on top of the generally accepted treatment of oral mucosal diseases and Ketorol MD and Cifran CT intake, the patients noted moderate aching and discomfort when talking and eating. After 14 days, all patients showed an improvement in qualitative and quantitative parameters, the absence of pain and the development of reinfection on therapy with non-steroidal anti-inf lammatory and antibacterial drugs.Conclusion. These drugs have a positive effect on the course of the phases of the wound process. They help reduce the pain response and contribute to faster patient rehabilitation af ter the biopsies in oral mucosal diseases.

Madelung's Disease: Analysis of Clinical Characteristics, Fatty Mass Distribution, Comorbidities and Treatment of 54 Patients in China.

PurposeMadelung’s disease (MD) is a rare disease characterized by the deposition of unencapsulated fat masses on the face, neck, chest, back and other areas of patients. The aim of the study was to analyze the clinical characteristics, comorbidities and treatment of MD in Chinese populations.Patients and MethodsWe retrospectively reviewed the medical records of 54 patients who were diagnosed with MD at the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital from January 2005 to February 2021 and collected the subjects’ demographic information, clinical indicators, location of fat deposits, treatment, complications and prognostic data.ResultsAmong 54 MD patients in the study, only 1 (1.85%) was female, and the subjects had an average age of 56.65 ± 7.93 years. More than 70% of patients had a history of long-term smoking or/and alcohol abuse. In our study, type I accounted for approximately 61.11% of cases according to Donhauser’s classification, and almost all patients had neck fat deposition. MD patients often have multiple comorbidities across several systems, such as the endocrine, digestive, circulatory, urinary, and neurological systems. Among these, endocrine system diseases were the most common comorbidities in our study, accounting for 81.48%. Notably, up to 20.37% of cases were complicated with cancer, especially digestive system tumors. More than 70% of the patients received surgical treatment, and nearly 40% experienced postoperative recurrence.ConclusionConsidering that MD patients often have comorbidities of multiple systems and that a small number of cases are even complicated by cancer, we recommend that clinicians comprehensively assess a patient’s condition and complications, advocate that patients quit consuming alcohol and smoking as soon as possible, establish healthy dietary and living habits, and formulate individualized and comprehensive diagnosis and treatment plans.

770 Mondor's Disease: A Rare Presentation of Inflammatory Bowel Disease

Abstract Introduction Mondor's Disease (MD) is a rare condition characterised by thrombophlebitis of the superficial veins of the breast and anterior chest wall. Cases associated with inflammatory bowel disease are rare. Case A 54-year-old male presented to the symptomatic breast clinic with a 6-week history of a painful linear area on the anterolateral aspect of his left chest wall. There was no history of trauma or underlying coagulopathy. He also described increased stool frequency and crampy abdominal pain. On clinical examination, superficial thrombophlebitis with cording was noted along the outer upper quadrant of the chest wall. His past medical history included a previous diagnosis of ulcerative colitis, with no pharmacological treatment. He was subsequently referred to a gastroenterologist and all symptoms resolved following management of his underlying colitis. Discussion This gentleman’s thrombophlebitis followed the course of the thoracoepigastric vein. The occurrence of thromboembolic events has been documented in association with an exacerbation of ulcerative colitis; however, literature describing MD is scarce. The underlying aetiology is reportedly due to the hypercoagulable state identified in ulcerative colitis. There is a lack of consensus on the treatment of MD, however cases have responded well to the management of the precipitating colitis. Low molecular weight heparin can be used if chronicity ensues. Surgical management is not recommended. Conclusions MD is a rare presentation of ulcerative colitis. Clinicians should be aware of underlying aetiologies and a potential hypercoagulable state. Such cases in relation to UC require early diagnosis and treatment of underlying colitis.

Acute abdomen in children due to different presentations of complicated Meckel\u2019s diverticulum: a case series

BackgroundMeckel’s diverticulum (MD) is the commonest congenital abnormality of the gastrointestinal tract that occurs in 2% of general population. It remains asymptomatic, but it may lead to life-threatening complications. These complications may be misdiagnosed with other gastrointestinal disorders like acute appendicitis, making its diagnosis challenging among pediatricians and pediatric surgeons. In this study, we reported five cases with different presentations of complicated MD in children.ResultsFive patients with different presentations of MD were reported during the period from January 2016 to January 2020. Patients’ demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed.ConclusionsThe present study highlights different presentations of MD. Surgical interference is the main key of treatment of symptomatic MD either by wedge resection of a small base diverticulum or by resection anastomosis of the small intestine in wide base and inflamed diverticulum.

Clinical Effect of Single-Site Laparoscopy in the Treatment of Meckel's Diverticulum in Children

Purpose: To observe the clinical effect of laparoscopic surgery on Meckel's diverticulum in children with (MD). Method: The clinical data of 20 children were analyzed retrospectively. All children were treated with laparoscopic surgery at single part of the umbilical cord, and the operation, clinical effects and postoperative complications were observed. Result: All the 20 children completed the operation successfully, and the operation time was 50. 5%. 2 ±5. 4) there were no complications such as abdominal pain, abdominal distension, vomiting, bleeding, intestinal adhesion obstruction, intestinal stricture and intestinal anastomotic fistula during and after min,. During the follow-up of 1 ~ 26 months, all the children ate and defecated normally and there was no recurrence. Conclusion: Umbilical laparoscopy is effective in the treatment of pediatric MD with less trauma, simple operation, short operation time and quick recovery after operation. Background Meckel's diverticulum is the most common congenital developmental malformation of the gastrointestinal tract, which is a mesenteric malformation caused by embryonic yolk tube degeneration. The incidence in the population is 2.0%, most patients have no clinical symptoms, occasionally found in autopsy, laparotomy, clinical diagnosis is more difficult. The clinical manifestations of its complications are easy to be confused with other diseases such as intussusception, colonic polyps, necrotizing enteritis and acute appendicitis perforation. Date sources Based on the progress in the treatment of Meckel's diverticulum in children at home and abroad, the clinical data of 20 children with Meckel's diverticulum treated in our hospital were analyzed retrospectively to observe the clinical effect of laparoscopy-assisted operation in the treatment of Meckel's diverticulum in children. Results All the 20 children completed the operation successfully, and the operation time was 50. 5%. 2 ±5. 4) there were no complications such as abdominal pain, abdominal distension, vomiting, bleeding, intestinal adhesion obstruction, intestinal stricture and intestinal anastomotic fistula during and after min,. During the follow-up of 1 ~ 26 months, all the children ate and defecated normally and there was no recurrence. Conclusions Surgical resection is the first choice for symptomatic Meckel diverticulum in children, and laparoscopic surgery is the first choice. The operative method of laparoscopic treatment of Meckel diverticulum in children with single part of umbilical cord has the advantages of less trauma, simple operation, short operation time and quick recovery after operation, and the operative effect is good.

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review.

Meniere's disease (MD) is a set of uncommon disorders with core phenotype of tinnitus, episodic vertigo, and sensorineural hearing loss. MD shows a genetic predisposition and a family history is found in 10% cases, with an autosomal dominant inheritance pattern. It is a multifactorial condition whose onset and development are triggered by the combined effect of genetic and environmental factors. Histopathological studies have associated MD with the accumulation of endolymph in the cochlea and the vestibular organs. However, endolymphatic hydrops does not fully explain the persistence of tinnitus, hearing loss progression, or the frequency of vertigo attacks.There are several comorbidities associated with MD, such as migraine, anxiety, autoimmune, and autoinflammatory disorders, adding more complexity to the phenotype. This "extended phenotype" can make the diagnosis and clinical management more complex, but it could also lead to a better characterization, understanding, and treatment of MD patients.We have conducted a systematic review on MD to update current knowledge, focusing on its mechanisms, diagnosis, comorbidities, and practical management.

Quality of health care with regard to detection and treatment of mental disorders in patients with coronary heart disease (MenDis-CHD): study protocol

BackgroundMental disorders (MD), such as depression, anxiety, and cognitive impairment, are highly prevalent in patients with coronary heart disease (CHD). Current guidelines on cardiovascular diseases recommend screening and appropriate treatment of MD; however, the degree of implementation of such recommendations in clinical practice is unknown. This study aims to analyze the quality of health care of patients with CHD and MD. Specifically, we aim to analyze (1) the quality of care, (2) trajectories of care, and (3) barriers regarding the detection and treatment of MD. Moreover, we want to identify potentials of changes in health care delivery towards more patient-centered care. The results of this study shall be the first step towards value-based care of people with CHD and comorbid mental disorders.MethodsWe aim to include the following participants: adult patients with CHD (n = 400), their relatives (n = 350) and physicians (n = 80). A particular focus will be on the vulnerable subgroups of patients with CHD and congestive heart failure (left ventricular ejection fraction < 40%) and on the underrepresented group of women with CHD. We will apply a mixed-method approach with a quantitative and a qualitative part.Patient-related outcomes (e.g., health-related quality of life, needs, and preferences regarding health care, reasons for non-detection, and lack of treatment of MD) will be explored in a multi-perspective approach including patients, relatives, and physicians’ perspectives. Furthermore, routine data from four statutory health insurance funds (SHI) will be analyzed regarding the frequency and treatment of MD in CHD patients.DiscussionMenDis-CHD will provide important insights into the trajectories of health care, quality of health care, barriers, patient needs and preferences as well as expectations and satisfaction with health care in patients with CHD and MD. Potential implications of MenDis-CHD are to enable health care providers to redesign care pathways concerning the treatment of mental comorbidity in patients with CHD by proposing value-based changes in health care and by understanding the barriers to and facilitators of change towards patient-centered care.Trials registrationGerman clinical trials register (Deutsches Register Klinischer Studien, DRKS) ieRegistration Number: DRKS00012434, date of registration: May 11th, 2017.

Muscle Dysmorphia: An Overview of Clinical Features and Treatment Options.

An increasing public and empirical focus on male body image indicates that muscularity is a preeminent concern among boys and men. For some, these concerns develop into a complex and disabling psychiatric disorder termed muscle dysmorphia (MD), the hallmark of which is an intense preoccupation regarding one's (subjectively) insufficient muscularity. Treatment of MD is critical; however, evidence to inform treatment approaches is sorely lacking. The purpose of this article is twofold. First, we provide an overview of the clinical features of MD, drawing particular attention to the preoccupation, functional impairment and psychiatric comorbidity associated with the disorder. Second, we discuss and recommend potential treatment directions for MD, including techniques that have demonstrated efficacy in the treatment of related disorders, namely, body dysmorphic disorder and eating disorders (and anorexia nervosa in particular). Psychotherapeutic techniques, including cognitive restructuring of deleterious perfectionistic and egosyntonic beliefs, and dialectical behavioral techniques to improve the repertoire of emotion regulation skills available to afflicted individuals, are discussed, in addition to psychopharmacological approaches.

Electroencephalographic changes following trigeminal nerve stimulation for major depressive disorder: study protocol for a randomized sham-controlled trial

Background: Major depressive disorder (MDD) is one of the most common psychiatric disorders. Trigeminal nerve stimulation (TNS) is a novel neuromodulation technology with impressive initial results in the treatment of MDD that lacks a better evaluation of neurobiological mechanisms of action. Methods/Design: This is a two-arm, randomized, double-blind, sham-controlled trial to evaluate the effect of TNS on severe MDD through quantitative electroencephalography (QEEG) pre and post intervention. Forty-four patients diagnosed with severe MDD will be randomly assigned to either a 10-session treatment protocol of real TNS or a 10-session treatment protocol of sham TNS. Outcome measures will be evaluated at baseline, at the end of the stimulation protocol and 30 days after the end of the 10-day treatment period. The primary outcome is changes in the previously established frequency band ranges in QEEG during resting state. The secondary outcome is heart rate variability for better evaluation of the sympathetic and parasympathetic changes after TNS. Discussion: Due to the high prevalence of MDD, the limited effect of antidepressant medications, the high rate of intolerable adverse events, and the high rate of refractoriness, we believe non-invasive neuromodulation strategies, e.g., TNS can be a useful tool for the treatment of MD. The evaluation of the effect of TNS with QEEG before and after stimulation may help us clarify the mechanisms involved in the clinical responses. Trial registration: ClinicalTrials.gov identifier: NCT02562703, registered on 25 September 2015. Ethics: This study protocol has been approved by the institutional review board (IRB) (approval number: 30960814.7.0000.5479) and will be performed in accordance with the Declaration of Helsinki. Informed consent: Patients will sign an informed consent prior to participation in the study.

A local complement response by RPE causes early-stage macular degeneration.

Inherited and age-related macular degenerations (AMDs) are important causes of vision loss. An early hallmark of these disorders is the formation of sub-retinal pigment epithelium (RPE) basal deposits. A role for the complement system in MDs was suggested by genetic association studies, but direct functional connections between alterations in the complement system and the pathogenesis of MD remain to be defined. We used primary RPE cells from a mouse model of inherited MD due to a p.R345W mutation in EGF-containing fibulin-like extracellular matrix protein 1 (EFEMP1) to investigate the role of the RPE in early MD pathogenesis. Efemp1(R345W) RPE cells recapitulate the basal deposit formation observed in vivo by producing sub-RPE deposits in vitro. The deposits share features with basal deposits, and their formation was mediated by EFEMP1(R345W) or complement component 3a (C3a), but not by complement component 5a (C5a). Increased activation of complement appears to occur in response to an abnormal extracellular matrix (ECM), generated by the mutant EFEMP1(R345W) protein and reduced ECM turnover due to inhibition of matrix metalloproteinase 2 by EFEMP1(R345W) and C3a. Increased production of C3a also stimulated the release of cytokines such as interleukin (IL)-6 and IL-1B, which appear to have a role in deposit formation, albeit downstream of C3a. These studies provide the first direct indication that complement components produced locally by the RPE are involved in the formation of basal deposits. Furthermore, these results suggest that C3a generated by RPE is a potential therapeutic target for the treatment of EFEMP1-associated MD as well as AMD.

Progress in Sonothrombolysis for the Treatment of Stroke

In 1974, Sobbe et al1 applied 26.5-kHz ultrasound (US) to recanalize thrombosed iliofemoral arteries in dogs with minimal complications. These pioneer efforts were followed by studies showing that catheter-based or transcutaneous US can enhance the effect of fibrinolytic agents in recanalizing thrombosed arteries,2–8 thus paving the way for first clinical studies evaluating the adjunct effect of US in treating patients with ischemic stroke. ### Mechanisms #### US Thrombolysis Despite numerous studies documenting a thrombolytic effect of US, the mechanisms remain poorly understood. Inertial cavitation (ie, the formation and violent collapse of gas-filled bubbles in a fluid exposed to US) gave rise to transient microjets that disintegrate thrombus mechanically.9 Stable cavitation (ie, sustainable nonlinear periodic contraction or expansion of a gas body or bubble) may be more effective than inertial cavitation in clot lysis.10 US also facilitates penetration of fibrinolytic drugs into the thrombus and binding to fibrin.11 This is because US promotes the motion of fluids around the clot surface through a process called microstreaming. Moreover, pressure waves may increase the permeation of tissue-type plasminogen activator (tPA) into the interior of the fibrin network.12 Heating is uniformly present in tissue exposed to US but has been deemed too mild to explain thrombolytic effects. #### Microbubble-Enhanced Thrombolysis With tPA Significant amplification of lysis occurs with the addition of microbubbles to the combination of thrombolytic drug and US.13–15 Microbubbles, composed of lipid, albumin, or galactose shells and ranging in size from 0.5 to 5 μm, lower the threshold for thrombolysis by providing a pre-existing bubble that easily can be made to cavitate by US. Stable cavitation can produce microstreaming in the area and dramatically enlarge the bubble momentarily. This will cause localized mechanical stress on the adjacent clot. The surface of the clot will erode, and even penetration and numerous microscopic …

Bleeding Meckel′s diverticulum diagnosed and treated by double-balloon enteroscopy

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal (GI) tract. The diagnosis of symptomatic MD has been cumbersome. Several case reports been published regarding direct visualization of MD with double balloon enteroscopy (DBE); diagnosing a bleeding MD leading to surgical resection. We report the use of DBE for the treatment of a bleeding MD.

Pentostatin for treatment of refractory autoimmune lymphoproliferative syndrome

Pediatric Blood & CancerVolume 58, Issue 2 p. 311-311 Letter to the Editor Pentostatin for treatment of refractory autoimmune lymphoproliferative syndrome Rajinder Bajwa MD, MRCP, Corresponding Author Rajinder Bajwa MD, MRCP rajinder.bajwa@nationwidechildrens.org Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OhioDepartment of Hematology/Oncology/BMT, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205.===Search for more papers by this authorStephanie Savelli MD, Stephanie Savelli MD Children's Hospital Medical Center of Akron, One Perkins Square, Akron, OhioSearch for more papers by this authorThomas Gross MD, PhD, Thomas Gross MD, PhD Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OhioSearch for more papers by this author Rajinder Bajwa MD, MRCP, Corresponding Author Rajinder Bajwa MD, MRCP rajinder.bajwa@nationwidechildrens.org Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OhioDepartment of Hematology/Oncology/BMT, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205.===Search for more papers by this authorStephanie Savelli MD, Stephanie Savelli MD Children's Hospital Medical Center of Akron, One Perkins Square, Akron, OhioSearch for more papers by this authorThomas Gross MD, PhD, Thomas Gross MD, PhD Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OhioSearch for more papers by this author First published: 14 June 2011 https://doi.org/10.1002/pbc.23218Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume58, Issue2February 2012Pages 311-311 RelatedInformation

Myotomy After Previous Coronary Artery Bypass Grafting for Treatment of Myocardial Bridging

A 57-year-old man with a long history of frequent chest pain was admitted to our cardiac center. Four years ago, he underwent coronary artery bypass grafting (CABG) with the left internal mammary artery (LIMA) to the distal segment of the left anterior descending coronary artery (LAD) grafting for myocardial bridging (MB) in LAD despite having β-blockers and calcium channel blockers. However, the patient still had recurrent angina within 3 months after the operation. ECG showed negative T wave in leads V1 and V2. On echocardiography, left ventricular ejection fraction was 60% with normal regional wall motion. The repeat coronary angiography showed a MB in the proximal LAD about 3 cm in length with 90% systolic narrowing of the LAD, and the LIMA graft was totally occluded (Figure 1A through 1C). The …

Statins in the Treatment of Heart Failure

The 3-hydroxy-3-methylglutaryl coenzyme-A inhibitors or statins have been shown to reduce morbidity and mortality in patients with coronary artery disease or those at increased risk of coronary artery disease (Table). Consequently, statin therapy has become the cornerstone treatment in primary and secondary prevention of coronary artery disease for almost every patient category. However, the case for the use of statin therapy in the most advanced stage of the cardiovascular disease continuum, namely patients with chronic heart failure (CHF) has been disputed. Until recently, we simply lacked data …

W05-01 - Rationale and design of an RCT comparing “EMC-strategy” with TAU in patients with major depression - the EMC trial

IntroductionFor Major Depression, current guidelines recommend treatment durations of 3-8 weeks until optimisation in case of insufficient outcome. Many retrospective studies indicate that improvement (HAMD-17 decrease ≥20%) occurs usually within 10-14 days and that non-improvement after 14 days of treatment is highly predictive for poor clinical outcome.MethodsIn level 1 of the EMC trial, non-improvers after 14 days of antidepressant treatment will be randomised to “early medication change” (EMC) strategy or treatment according to current guidelines (TAU). EMC schedules treatment optimisations on day 15 and day 29 in case of non-improvement. TAU schedules a medication change after 28 days in case of non-response (HAMD-17 decrease &lt; 50%). Both interventions will last 42 days. In levels 2 and 3, EMC strategies will be compared with TAU strategies in improvers on day 14, who experience a stagnation of improvement during the course of treatment. The EMC trial is a multi-centre, multi-step, randomised controlled trial investigating for the first time prospectively, whether non-improvers after 14 days of antidepressant treatment with EMC are more likely to attain remission on treatment day 56 compared to patients with TAU. The trial is funded by the German Federal Ministry of Education and Research (BMBF), will be conducted in cooperation with the BMBF supported Interdisciplinary Centre for Clinical Trials (IZKS) Mainz and at six trial sites in Germany.Results/conclusionsIf the EMC strategy leads to significantly more remitters, consecutive revision of guidelines, clinical practice and research settings for the treatment of MD can be expected.

An open-label trial of levetiracetam for treatment of cervical dystonia

Movement DisordersVolume 21, Issue 5 p. 734-735 Letter to the Editors An open-label trial of levetiracetam for treatment of cervical dystonia Daniel Tarsy MD, Daniel Tarsy MD dtarsy@bidmc.harvard.edu Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this authorR. Kevin Ryan MD, R. Kevin Ryan MD Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this authorSusie I. Ro MD, Susie I. Ro MD Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this author Daniel Tarsy MD, Daniel Tarsy MD dtarsy@bidmc.harvard.edu Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this authorR. Kevin Ryan MD, R. Kevin Ryan MD Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this authorSusie I. Ro MD, Susie I. Ro MD Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this author First published: 28 March 2006 https://doi.org/10.1002/mds.20873Citations: 11Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume21, Issue5May 2006Pages 734-735 RelatedInformation