Use Of Pharmacological Interventions Research Articles

Pain management in cervical cancer.

Cervical cancer (CC) occupies the second place in incidence and mortality among women in México. Despite this, Cervical Cancer continues to have a late diagnosis which leads to a high rate of complications. Pain represents the most feared and disabling symptom, being present in up to 86% of patients with advanced disease. The approach to managing pain in this population has not been studied and described to a full extent. In addition, there is a pressing need to provide concise recommendations to promote adequate pain control. We performed a review of the literature in CC and had experts in the field of pain management evaluate the evidence found. We then issued relevant recommendations on pharmacology and interventional pain management. Thus, the approach to pain management must be comprehensive and individualized, considering the timely and appropriate use of pharmacologic treatment as well as interventional procedures.

Orexinergic Receptor Antagonists as a New Therapeutic Target to Overcome Limitations of Current Pharmacological Treatment of Insomnia Disorder.

Insomnia disorder is a common condition that is considered a risk factor for multiple physical and mental disorders, contributing to reduced quality of life and increased healthcare expenditures. Although cognitive behavioral therapy (CBT) is typically recommended as the primary intervention, its accessibility is hindered by limited resources, prompting the prevalent use of pharmacological interventions as the primary treatment in clinical settings. This study reviews the benefits and risks of current pharmacological treatments for insomnia, with special reference to the orexinergic system as a novel therapeutic target for treatment. The prescription of GABAergic mechanism enhancers (benzodiazepine (BZD) and "Z drugs") has shown efficacy in short-term insomnia treatment (less than 4 weeks), however, concerns arise regarding their long-term effectiveness, unfavorable tolerability and safety profiles, including the potential for dependency. Drugs with antihistamine properties, including certain antidepressants and antipsychotics, exhibit short-term efficacy but have documented tolerability limitations, especially in the elderly. The use of melatonin, available in various formulations, lacks comprehensive long-term data. Dual orexin receptor antagonists (DORAs) such as daridorexant, lemborexant, and suvorexant, represent a novel approach to insomnia treatment by inhibiting wakefulness rather than enhancing sedation. As the only DORA approved for insomnia treatment by the European Medicines Agency (EMA) and Food and Drug Administration (FDA), daridorexant has demonstrated sustained efficacy over a 12-month period, improving nocturnal sleep parameters and daytime functionality, with a favorable safety and tolerability profile.

Evaluation of the Protoscolicidal Activity of Humulus lupulus Methanolic Extracts on Echinococcus granulosus Sensu Stricto.

The larval stage of the parasite Echinococcus granulosus sensu lato (s.l) is responsible for cystic echinococcosis (CE), a long-term infection affecting humans and animals worldwide, and constitutes a serious public health concern. If left untreated, CE can cause serious damage to multiple organs, especially the liver and lungs. Regarding the treatment, in the last few years, the use of pharmacological treatment has increased, suggesting that in the future, drug therapy may replace surgery for uncomplicated cysts. However, the only available anthelmintic drug to treat this infection is the albendazole, which has an efficacy that does not exceed 50%. On the basis of the above-mentioned evidence, new and improved alternative treatments are urgently needed. The use of natural products and their active fractions and components holds great promise as a valuable resource for the development of novel and effective therapies. Hop (Humulus lupulus L.) is a bittering agent in the brewing industry for which the sedative, digestive, anti-inflammatory, and antimicrobial effects have been reported. The purpose of this study was to assess the in vitro efficacy of methanolic extracts from the leaves of hop varieties against E. granulosus sensu stricto (s.s) protoscoleces. Varieties Mapuche and Victoria caused a stronger protoscolicidal effect compared to the Bullion, Cascade, and Traful varieties (P < 0.01), coinciding with their highest content of flavonoids, total polyphenols, and saponins. The viability of protoscoleces treated with the varieties Mapuche and Victoria decreased to approximately 50% at days 5 y 8, respectively, showing alterations such as soma contraction and impaired microtriches. After 18 days of treatment with both varieties, protoscoleces were completely altered both structurally and ultrastructurally. In conclusion, the methanolic extracts of the H. lupulus varieties Mapuche and Victoria demonstrated a marked in vitro effect against E. granulosus s.s. protoscoleces. The beer-making industry exclusively uses hop cones, leaving behind large amounts of hop leaves as an agricultural by-product that is not being utilized. On the basis of our study, we propose that hop leaves could also be used as a source of secondary metabolites with anthelmintic activity.

UK Optometrists' Professional Learning Needs Toward Engaging with Myopia Control Interventions.

This study aimed to explore the support that UK optometrists feel they require to facilitate their engagement with myopia control intervention. A self-administered online survey was distributed via QualtricsXM to practising optometrists in the UK via email lists and newsletters of local optical committees, social media, and optometric networks. Questions focussed on learning styles, training needs and barriers to learning. Fifty-five respondents completed the survey. Forty-eight respondents answered the question on where they get information about myopia control and learning style, 79.2% indicated that conferences offering Continuing Professional Development (CPD) material were their main source, and 20.8% preferred online learning as the preferred format of delivery. Optometrists would like to receive training in clinical assessments (78.9%), evaluating suitable interventions (76.3%), developing and implementing specific patient intervention plans (76.3%), carrying out chosen myopia control interventions (fitting/prescribing) (73.7%), and the use of pharmacological interventions (94.4%). Of the 40 respondents who answered professional development questions, 97 5% were most interested in finding, identifying and applying evidencebased practice (EBP), followed by clinical decision-making in myopia control (95.0%). When asked about barriers to learning in this field, 29.7% reported limited time to attend training as the greatest barrier. Optometrists felt they need training in various aspects of myopia management, from practical skills to assessing and fitting/prescribing appropriate myopia control interventions. They were also interested in learning more on EBP and clinical decision-making related to myopia control. To improve the uptake of myopia control among optometrists, various learning methods, especially online learning, and providing sufficient time for training are crucial.

Pharmacological interventions for reducing the incidence of myoclonus in patients receiving etomidate for induction of general anesthesia: an umbrella review.

The objective of this umbrella review was to examine various pharmacologic interventions for their potential to reduce etomidate-induced myoclonus. A secondary objective was to compare the relative effectiveness of those medications in reducing the incidence of myoclonus when etomidate is utilized for the induction of general anesthesia. Etomidate is the drug of choice when inducing general anesthesia in hemodynamically unstable patients. However, its use is limited among the general surgical population due to its ability to cause adrenal suppression, vomiting, and myoclonus. Myoclonus can lead to damage of muscle fibers, myalgias, and patient discomfort, and can also be detrimental in patients with low cardiac reserve. Several systematic reviews have reported on the effectiveness of various intravenous medications in reducing mild, moderate, and severe myoclonus; however, a more thorough examination of their influence was lacking. This review included systematic reviews and meta-analyses of randomized controlled trials involving the use of pharmacologic interventions to reduce etomidate-induced myoclonus. Reviews in English and conducted after 1965 were considered for inclusion. A comprehensive search of 11 databases was conducted to identify published and unpublished reviews up to March 2022. Critical appraisal was conducted by 2 independent reviewers using the standardized JBI appraisal tool. Quantitative findings were summarized according to the dose, timing of administration, and relative risk using a data matrix, and were synthesized in tabular format with supporting narrative text. Results were organized by severity of myoclonus (overall, mild, moderate, and severe) and by type of intervention. Eight systematic reviews were included in this umbrella review, which included 48 relevant studies, after removal of duplicates (3909 participants included in the primary studies). Five of the systematic reviews examined the effectiveness of various types of opioids in the prevention of myoclonus, and 3 systematic reviews examined the effectiveness of non-opioid interventions, such as lidocaine, midazolam, and dexmedetomidine. Seven reviews searched at least 4 databases for pertinent studies and specifically indicated that blinded reviewers appraised the articles. All reviews used a published and validated appraisal instrument. The overall quality of all included reviews was judged to be moderate to high. The absolute risk reduction indicating the effectiveness of the prophylactic medications ranged from 47% to 81% for mild, 52% to 92% for moderate, and 61% to 96% for severe myoclonus. Opioids demonstrated the most consistent and substantial effect on the reduction in myoclonus. All pharmacologic interventions identified in this review demonstrated a statistically significant reduction in the incidence of myoclonus. Future studies and reviews should focus on elucidating the particular dose range and timing that is most effective. Anesthesia providers should consider a pre-treatment dose of one of the medications described in this umbrella review as a means to reduce myoclonus and the untoward effects of that condition.

Application And Research Progress of T Cells in Immunotherapy in Cancer Treatment

Chimeric Antigen Receptor T-cell therapy (CAR-T) has emerged as a revolutionary approach in cancer treatment, offering hope to patients with previously untreatable malignancies. This review paper provides a comprehensive overview of CART therapy, covering its structure, working mechanism, clinical applications, and strategies to mitigate adverse effects. Firstly, we delve into the structural intricacies of CAR-T cells, exploring how they are genetically engineered to express chimeric antigen receptors that enable them to target specific tumor-associated antigens. The paper elucidates the mechanisms by which CAR-T cells recognize and eliminate cancer cells, including the activation of immune responses and the production of cytokines. Next, we present an in-depth analysis of CAR-T cell therapy in clinical practice, highlighting its remarkable successes in treating various hematological malignancies and solid tumors. The review discusses the challenges associated with manufacturing, patient selection, and long-term persistence of CAR-T cells in vivo. Finally, we address the adverse effects associated with CAR-T therapy, such as cytokine release syndrome and neurotoxicity, and propose strategies to mitigate these side effects. These include the use of pharmacological interventions, patient monitoring, and the development of novel CAR-T cell constructs with improved safety profiles. In summary, this review paper provides a comprehensive and up-to-date perspective on CAR-T cell therapy, emphasizing its potential to transform the landscape of cancer treatment while addressing the challenges and risks that accompany this groundbreaking approach.

TREATMENT OF PAIN DURING THE ACUTE CARE STAY FOR PATIENTS LIVING WITH DEMENTIA

Abstract The purpose of this study was to describe pain among hospitalized patients living with dementia, the use of pharmacologic and nonpharmacologic treatment, and to compare treatments among those with and without pain. Data from the first 365 participants in the FFC-AC-EIT study was used. The mean age of participants was 83 (SD=5), the majority was female (65%) and White (67%). Controlling for treatment, between admission to discharge there was a significant decrease in pain from 36% having pain on admission to 31% at discharge (F=5.30, p=.02). At discharge 125 (30%) had pain and 8 (6%) of individuals with pain received no nonpharmacological or pharmacological treatments during the hospital stay. The most frequently used pharmacological intervention was acetaminophen (52%), then tramadol (8%). Comfort measures (49%), physical activity (46%), and communication (38%) were the most common nonpharmacologic approaches. Between those with and without pain there was no difference in use of pharmacologic interventions (F = .38, p =.54) and there was less use of nonpharmacological treatments for those with pain (F=10.24, p=.002). The majority of patients living with dementia were treated for pain, but an ongoing focus is needed to assure optimal pain management for all patients. More attention to use of and evaluation of effectiveness of pharmacologic and nonpharmacologic treatments alone or together are needed for hospitalized patients living with dementia.

The Benefits and Harms of Pharmacological Treatment for Postradiation Pelvic Pain: A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel with Recommendations for Clinical Practice.

Radiotherapy of the pelvis is a widely used method for the treatment of malignancies, and local complications including pain following pelvic radiation therapy are acknowledged complications. The primary objective is to assess the clinical effectiveness and safety of pharmacological therapies on postradiation pelvic pain. A systematic review of the use of different pharmacological treatments in the management of post-radiation pelvic pain was conducted (PROSPERO-ID: CRD42021249026). Comprehensive searches of EMBASE, Medline, and Cochrane library were performed for publications between January 1980 and April 2021. The primary outcomes were improvement in pain and adverse events following treatment. The secondary outcomes included quality of life, bowel function, and urinary function. After screening 1514 abstracts, four randomised controlled trials were identified, enrolling 355 patients with bladder and anorectal subtypes of postradiotherapy chronic pelvic pain (CPP). A narrative synthesis was performed as heterogeneity of included studies precluded a meta-analysis. A single study reported a significant reduction in pain after 6 mo in patients with bladder pain syndrome treated with hyaluronic acid or hyperbaric oxygen. Anorectal pain was reported to be reduced by the application of 4% formalin, but the use of hyperbaric oxygen in postradiotherapy anorectal pain remains controversial. Adverse event reporting was generally poor. Studies looking at medications used routinely in guidelines for neuropathic pain, such as gabapentin, pregabalin, amitriptyline, and duloxetine, were absent or of poor quality when it came to postradiation pelvic pain. Beneficial effects of hyperbaric oxygen or formalin on pain, quality of life, and functional symptoms were seen in patients with certain CPP subtypes, but the current evidence level is too weak to allow recommendations about the use of any pharmacological treatment for postradiation pelvic pain. Different pharmacological treatments are used to treat pain after radiotherapy, but current studies are of insufficient quality to determine whether these should be recommended and many chronic pelvic pain subtypes are not covered. Further research is needed.

Real-world use of pharmacological treatments for incident bipolar disorder: A Finnish nationwide cohort study

BackgroundPharmacotherapy remains crucial for treating bipolar disorder (BD), but knowledge on the treatments actually used by newly diagnosed patients in real-world settings is sparse. MethodsIndividuals newly diagnosed with BD during 1996–2018, aged 15–65 years, were identified from national Finnish registers. The patients' use of different drug classes (mood stabilizers, antipsychotics and antidepressants) or combinations of these drug classes were followed from initial pharmacotherapy (first line) after BD diagnosis until the fifth line of treatment or until the two-year follow-up time ended. Clinical and sociodemographic factors associated with antidepressants-only as the first treatment line were assessed with logistic regression. Results82.6 % of all patients used BD medication during the follow-up. 33.9 % had antidepressants-only as the first, 22.9 % as the second and 19.7 % as the third treatment line. Use of combinations of mood stabilizers, antipsychotics and antidepressants increased by successive treatment lines. Factors associated with antidepressants-only as the first treatment line included older age (>45 years aOR 2.20, 95% CI: 2.01–2.40, 25–45 years: 1.55, 1.42–1.68, compared with those aged <25), diabetes (1.35, 1.17–1.55) and female sex (1.29, 1.21–1.37). BD diagnosis registered in 2016–2018 (0.48, 0.42–0.55) and substance abuse (0.77, 0.71–0.83) were associated with decreased odds. LimitationsDue to the register-based nature of this study, not all potentially important clinical factors influencing medication use could be controlled for. ConclusionsA large proportion of patients with bipolar disorder are not treated according to treatment guidelines, as use of antidepressants alone is common. Reasons for not following evidence-based recommendations need to be further researched.

Pharmacological and non-pharmacological prophylaxis in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a narrative review

Endoscopic retrograde cholangiopancreatography is a diagnostic and therapeutic procedure for various gastrointestinal problems. Pancreatitis is a severe complication of the procedure. The main objective of this study was to address if post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis can be prevented and what are the various pharmacological and non-pharmacological options along with their efficacy. Keywords “post-ERCP” and “pancreatitis” were used to search articles in Pubmed. Randomized controlled trials on patients undergoing ERCP due to any disease using pharmacological or non-pharmacological intervention published in the last 7 years were included. Observational studies, descriptive studies, reviews, and studies with no full access were excluded. The primary outcome in the trials was a frequency of post-ERCP pancreatitis. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most effective drugs in reducing the incidence of pancreatitis. The preferred route was rectal. After NSAIDs, intravenous hydration and sublingual nitrate showed promising outcomes, especially when combined with rectal NSAIDs. Other drugs like magnesium sulfate and nafamostat mesilate did reduce the incidence, but the results were not statistically significant. Epinephrine spray on duodenal papilla showed no benefits and instead had a risk of increasing the incidence. Stent placement also reduced the incidence of pancreatitis. In conclusion, rectal NSAIDs alone or combined with IV hydration and sublingual nitrate significantly reduced the incidence of pancreatitis, and stent placement was comparable to pharmacological interventions. Thus, regular use of pharmacological interventions before the procedure can help to reduce the incidence of this grave complication.

Valoración funcional en mayores de 60 años con gonartrosis

The objective of this research is to assess the pre-treatment and post-pharmacological treatment functionality in patients over 60 years of age with gonarthrosis, treated in an outpatient clinic in the community of Hichuraya Grande, Villa Remedios, Department of La Paz in Bolivia. It is a descriptive, longitudinal research; with an epidemiological field design. The population is 110 adults over 60 years old diagnosed with osteoarthritis. The sample was made up of 73 who were followed up for three months. The data collection technique is the survey and the instrument is the KOOS questionnaire, which allows evaluating the functionality of the knee. The main results demonstrate that the use of pharmacological treatment improved the patients' condition in terms of pain, stiffness, daily activities and quality of life. It is concluded that pharmacological treatment shows effectiveness in improving the condition of gonarthrosis, however, the indiscriminate use of NSAIDs causes patients to have difficulty accepting other types of treatment.

How to treat chronic pain in rheumatic and musculoskeletal diseases (RMDs) – A pharmacological review

IntroductionChronic pain is a common symptom of rheumatic diseases that impacts patients’ quality of life. While non-pharmacological approaches are often recommended as first-line treatments, pharmacological interventions are important for pain management. However, the effectiveness and safety of different pharmacological treatments for chronic pain in rheumatic diseases are unclear. MethodsThis review critically synthesizes the current evidence base to guide clinicians in selecting appropriate pharmacological treatments for their patients, considering the expected benefits and potential risks and side effects. ResultsFor osteoarthritis, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, opioids, and antidepressants are commonly used, with NSAIDs being the most recommended. In addition, topical agents, such as topical NSAIDs, are recommended for localized pain relief. For fibromyalgia, amitriptyline, serotonin and noradrenaline reuptake inhibitors (SNRIs), and gabapentinoids are commonly used, with SNRIs being the most recommended. For back pain, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, opioids are used only for acute of flare-up pain, whereas neuropathic pain drugs are only used for chronic radicular pain. For inflammatory rheumatic diseases, disease-modifying antirheumatic drugs (DMARDs) and biological agents are recommended to slow disease progression and manage symptoms. ConclusionWhile DMARDs and biological agents are recommended for inflammatory rheumatic diseases, pharmacological treatments for other rheumatic diseases only alleviate symptoms and do not provide a cure for the underlying condition. The use of pharmacological treatments should be based on the expected benefits and evaluation of side effects, with non-pharmacological modalities also being considered, especially for fibromyalgia.

Predicting Therapeutic Efficacy of Pharmacological Treatments in Children with Postural Orthostatic Tachycardia Syndrome: A Mini-Review.

Postural orthostatic tachycardia syndrome (POTS) is common in children, with an excessive increment in heart rate when moving from the supine to upright position. It has significant negative impacts on the daily life of pediatric patients. The pathogenesis of POTS includes peripheral vascular dysfunction, central hypovolemia, abnormal autonomic function, a high-adrenergic state, impaired skeletal-muscle pump function, the abnormal release of vasoactive factors, and autoimmune abnormalities. Therefore, the empirical use of pharmacological treatments has limited therapeutic efficacy due to the diversity of its mechanisms. A crucial aspect of managing POTS is the selection of appropriate treatment targeting the specific pathogenesis. This review summarizes the commonly used pharmacological interventions, with a focus on their predictive indicators for treatment response. Factors such as heart rate variability, plasma biomarkers, and cardiac-function parameters are discussed as potential predictors of therapeutic efficacy, enabling the implementation of individualized treatment to improve therapeutic effectiveness. This review consolidates the current knowledge on POTS, encompassing its clinical characteristics, epidemiological patterns, underlying pathogenic mechanisms, and predictive indicators for treatment response. Further research is warranted to enhance the understanding of POTS and facilitate the development of more effective therapeutic approaches for this challenging syndrome.

EPH216 The Use of Pharmacological Treatment Management Vs. the Use of Diet Quality to Evaluate the Health Outcomes in Managing Type 2 Diabetes

Only a few research studies have investigated the role of diet quality in the management of type 2 diabetes (T2D) when compared to the use of pharmacological treatments. The objective of this study is to examine the impact of diet quality, both with and without pharmacological treatment on the health outcomes of T2D patients.

Association Between Chronic Diseases and Need for Dental Treatment in a Stomatology of Special Patients Service

Aim: To determine the association between chronic diseases (CD) and the need for dental treatment in patients of the stomatology of special patients service (SSPS) of the Teaching Dental Center (TDC) of Universidad Peruana Cayetano Heredia (UPCH) in Lima-Peru from 2016 to 2019. Materials and Methods: A cross-sectional study with a total population of 2024 digital medical records of individuals over 18 years old. A dependent variable was need for dental treatment, so an instrument to assess it was created; additionally, the presence of CD was evaluated. Other covariates considered were pharmacological treatment, last dental visit, provenance, age group, and sex. Statistical analyses were performed, including a bivariate analysis using the Chi-square test. Finally, a Poisson linear regression was performed to determine crude and adjusted prevalence ratios (aPR) with the variables showing associations, with a 95% confidence level (95%CI) and a p &lt; .05 value. Results: The need for low-complexity dental treatment was present in 2.62% ( n = 52) of patients, moderate complexity in 27.21% ( n = 541) of patients, and high complexity in 70.17% ( n = 1395) of patients. In relation to CD, 30.58% ( n = 608) had one, 31.39% ( n = 624) had two, and 38.03% ( n = 756) had three or more. In the multivariate analysis, the presence of three to more CD and the need for high-complexity vs. low-complexity treatment, an aPR of 1.02 (95%CI): 1.01–1.04; p = .019) was obtained. Conclusion: There is a positive association between the presence of three or more CD and the need for high complexity dental treatment compared to low-complexity dental treatment, adjusted for use of pharmacological treatment and age.

Media portrayals of psychotropic agents in AD/HD treatment: A social constructionist approach.

In recent decades there has been a significant increase in diagnosing children and adults with Attention-Deficit/Hyperactivity Disorder (AD/HD), and in the use of pharmacological treatment with Ritalin, Concerta and Strattera for AD/HD. This development has given rise to scientific criticism, claiming that the pharmaceuticals prescribed by doctors are, to a large extent, ineffective or harmful. This study discusses media's portrayal of treatment of AD/HD. The aim of the article is to develop a social constructionist perspective, highlighting how scientific critique of pharmaceuticals for AD/HD is handled in the mass media. The authors introduce the concept of "psychopharmacological extensibility," which demonstrates the importance of collective definitional processes in society. Psychopharmacological extensibility reflects the fact that the perception of AD/HD agents as beneficial medicines or harmful drugs is open to interpretation and dependent on social factors related to context, power, rhetoric, and marketization. The empirical data are based on 211 articles from eight of the largest newspapers in Sweden, published between 2002 and 2021. The result shows that Swedish mass media, in numerous ways, neglects or undermines the scientific criticism made, thereby facilitating an increased use of the diagnosis and of psychotropic agents in society.

MISSED SEIZURE DURING ELECTROCONVULSIVE THERAPY

Background: Here, the authors reported two cases of electroconvulsive therapy with a missed seizure and present a literature review to explore the possible reasons and recommendations. To date, most authorities agreed seizure duration correlates to the effectiveness of the ECT, and a reason to a minimum of 25 seconds duration of seizure is defined as a good seizure. Many aspects of the seizures during the ECT are well researched and lots of data is available about the possible modifiers of seizures, indicators of an effective seizure, and ways to monitor an effective seizure but very few data reported missed seizures and strategies to follow in the events of no fits. In this case series, we described two cases of missed seizures which were identified and addressed appropriately with subsequent successful ECT sessions. We also presented the literature regarding the strategies to follow immediately post-event. Case 1: A 42-year-old married lady with a diagnosis of bipolar type I disorder, current episode manic, with psychotic symptoms (6A60.1) according to the ICD-11 diagnostic and classification system. Case 2: A middle-aged male with a diagnosis of severe depressive episodes with psychotic symptoms. Both cases had missed seizures during the 3rd session of the electroconvulsive therapy. Conclusion: Studies have shown that the phenomena of missed seizures are common but less reported and are caused by a number of factors including individual factors, the ECT technical parameters as well as concurrent use of pharmacological treatment and anesthetic agent which should be considered before every ECT session. There is a paucity of literature on the strategies to follow immediately after an event of no fits. Therefore, we tried to summarize some possible recommendations which need to be personalized according to a case-to-case basis.

The efficacy of cognitive remediation in children and adolescents: results from a new meta-analysis.

AbstractThis presentation will share data from a new meta-analysis of RCT studies using cognitive remediation to treat children and adolescents with ADHD. For this matter, 25 studies were accessed, and results will focus on outcomes immediately after the end of the program and in follow-up. Outcomes include subjective measures of functioning (through validated scales), neuropsychological measurements and academic performance. Comparisons regarding length of training, intensity, concomitant use of pharmacological treatments will also be provided. These findings will build on previous meta-analysis on the issue that were performed in the past.Disclosure of InterestNone Declared

The Cumulative Use of Muscle Relaxants and the Risk of Alzheimer's Disease: A Nationwide Case-Control Study.

Use of pharmacological treatments is one possible modifiable risk factor for cognitive disorders. To investigate if the use of muscle relaxants is associated with the risk of Alzheimer's disease (AD). The study was performed in a nested case-control design. Altogether 70,718 community-dwelling residents of Finland who received AD diagnosis in 2005-2011 were included as cases (the MEDALZ study). Each case was matched with four controls without AD by age, sex, and region of residence (N = 282,858). Data was extracted from Prescription register (1995-2012), Special Reimbursement register (1972-2012), and Hospital Discharge register (1972-2012). Drug use periods were modeled with PRE2DUP-method. Defined daily dose (DDD) was used to quantify the use. Analyses were conducted for any muscle relaxant use, and drug specific analyses were done for orphenadrine and tizanidine. A five-year lag window prior to the diagnosis was used, and results analyzed with conditional logistic regression. The use of any muscle relaxant was associated with the risk of AD, aOR (95% CI) 1.04 (1.02-1.07). Stronger associations were observed with longer use (>366 days, aOR 1.12 (1.03-1.21)) than shorter use (1-365 days aOR, 1.04 (1.02-1.06)) compared to non-users. Dose-response was not observed. Tizanidine was not associated with AD, whereas cumulative exposure of orphenadrine (≥101 DDDs) was associated with the risk of AD, aOR 1.19 (1.07-1.32). Muscle relaxant use was associated with the risk of AD and higher exposure to orphenadrine showed increased risk. Further studies on higher doses and longer durations of use are warranted.

Evaluating the use of pharmacological treatments for attention-deficit hyperactivity disorder in autistic individuals: a retrospective cohort study

Evaluating the use of pharmacological treatments for attention-deficit hyperactivity disorder in autistic individuals: a retrospective cohort study