The healthcare enterprises are using new treatment methods to diagnose and treat patients with neurology problems.
FREMONT, CA: The primary care of adult patients with Down syndrome is comparable to that of the general adult population, but clinical practice guidelines have been developed by the Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup to resolve screening considerations that are distinctive to this population.
For instance, they recommend annual assessment for Alzheimer's-type dementia starting at age 40, with clinical evaluation for improvements in cognition, memory, behavior, and other functional skills. In addition, screening for diabetes mellitus must be done every three years from 30 in all adults with Down syndrome. For those with comorbid obesity, starting at age 21, screening should be performed every two to three years.
Screening for hypothyroidism with serum TSH must be conducted on individuals every one to two years. Every asymptomatic adult with Down syndrome should be screened periodically with a history and physical examination for signs and symptoms of cervical myelopathy instead of screening with cervical radiographs.
Pharmacologic therapy for fatigue in multiple sclerosis
Several drugs are often recommended for fatigue in patients with multiple sclerosis (MS), but the supporting evidence is insufficient. One hundred forty-one patients with MS and fatigue were randomly categorized into four therapies (oral amantadine, modafinil, methylphenidate, or placebo) for up to six weeks in a blind cross-over trial.
The primary outcome measure was the Updated Fatigue Impact Scale (MFIS), where lower scores reflect less fatigue. The trial showed that each successful treatment reduced approximately 10 points in the MFIS score, so did placebo. Nevertheless, adverse effects were more frequent with the active drugs. For the treatment of fatigue in MS, the healthcare sector usually favors non-pharmacological methods.
Oral rimegepant for episodic migraine prevention
The small-molecule antagonists ('gepants') of calcitonin gene-related peptide (CGRP) are orally administered drugs that have been utilized for the acute treatment of migraine. A preventive treatment study of 1,591 migraine patients allocated to rimegepant had a better response rate relative to placebo and a higher reduction of migraine days per month over baseline.