关键词： Moyamoya disease   Neurological outcomes   Postoperative stroke   Revascularization surgeries  

摘要： Stroke and neurological outcomes in the early phase following revascularization for moyamoya disease (MMD) may depend on the patient's age. In this study, an age-stratified comparative analysis was performed to clarify this issue. We reviewed 105 MMD patients who underwent 179 revascularization surgeries. The demographic characteristics were collected in four age groups (<= 5 and 6-17 years for pediatric patients and 18-49 and >= 50 years for adults). Additionally, we assessed the incidence of subsequent stroke and deterioration of modified Rankin Scale (mRS) score. Then, we evaluated predictors of postoperative stroke and mRS deterioration using logistic regression. The mean patient age was 26.2 +/- 18.5 years. No significant difference in the incidence of postoperative stroke was observed between age groups;however, the incidence tended to be increased among patients aged <= 5 years (17.9%) and patients aged >= 50 years (16.7%). Deterioration of mRS scores was significantly associated with ages <= 5 years (17.9%) and >= 50 years (11.1%). Logistic regression showed that posterior cerebral artery involvement (odds ratio [OR], 4.6) and postoperative transient neurological events (TNEs) (OR, 5.93) were risk factors for postoperative stroke. Age <= 5 years (OR, 9.73), postoperative TNEs (OR, 7.38), and postoperative stroke (OR, 49) were identified as predictors of unfavorable neurological outcomes. The novel feature of this comparative analysis by age group is that membership in the early-childhood MMD patient group (under 5 years old) was an independent risk factor for unfavorable short-term neurological outcomes and was mainly associated with the incidence of postoperative severe cerebral infarction.

关键词： Abobotulinum toxin A   Onabotulinum toxin A   Dystonia   Dysport   Botox   Dose conversion ratio  

摘要： Objectives: Onabotulinum toxin A (ONA, Botox (R)) and abobotulinum toxin A (ABO, Dysport (R)) are most frequently used in the treatment of movement disorders. The aim of this study was to identify the dose conversion ratio (ABO dose:ONA dose), comparative efficacy, and adverse events in patients who switched from ONA to ABO. Methods: There were 64 patients with cervical dystonia (39), hemifacial spasm (16), oromandibular dystonia (5), blepharospasm (3), and extremity dystonia (1) who switched from ONA to ABO. The efficacy, adverse events, duration of action, and severity of the adverse events after the final dose of ONA, initial dose of ABO, and second dose of ABO were investigated in these patients. Results: The mean dose conversion ratio was 4.70 (2.27-9.62). The mean efficacy of the final ONA injection was 70.62%;initial ABO injection, 72.27%;and second ABO injection, 73.52%, which showed improvement on a visual analog scale (p = 0.71, p = 0.5). Incidence of adverse events after the final ONA injection was 18.8%;this increased to 39.1% after the initial ABO injection (p < 0.001) and decreased to 14.1% after the second ABO injection (p = 0.77). After the initial ABO injection, 20% of the adverse events were trivial, 36% were mild, and 32% were severe. After the second ABO injection, 7.8% of the adverse events were mild and 6.3% were severe. Conclusion: Although the mean dose conversion ratio was 4.70, the range was very wide (approximately 2-9). Therefore, we conclude that after the switch from Botox to Dysport, the doses should be tailored to the patients' clinical situation at treatment initiation, without using a dose conversion ratio.

摘要： Objective On behalf of the German Neurological Society (DGN), a study was conducted into how far former chairmen, honorary chairmen, and honorary members could be regarded as incriminated from the National Socialist period. While an online supplement of this journal presents seven individual biographies (in six papers) by way of example, this paper offers an overview summarizing the project results and introducing the biographies. Methods The first part and the methodological section discuss the difficulties of retrospectively identifying neurologists involved in the Nazi movement. Formal characteristics (eg, membership of the Nazi Party (NSDAP) or other Nazi organizations or participation in Nazi crimes) and content-related clues (eg, statements reflecting Nazi ideology, personal contacts with Nazi officials or active support of the system) can be helpful. Results The second part summarizes the principal results of a study of 28 German and Austrian neuroscientists with regard to their involvement and their post-war careers. Six of the seven "founding fathers" of the DGN were former NSDAP members;10 of the 13 presidents in office until 1976 had belonged to Nazi organizations-the NSDAP, the SA ("Brownshirts") or the SS ("Blackshirts"). Moreover, seven out of 10 honorary presidents had formal or substantive links to National Socialism. Of the German and Austrian honorary members appointed up to 1985, two-thirds had leanings to Nazi ideology or the National Socialist system. Interpretation This paper concludes by outlining how the DGN and its members are currently addressing this historical legacy in order to establish a responsible culture of remembrance. ANN NEUROL 2021