RESUMEN
BACKGROUND: Eating disorders (EDs) are serious, often chronic, conditions associated with pronounced morbidity, mortality, and dysfunction increasingly affecting young people worldwide. Illness progression, stages and recovery trajectories of EDs are still poorly characterised. The STORY study dynamically and longitudinally assesses young people with different EDs (restricting; bingeing/bulimic presentations) and illness durations (earlier; later stages) compared to healthy controls. Remote measurement technology (RMT) with active and passive sensing is used to advance understanding of the heterogeneity of earlier and more progressed clinical presentations and predictors of recovery or relapse. METHODS: STORY follows 720 young people aged 16-25 with EDs and 120 healthy controls for 12 months. Online self-report questionnaires regularly assess ED symptoms, psychiatric comorbidities, quality of life, and socioeconomic environment. Additional ongoing monitoring using multi-parametric RMT via smartphones and wearable smart rings ('Oura ring') unobtrusively measures individuals' daily behaviour and physiology (e.g., Bluetooth connections, sleep, autonomic arousal). A subgroup of participants completes additional in-person cognitive and neuroimaging assessments at study-baseline and after 12 months. DISCUSSION: By leveraging these large-scale longitudinal data from participants across ED diagnoses and illness durations, the STORY study seeks to elucidate potential biopsychosocial predictors of outcome, their interplay with developmental and socioemotional changes, and barriers and facilitators of recovery. STORY holds the promise of providing actionable findings that can be translated into clinical practice by informing the development of both early intervention and personalised treatment that is tailored to illness stage and individual circumstances, ultimately disrupting the long-term burden of EDs on individuals and their families.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Humanos , Adolescente , Adulto Joven , Adulto , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/fisiopatología , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Estudios Prospectivos , Femenino , Masculino , Progresión de la Enfermedad , Tecnología de Sensores Remotos/métodos , Tecnología de Sensores Remotos/instrumentación , Teléfono Inteligente , Estudios Longitudinales , Calidad de Vida/psicologíaRESUMEN
Severe orolingual angioedema is a life-threatening complication of alteplase treatment for acute ischemic stroke that occurs during alteplase infusion or in the first 2 hours afterward. Currently, there are no proven therapies, although glucocorticoids, antihistamines, and adrenaline are sometimes used. Intubation is required if significant airway compromise supervenes. The incidence is .2%-5.1%, and risk factors include treatment with angiotensin-converting enzyme inhibitors and total insular infarcts. Here we report a case of alteplase-induced severe angioedema, which resolved briskly following icatibant treatment.
Asunto(s)
Angioedema/tratamiento farmacológico , Antagonistas del Receptor de Bradiquinina B2/uso terapéutico , Bradiquinina/análogos & derivados , Fibrinolíticos/efectos adversos , Infarto de la Arteria Cerebral Posterior/tratamiento farmacológico , Terapia Trombolítica/efectos adversos , Activador de Tejido Plasminógeno/efectos adversos , Angioedema/inducido químicamente , Angioedema/diagnóstico , Bradiquinina/uso terapéutico , Humanos , Infarto de la Arteria Cerebral Posterior/diagnóstico , Masculino , Persona de Mediana Edad , Resultado del TratamientoAsunto(s)
Isquemia Encefálica/terapia , Procedimientos Endovasculares , Fibrinolíticos/uso terapéutico , Procedimientos Neuroquirúrgicos , Accidente Cerebrovascular/terapia , Activador de Tejido Plasminógeno/uso terapéutico , Anciano , Isquemia Encefálica/epidemiología , Isquemia Encefálica/patología , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/instrumentación , Procedimientos Endovasculares/métodos , Femenino , Fibrinolíticos/efectos adversos , Humanos , Masculino , Procedimientos Neuroquirúrgicos/efectos adversos , Procedimientos Neuroquirúrgicos/instrumentación , Procedimientos Neuroquirúrgicos/métodos , Índice de Severidad de la Enfermedad , Australia del Sur/epidemiología , Stents , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/patología , Centros de Atención Terciaria , Activador de Tejido Plasminógeno/efectos adversos , Resultado del TratamientoAsunto(s)
Accidente Cerebrovascular/terapia , Terapia Trombolítica/métodos , Terapia Trombolítica/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Australia del Sur/epidemiología , Accidente Cerebrovascular/epidemiologíaRESUMEN
Following a heat wave in January 2014 in Adelaide, state capital of South Australia, we asked the question whether extreme heat was associated with an increase in stroke incidence. We found in the literature that the association between stroke presentation to hospital and meteorological factors has long been a topic of debate and subject to numerous studies. The literature indicated that an association between heat waves and an increase in admissions for stroke was unlikely in Australia and the United States. We suggest that it may be inappropriate to generalize this conclusion to other countries and rural areas. In view of the global climate change debate, we suggest that prospective studies be focused in developing countries and rural areas to assess the real impact of extreme heat on respective populations to better inform stroke physicians and health policy makers.