Jas Wall

Neurology trainee in Lancashire, hiking and climbing in my spare time

[Jas Wall @jaz_walker]

@bananatransit @stevohaddo @AlexJDeighton As previously, there is no doctor on the current contract in England receiving 50% banding/uplift, this does not exist any more. The advert is wrong.

[Jas Wall @jaz_walker]

@bananatransit @stevohaddo @AlexJDeighton Banding to 50% no longer exists since the 2017 new contract (the advert must be incorrect) so all that it tells people when you say this is that you have no idea about doctors salaries and that neither does the person submitting the advert.

[Jas Wall @jaz_walker]

@drnikkistamp @AriReddy The uk data is also based on best case not actual scenario. For example my partner (ICU/resp) will take 13 years post med school with no time out of training or fellowships. So the comparison holds.

[Martin Picard @MitoPsychoBio]

The brain did not evolve to think, but to regulate the energetic state of the organism.

https://t.co/cAijs8Hqfi

[Robert Y. Chen @therealRYC]

🚨 The first disease-modifying therapy for Huntington's disease was just announced this morning.

75% reduction in symptoms over 36 months.

This isn't hype.

It's field-changing.

And it uses RNA.

Here's what you need to know about $QURE AMT-130 🧵

[JAMA Neurology @JAMANeuro]

Amyloid-beta accumulation in centenarians is associated with reduced cognitive performance and is not a benign aspect of aging. https://t.co/ZfEZ0amR5c

[Brain @Brain1878]

In a postmortem analysis of >10,000 people with dementia, Zawar et al. show that those with ongoing seizures in the year prior to death died at a younger age and had more severe neurodegeneration and neuropathology linked to AD. https://t.co/dFDixnJWqP; https://t.co/yMETukbBlf

[Dario J. Englot @Englot]

Seizures are debilitating for people with epilepsy, and seizure medications are also not completely benign.

The International League Against Epilepsy (ILAE) recommends early surgical referral for people with focal epilepsy and a brain lesion, even if seizures are controlled on medications.

Early surgery may reduce medication burden, improve cognitive outcomes, increases lifespan, and enhance quality of life.

@IlaeWeb @Brain1878 @AmEpilepsySoc

https://t.co/7IcltXw7Sw

[Ameer E. Hassan @AmeerEHassan]

🚨 No drugs. No wires. No incisions. Just sound waves.

For the first time, we’ve used focused ultrasound to completely liquefy stroke clots in under 2 minutes—without the need for thrombolytics or catheters.

Our latest study on histotripsy marks a major step toward a non-invasive, drug-free and device-free future for stroke care. This could radically expand access to treatment for patients worldwide, democratizing stroke care and opening the doors even for those ineligible for tPA or mechanical thrombectomy today.

🔗 Read the full paper here: https://t.co/ffFOXnsyHs

https://t.co/PoWA9og70t - https://t.co/0RkPy51Vdw

@svinsociety @MThrombectomy @SNISinfo @INR_WFITN @slice_inr @iCure @WLNCofficial #NeuroInnovation #Histotripsy #MedTech #UltrasoundTherapy #DigitalHealth #MedicalDevices #AccessToCare

[JAMA Neurology @JAMANeuro]

The ImmunoWELL JCV IgG test for detecting John Cunningham virus antibodies in natalizumab-treated multiple sclerosis patients yielded more positive results compared to the second-generation STRATIFY JCV DxSelect assay. https://t.co/12C1I8TAZ5 @eefst

[JAMA Neurology @JAMANeuro]

In patients with Duchenne muscular dystrophy, delandistrogene moxeparvovec demonstrated efficacy in reducing muscle fat accumulation and slowing disease progression compared to placebo. https://t.co/xIFSF7LOF0

[John J. Millichap MD @JohnMillichapMD]

Pharmacological management of prolonged seizures in Dravet syndrome including intravenous phenytoin https://t.co/zc11pNCpPu #Neurology #Epilepsy

[Lea Alhilali, MD @teachplaygrub]

Are you pretty bad about knowing when to give gad?

Do you know which gadolinium contrast is safe to give?

Know what to do w/gadolinium in patients w/kidney disease?

Here’s the gadolinium cheat sheet you NEED from @theAJNR SCANtastic! Read on...

https://t.co/GKTQxX83mc

➡️RISK OF NSF
--Class 1: High risk, linear agents
🔸Remember 1 is done!
--Class 2: Safe, no NSF cases, mainly cyclic
🔸Remember 2 is the go to agent!
--Class 3: Liver agents, no NSF cases, but small numbers
🔸Remember 3 is for biliaree & safety is maybe

➡️CLASS TWO AGENTS (LOWEST RISK):
--Dotarem
🔸Remember: DOTarem is the antiDOTE so it’s safe
--ProHance
🔸Remember: ProHance sounds like Low-chance, so safe
--Gadavist
🔸Remember: Sounds like Nada-Risk, so low risk
--MultiHance
🔸Remember: Sounds like Paltry-chance, so safe
--Clariscan
🔸Remember: Sounds like Clear-to-scan so good to go!

➡️RENAL PTS:
FOUR RULES
1. Try to space gad administration apart 1 wk or 3 dialysis sessions
2. If on dialysis, try to schedule dialysis ASAP after
3. Don’t need GFR for Class II agents
4. If not class II, low GFR or AKI should can get class III if necessary, but never class I

So next time, don't get mad when they ask you about gad! Just use this cheat sheet!

Follow @theAJNR & check the article out for yourself:

https://t.co/GKTQxX83mc

[Casey Albin, MD @caseyalbin]

16/
This article by @StaceyLClardy and Tammy Smith, MD PhD is an in-depth look at all the new treatments: the evidence, what to watch for, & how to select an immunosuppressant with evidence!
I learned a ton and you will too!
https://t.co/cbJZ5LR0DN

[Rajiv Mohanraj @neuro_manc]

For neurologists wishing to develop EEG / epilepsy surgery / ICU cEEG skills. The post is ABN approved, the candidate will achieve competences to be an epileptologist. Based on the current post holder @Rachel_T1990 the programme produces world class epileptologists!

[International League Against Epilepsy @IlaeWeb]

Key point: "No evidence exists for vitamin D prophylaxis in all persons w/#epilepsy, underscoring the need for prospective trials exploring a potential benefit."
#ILAE Medical Therapies Commission special report: https://t.co/akgYmt9Pyi

@stephane_auvin @TonyMarson2 @LievenLagae

[Brain @Brain1878]

Shi et al. show that spike ripples are more effective than leading biomarkers at revealing brain areas that generate seizures. An automated spike ripple detector performed well in surgical patients in a multicentre cohort. https://t.co/nklU6wHHvX

[John J. Millichap MD @JohnMillichapMD]

Brivaracetam effectiveness and tolerability in older and younger adults with epilepsy: EXPERIENCE, a pooled analysis of international data from retrospective studies https://t.co/j2Ah3Zy3CS #Neurology #Epilepsy

[Samuel Hume @DrSamuelBHume]

This is the report of a novel autoimmune disorder, that causes specific deficiency of vitamin B12 in the cerebrospinal fluid (CSF)

It's caused by autoantibodies against a B12 receptor, CD320, which transports B12 from the blood into the CSF

What this means is that B12 levels in blood are high, but in the CSF are ~undetectable (as in case 1, here, vs. the controls):
This highlights a pitfall in the diagnosis of B12 deficiency: if only serum B12 is measured, the diagnosis might be missed

CD320 autoantibodies were also found in the CSF of ~20% of patients with neuropsychiatric lupus (a subset of lupus that affects the brain) suggesting that these patients may also benefit from high dose B12 supplementation

Really nice work from Pluvinage et al: https://t.co/UTICEBg2HO

[pedneurojournal @pedneurojournal]

Eculizumab in adolescent patients with refractory myasthenia Gravis - it works!

10/11 patients completed
-patients improved, had sustained complement inhibition
-mild adverse events and not related to eculizumab

open access: https://t.co/aF3u5xZwwQ