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Trial of intrathecal rituximab in progressive multiple sclerosis patients with evidence of leptomeningeal contrast enhancement. Effect of disease-modifying therapies on subcortical gray matter atrophy in multiple sclerosis.

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Temporal and geospatial trends of adolescent intentional overdoses with suspected suicidal intent reported to a state poison control center. Indiana has the highest rate of adolescent suicidal ideation in the US. Age, sex, outcome, involved substances and case volume by weekday and month were assessed Preparing nurses to recognize the signs and symptoms of a deteriorating patient and to provide appropriate initial interventions is essential. Hospital-based in situ simulation education is an effective evidence-based method that supports adult learning in a safe environment.

The purpose of this article is to discuss the development, implementation, and evaluation of an in situ simulation program and the positive impact on nurses' confidence level in the recognition and initiation of interventions for a deteriorating patient The upload interval was 8. Body mass index, but not vitamin D status, is associated with brain volume change in MS.

Participants had clinical evaluations, brain MRI, and blood draws annually Multiple sclerosis relapse: Qualitative findings from clinician and patient interviews. These missed relapses have broad implications for the conduct of clinical trials as well as for the care and prognosis of people with multiple sclerosis MS. With the ultimate goal of developing new methods to identify relapse, the purpose of this qualitative research with patients and clinicians was to examine the definition, symptoms, and impact of relapse.

For those with diabetes, these injuries are further complicated by alterations to the extracellular matrix of the tendon, poor circulation, and delayed wound healing; consequently, complications and re-rupture rates for patients with diabetes are reported higher than the typical patient population. Brain and retinal atrophy in African-Americans versus Caucasian-Americans with multiple sclerosis: a longitudinal study. On average, African Americans with multiple sclerosis demonstrate higher inflammatory disease activity, faster disability accumulation, greater visual dysfunction, more pronounced brain tissue damage and higher lesion volume loads compared to Caucasian Americans with multiple sclerosis.

Neurodegeneration is an important component of multiple sclerosis, which in part accounts for the clinical heterogeneity of the disease. Brain atrophy appears to be widespread, although it is becoming increasingly recognized that regional substructure atrophy may be of greater clinical relevance Diagnosis of multiple sclerosis: revisions of the McDonald criteria. The McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice.

Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers.

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The McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation The upload interval was 9. The regional distribution of white matter WM abnormalities in schizophrenia remains poorly understood, and reported disease effects on the brain vary widely between studies.

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In an effort to identify commonalities across studies, we perform what we believe is the first ever large-scale coordinated study of WM microstructural differences in schizophrenia. He went over all the options and helped us choose the service that best fit our needs.

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I will definitely use again! This page is under constructiona and will be updated with several more reviews. Superior Fabric Cleaners is an honored recipient of the highly esteemed Angie's List Super Service Award for carpet and upholstery cleaning for the five consecutive years , , , , Angie's List members pay a fee to have access to top rated service companies through verified reviews from other members. These members seek the best and expect the best.

We are gratified to obtain and maintain the top service rating level of an A in all categories. We take pride in delivering world-class service to all of our customers and, thankfully, services such as Angie's List allows it to show. Steam Cleaners Us Vs. April 10th, by Peggy Blakeny - Woodbridge Va "These guys are amazing - very courteous, contacted me immediately, set up a date, even though we had snow they still came out, they were running a little late but the most important thing kept me informed at every step.

John and Reggie were right on time and very professional. They moved all the furniture I asked them to and got right to work. The house smells wonderful. I'll be calling them again in a year to do it all over again. Description of work: Cleaned all the carpets in my townhome 3 stories starting with pre-treatment and ending with protectant.

We virtually walked through my home and was given a quote for the upcoming weekend. When the time came, the gentleman that came out explained that I have three sets of stairs, not two. I explained to him that I walked through the operator and realistically it's 2. He agreed to honor the quote. This was a pre move in cleaning. There was absolutely nothing in my house except a photo frame leaning up against a wall and blinds on all of the Windows, yet somehow they managed to break a set of blinds and the frame!!!!

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Reggie and John called ahead and arrived on time. They were polite and professional and we highly recommend them.

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We have set up an appointment for more work in our home. Description of work: Cleaned the fabric on 5 pieces of furniture and two sets of drapes. We opted for their additional fabric protection service. They arrived they went straight to work. Did their jobs promptly. Description of work:. In both the carpet cleaning and the housecleaning did everything I asked for and then went beyond what was expected. It is nice working with you and it's our pleasure to provide a service that you are thoroughly satisfied with and makes you happy with your surroundings.

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The windows were filthy and took the most time to clean which lead to the extended duration of the cleaning. We were looking to clean our house prior to showing it to be sold. Terrific customer service, great elbow grease, and a terrific effort all the way round. I would definitely recommend these guys to anyone and plan on using them again in my new home. Description of work: Greg and his team cleaned baseboards, vacuumed rugs, shampooed rugs, steamed tile, cleaned baseboards, bathrooms, the kitchen, oven, and deep cleaned window interiors.

It was a pleasure to be of service to you and an honor to know you are impressed with our cleaning services. My staff and I greatly appreciate you taking the time to share your experience with others who may be in search of professional carpet or upholstery cleaning, as well as a thorough house cleaning. Our ongoing commitment to ourselves and our clients is to be the best.

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This is a goal that we never rest upon as though it is obtained once and for all. Instead, this commitment is renewed with each and every client, each and every time. Our grand plan to be "The Best There Is" will afford us nothing less! To fellow Angie's List members, be sure to ask about our housecleaning services when scheduling your carpet, area rug, furniture or tile cleaning.

HAPPY ! They live up to their name, because they did superior work for me. The mattress looks brand new. The sofa, I will use for a long time instead of throwing out. I would never use anyone else. My sister also hired them and they did excellent work for her, cleaning out the stains in her off-white carpet.