Lumbar puncture safety and tolerability in premanifest and manifest Huntington's disease: a multi-analysis cross-sectional study.

Lumbar puncture (LP) has become increasingly common for people with Huntington's disease (HD) both to administer intrathecal investigational medicinal products and to collect cerebrospinal fluid to develop biological markers to track disease stage and progression. We aimed to investigate the safety profile of LP in people with HD, building on a recently published work by increasing the sample size and more specifically, increasing the representation of the premanifest population and healthy controls. We conducted a multi-study cross-sectional analysis including eligible participants from the HDClarity (304 Huntington's disease gene expansion carriers and 91 controls) and HD-YAS studies (54 premanifest and 48 controls), enrolled between February 2016 and September 2019. We investigated the odds of any adverse events, headaches, and back pain independently. Intergroup comparisons and adjusted event odds were derived using hierarchical logistic regressions. A total of 669 LP procedures involving 497 participants were included in this analysis. There were 184 (27.5%) LP procedures associated with one or more adverse events. The two most common adverse events were: post LP headache and back pain. Younger age and female gender were found to be associated with a higher risk of developing adverse events. There was no difference in the rate of adverse events between the disease subgroups after adjusting for covariates such as age and gender. Our results suggest that the LP is safe and tolerable in premanifest and manifest HD subjects, providing useful reassurance about the procedure to the HD community.

[Analysis of the Cochrane Review: Portion, Package or Tableware Size for Changing Selection and Consumption of Food, Alcohol and Tobacco. Cochrane Database Syst Rev. 2015;09: CD011045.] / Análise da Revisão Cochrane: O Tamanho das Porções, das Embalagens, dos Pratos e dos Copos para Alterar a Seleção e o Consumo de Alimentos, Bebidas Alcoólicas e Tabaco. Cochrane Database Syst Rev. 2015;09: CD011045.

Some of the main causes of mortality and morbidity among the developed countries - such as the cardiovascular, neurological and oncologic diseases - are deeply associated with modifiable risk factors. Primordial/primary prevention strategies that alter our environment can have an impact on these risk factors. The authors of this Cochrane systematic review sought evidence from randomized controlled trials to study the effect of the size of portions, packages, dishes and cups, as well as their respective formats, on the consumption and selection of food, alcoholic and non-alcoholic beverages and tobacco products. Overall, this review concludes that the choice of larger portions results in an increased consumption in food, non-alcoholic beverages and tobacco.

Algumas das principais causas de mortalidade e morbilidade nos países desenvolvidos ­ como as doenças cardiovasculares, neurológicas e oncológicas ­ são dependentes de fatores de risco modificáveis. Estratégias de prevenção primordial/ primária que alterem o meio ambiente em que vivemos podem ter impacto nestes fatores de risco. Os autores desta revisão sistemática Cochrane procuraram evidência em ensaios clínicos controlados e randomizados para perceber se o tamanho das porções, embalagens, pratos e copos tinham influência no consumo e seleção de alimentos, bebidas alcoólicas e não alcoólicas e produtos derivados do tabaco, tendo concluído que as escolhas de tamanho maior estão associadas a um incremento na seleção e consumo de alimentos, bebidasnão alcoólicas e cigarros.