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Neurology. Clinical Practice

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https://www.readbyqxmd.com/read/28840919/virtual-visits-for-parkinson-disease-a-multicenter-noncontrolled-cohort
#1
Ryan E Korn, Aparna Wagle Shukla, Maya Katz, H Tait Keenan, Steven Goldenthal, Peggy Auinger, William Zhu, Michael Dodge, Kyle Rizer, Meredith A Achey, Erica Byrd, Richard Barbano, Irene Richard, Kelly L Andrzejewski, Heidi B Schwarz, E Ray Dorsey, Kevin M Biglan, Gail Kang, Sulada Kanchana, Ramon Rodriguez, Caroline M Tanner, Nicholas B Galifianakis
BACKGROUND: Previous small-scale studies have demonstrated the feasibility of providing remote specialty care via virtual visits. We assessed the feasibility and benefits of a one-time consultation between a remote Parkinson Disease (PD) specialist and an individual with PD at home on a larger scale. METHODS: We conducted a multicenter noncontrolled cohort of virtual visits administered over videoconferencing between remote PD specialists and individuals with PD in their home...
August 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28840913/effect-of-integrated-community-neurology-on-utilization-diagnostic-testing-and-access
#2
Muhamad Y Elrashidi, Lindsey M Philpot, Nathan P Young, Priya Ramar, Kristi M Swanson, Paul M McKie, Sarah J Crane, Jon O Ebbert
BACKGROUND: The primary care medical home (PCMH) aims to promote delivery of high-value health care. However, growing demand for specialists due to increasingly older adults with complicated and chronic disease necessitates development of novel care models that efficiently incorporate specialty expertise while maintaining coordination and continuity with the PCMH. We describe the effect of a model of integrated community neurology (ICN) on health care utilization, diagnostic testing, and access...
August 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28840904/adult-onset-dystonia-with-marfanoid-features
#3
Scott A Norris, Anja Pogarcic, Matt Hicks, Joel S Perlmutter, Marwan Shinawi
No abstract text is available yet for this article.
August 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28680768/restless-legs-syndrome-with-augmentation-successfully-treated-with-iv-iron
#4
Vincent LaBarbera, Lynn Marie Trotti, David Rye
No abstract text is available yet for this article.
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28680767/a-resident-boot-camp-for-reducing-door-to-needle-times-at-academic-medical-centers
#5
REVIEW
Ilana M Ruff, Ava L Liberman, Fan Z Caprio, Matthew B Maas, Scott J Mendelson, Farzaneh A Sorond, Deborah Bergman, Richard A Bernstein, Yvonne Curran, Shyam Prabhakaran
BACKGROUND: We sought to determine if a structured educational program for neurology residents can lower door-to-needle (DTN) times at an academic institution. METHODS: A neurology resident educational stroke boot camp was developed and implemented in April 2013. Using a prospective database of 170 consecutive acute ischemic stroke (AIS) patients treated with IV tissue plasminogen activator (tPA) in our emergency department (ED), we evaluated the effect of the intervention on DTN times...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28680766/cerebrovascular-fibromuscular-dysplasia-the-mgh-cohort-and-literature-review
#6
Andrea M Harriott, Eli Zimmerman, Aneesh B Singhal, Michael R Jaff, Mark E Lindsay, Guy A Rordorf
BACKGROUND: Fibromuscular dysplasia (FMD) is a rare noninflammatory, nonatherosclerotic arteriopathy of medium-sized arteries affecting up to 7% of the population. The disease can affect any artery but commonly affects renal, extracranial carotid, and vertebral arteries. The epidemiology and natural course of cerebrovascular FMD is unknown and requires further investigation. METHODS: We present demographic and outcomes data on a case series of 81 patients with cerebrovascular FMD from Massachusetts General Hospital presenting between 2011 and 2015 followed by a review of the peer-reviewed literature...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28680765/barriers-and-facilitators-to-ed-physician-use-of-the-test-and-treatment-for-bppv
#7
Kevin A Kerber, Jane Forman, Laura Damschroder, Steven A Telian, Angela Fagerlin, Patricia Johnson, Devin L Brown, Lawrence C An, Lewis B Morgenstern, William J Meurer
BACKGROUND: The test and treatment for benign paroxysmal positional vertigo (BPPV) are evidence-based practices supported by clinical guideline statements. Yet these practices are underutilized in the emergency department (ED) and interventions to promote their use are needed. To inform the development of an intervention, we interviewed ED physicians to explore barriers and facilitators to the current use of the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). METHODS: We conducted semi-structured in-person interviews with ED physicians who were recruited at annual ED society meetings in the United States...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28680764/early-transition-to-comfort-measures-only-in-acute-stroke-patients-analysis-from-the-get-with-the-guidelines-stroke-registry
#8
Shyam Prabhakaran, Margueritte Cox, Barbara Lytle, Phillip J Schulte, Ying Xian, Darin Zahuranec, Eric E Smith, Mathew Reeves, Gregg C Fonarow, Lee H Schwamm
BACKGROUND: Death after acute stroke often occurs after forgoing life-sustaining interventions. We sought to determine the patient and hospital characteristics associated with an early decision to transition to comfort measures only (CMO) after ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in the Get With The Guidelines-Stroke registry. METHODS: We identified patients with IS, ICH, or SAH between November 2009 and September 2013 who met study criteria...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28409063/a-practical-approach-to-detection-and-treatment-of-depression-in-parkinson-disease-and-dementia
#9
REVIEW
Zahra Goodarzi, Zahinoor Ismail
PURPOSE OF REVIEW: To review the available evidence for the detection and management of depression in Parkinson disease (PD) and dementia. RECENT FINDINGS: Depression is a common comorbidity in those with PD or dementia, and leads to increased morbidity. There are several available and accurate tools for the detection of depression in PD (e.g., Geriatric Depression Scale) and dementia (e.g., Cornell Scale for Depression in Dementia). Treatment of depression depends on patient preference, severity of depression, comorbidities, and available resources...
April 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28409062/improved-availability-and-quality-of-care-with-epilepsy-nurse-practitioners
#10
Chloe E Hill, Bethany Thomas, Kimberly Sansalone, Kathryn A Davis, Judy A Shea, Brian Litt, Nabila Dahodwala
BACKGROUND: This study investigated the quality of care delivered by nurse practitioner (NP)-physician teams employed to expand clinic appointment availability for patients with epilepsy. METHODS: We performed a retrospective observational cohort study of patients with epilepsy presenting to the Penn Epilepsy Center for a new patient appointment in 2014. During this time, patients were seen either by an NP-physician team care model or a more traditional physician-only care model...
April 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28243505/optimizing-extended-release-carbidopa-levodopa-in-parkinson-disease-consensus-on-conversion-from-standard-therapy
#11
REVIEW
Alberto J Espay, Fernando L Pagan, Benjamin L Walter, John C Morgan, Lawrence W Elmer, Cheryl H Waters, Pinky Agarwal, Rohit Dhall, William G Ondo, Kevin J Klos, Dee E Silver
PURPOSE OF REVIEW: To help clinicians optimize the conversion of a patient's Parkinson disease pharmacotherapy from immediate-release carbidopa/levodopa (IR CD/LD) to an extended-release formulation (ER CD/LD). RECENT FINDINGS: Eleven movement disorders specialists achieved consensus positions on the modification of trial-based conversion guidelines to suit individual patients in clinical practice. SUMMARY: Because the pharmacokinetics of ER CD/LD differ from those of IR CD/LD, modification of dosage and dosing frequency are to be expected...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28243504/aminopyridines-for-the-treatment-of-neurologic-disorders
#12
REVIEW
Michael Strupp, Julian Teufel, Andreas Zwergal, Roman Schniepp, Kamran Khodakhah, Katharina Feil
PURPOSE OF REVIEW: To identify the different indications for the treatment of neurologic disorders with the potassium channel blockers 4-aminopyridine (4-AP) and 3,4-diaminopyridine (3,4-DAP). RECENT FINDINGS: 4-AP is an effective symptomatic treatment for downbeat nystagmus (DBN), episodic ataxia type 2 (EA2) (5-10 mg TID), and impaired gait in multiple sclerosis (MS) (10 mg BID). 3,4-DAP (5 mg/d-20 mg TID) improves symptoms in Lambert-Eaton myasthenic syndrome (LEMS) (randomized placebo-controlled trials for all 4 entities)...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28243503/hemorrhagic-primary-cns-angiitis-and-vasoconstrictive-drug-exposure
#13
Mehmet A Topcuoglu, Ruchira M Jha, Jacob George, Matthew P Frosch, Aneesh B Singhal
BACKGROUND: Primary angiitis of the CNS (PACNS) typically manifests with accumulating neurologic deficits from ischemic strokes. Intracerebral hemorrhage (ICH) is an uncommon complication. There is limited knowledge about the risk factors and features of hemorrhagic PACNS. METHODS: We identified 49 patients (20 biopsy-proven) with PACNS diagnosed at our hospital from 1993 to 2015. We compared the features of hemorrhagic and nonhemorrhagic PACNS and analyzed the hemorrhagic PACNS cases in detail...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28243502/ceeg-electrode-related-pressure-ulcers-in-acutely-hospitalized-patients
#14
Lidia M V R Moura, Thiago S Carneiro, David Kwasnik, Valdery F Moura, Christine S Blodgett, Joseph Cohen, Mary McKenna Guanci, Daniel B Hoch, John Hsu, Andrew J Cole, M Brandon Westover
BACKGROUND: Pressure ulcers resulting from continuous EEG (cEEG) monitoring in hospitalized patients have gained attention as a preventable medical complication. We measured their incidence and risk factors. METHODS: We performed an observational investigation of cEEG-electrode-related pressure ulcers (EERPU) among acutely ill patients over a 22-month period. Variables analyzed included age, sex, monitoring duration, hospital location, application methods, vasopressor usage, nutritional status, skin allergies, fever, and presence/severity of EERPU...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28243501/validation-of-olfactory-deficit-as-a-biomarker-of-alzheimer-disease
#15
Matthew R Woodward, Chaitanya V Amrutkar, Harshit C Shah, Ralph H B Benedict, Sanjanaa Rajakrishnan, Rachelle S Doody, Li Yan, Kinga Szigeti
BACKGROUND: We evaluated smell identification as a biomarker for Alzheimer disease (AD) by assessing its utility in differentiating normal aging from an amnestic disorder and determining its predictive value for conversion from amnestic mild cognitive impairment (aMCI) to AD. METHODS: Cross-sectional study (AD = 262, aMCI = 110, controls = 194) measuring smell identification (University of Pennsylvania Smell Identification Test [UPSIT]) and cognitive status was performed, as well as longitudinal analysis of aMCI participants (n = 96) with at least 1 year follow-up (mean 477...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28058208/quantitative-eeg-in-attention-deficit-hyperactivity-disorder-a-companion-payment-policy-review-for-clinicians-and-payers
#16
Marc R Nuwer, Jeffrey Buchhalter, Katie M Shepard
Quantitative EEG measurement of the scalp vertex theta/beta ratio (TBR) is marketed as a tool for use in the evaluation of patients who may have attention-deficit/hyperactivity disorder (ADHD). The American Academy of Neurology (AAN) recently assessed the literature about this tool. The assessment urged caution, considering that the TBR remains an investigational research tool at this time. This perspective comments further on that assessment and its rationale, and recommends a perspective for the clinician and payer...
December 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28058207/memory-loss-five-new-things
#17
Ferenc Deak, Nidhi Kapoor, Calin Prodan, Linda A Hershey
PURPOSE OF REVIEW: Memory loss can be due to a wide variety of causes. We provide new information about the biology of common genetic and acquired causes of memory loss in older adults. RECENT FINDINGS: New data are available about the genetics of Alzheimer disease (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia. Amyloid PET, FDG-PET, and MRI have improved our understanding of how mild cognitive impairment evolves to AD. Several studies have shown links between concussion and chronic traumatic encephalopathy...
December 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28058206/zika-virus-disease-for-neurologists
#18
REVIEW
Daniel E Smith, J David Beckham, Kenneth L Tyler, Daniel M Pastula
PURPOSE OF REVIEW: Zika virus (ZIKV) was not initially thought to be an important cause of neurologic disease, but with the recent epidemic in the Western Hemisphere, there is a growing body of evidence for possible neurologic complications. This review discusses these in addition to what is known about modes of transmission, testing for the virus, as well as future directions. RECENT FINDINGS: ZIKV disease has been associated with microcephaly and congenital eye disease in infants, as well as with Guillain-Barré syndrome, uveitis, myelitis, and meningoencephalitis in adults...
December 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28058205/rehabilitation-in-multiple-sclerosis-commentary-on-the-recent-aan-systematic-review
#19
Matthew H Sutliff, Susan E Bennett, Patricia Bobryk, June Halper, Lori A Saslow, Lisa T Skutnik, Christine Smith, Kathleen Zackowski, David E Jones
No abstract text is available yet for this article.
December 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/27847687/stuttering-lacunar-infarction-captured-on-serial-mris
#20
Pouya Tahsili-Fahadan, Alexis N Simpkins, Richard Leigh, José G Merino
No abstract text is available yet for this article.
October 2016: Neurology. Clinical Practice
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