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https://www.readbyqxmd.com/read/28099564/guideline-for-multiple-sclerosis-treatment-in-brazil-consensus-from-the-neuroimmunology-scientific-department-of-the-brazilian-academy-of-neurology
#1
Elizabeth Regina Comini-Frota, Cláudia C F Vasconcelos, Maria Fernanda Mendes
Multiple sclerosis has become an ever-increasing challenge to neurologists. With the release of the latest medications on the market, Brazilian neurologists feel divided between following their patients' evolution in accordance with the strict rules established by the Brazilian Ministry of Health regarding drug distribution, or following disease progression and worsening in accordance with the evidence in the literature. Therefore, a systematic review of the main published treatment guidelines was conducted and an escalating therapy proposed for guiding multiple sclerosis patient treatment in Brazil...
January 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28099563/brazilian-guidelines-for-endovascular-treatment-of-patients-with-acute-ischemic-stroke
#2
Octávio Marques Pontes-Neto, Pedro Cougo, Sheila Cristina Ouriques Martins, Daniel G Abud, Raul G Nogueira, Maramélia Miranda, Luiz Henrique de Castro-Afonso, Leticia C Rebello, José Guilherme M Pereira Caldas, Rodrigo Bazan, Daniel C Bezerra, Marco Tulio Rezende, Gabriel R de Freitas, Alexandre Longo, Pedro Magalhães, João José Freitas de Carvalho, Francisco José Montalverne, Fabricio Oliveira Lima, Gustavo H V Andrade, Ayrton R Massaro, Jamary Oliveira-Filho, Rubens Gagliardi, Gisele Sampaio Silva
These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus...
January 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28099516/clinical-practice-guidelines-for-rare-diseases-the-orphanet-database
#3
Sonia Pavan, Kathrin Rommel, María Elena Mateo Marquina, Sophie Höhn, Valérie Lanneau, Ana Rath
Clinical practice guidelines (CPGs) for rare diseases (RDs) are scarce, may be difficult to identify through Internet searches and may vary in quality depending on the source and methodology used. In order to contribute to the improvement of the diagnosis, treatment and care of patients, Orphanet (www.orpha.net) has set up a procedure for the selection, quality evaluation and dissemination of CPGs, with the aim to provide easy access to relevant, accurate and specific recommendations for the management of RDs...
2017: PloS One
https://www.readbyqxmd.com/read/28099439/single-versus-serial-measurements-of-neuron-specific-enolase-and-prediction-of-poor-neurological-outcome-in-persistently-unconscious-patients-after-out-of-hospital-cardiac-arrest-a-ttm-trial-substudy
#4
Sebastian Wiberg, Christian Hassager, Pascal Stammet, Matilde Winther-Jensen, Jakob Hartvig Thomsen, David Erlinge, Michael Wanscher, Niklas Nielsen, Tommaso Pellis, Anders Åneman, Hans Friberg, Jan Hovdenes, Janneke Horn, Jørn Wetterslev, John Bro-Jeppesen, Matthew P Wise, Michael Kuiper, Tobias Cronberg, Yvan Gasche, Yvan Devaux, Jesper Kjaergaard
BACKGROUND: Prediction of neurological outcome is a crucial part of post cardiac arrest care and prediction in patients remaining unconscious and/or sedated after rewarming from targeted temperature management (TTM) remains difficult. Current guidelines suggest the use of serial measurements of the biomarker neuron-specific enolase (NSE) in combination with other predictors of outcome in patients admitted after out-of-hospital cardiac arrest (OHCA). This study sought to investigate the ability of NSE to predict poor outcome in patients remaining unconscious at day three after OHCA...
2017: PloS One
https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#5
Paul R Lewis, Casey E Dunne, James D Wallace, Jason B Brill, Richard Y Calvo, Jayraan Badiee, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: The Brain Trauma Foundation guidelines provide indications for neurosurgical intervention in traumatic brain injury (TBI) with moderate or severe intracranial hemorrhage (ICH). In TBI patients with less severe ICH, the utility of neurosurgical consultation remains unclear. We sought to determine if routine neurosurgical consultation is necessary for mild blunt TBI patients with ICH. METHODS: A retrospective cohort study was conducted on 500 consecutive blunt TBI patients aged 15 years or older with Glasgow Coma Scale score ≥13 and ICH on initial head computed tomography (CT) admitted to a Level 1 trauma center over 28 months...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28097621/practice-patterns-of-venous-thromboembolism-prophylaxis-in-underweight-critically-ill-patients-with-neurologic-injury
#6
Kevin Betthauser, Hannah Pope, Mollie Gowan, Theresa Human
PURPOSE: Venous thromboembolism (VTE) prophylaxis in underweight patients with neurologic injury remains unaddressed by guidelines and primary literature. This study aimed to describe VTE prophylaxis strategies employed in this population and compare the impact of underweight and non-obese patients on thrombotic and bleeding events. METHODS: A retrospective review of adults admitted with a diagnosis of neurologic injury to a neurology/neurosurgery intensive care unit (ICU) over 6 years...
January 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28096078/how-to-prevent-the-microvascular-complications-of-type-2-diabetes-beyond-glucose-control
#7
REVIEW
Willy Marcos Valencia, Hermes Florez
Microvascular complications (retinopathy, nephropathy, and neuropathy) affect hundreds of millions of patients with type 2 diabetes. They usually affect people with longstanding or uncontrolled disease, but they can also be present at diagnosis or in those yet to have a diagnosis made. The presentation and progression of these complications can lead to loss of visual, renal, and neurologic functions, impaired mobility and cognition, poor quality of life, limitations for employment and productivity, and increased costs for the patient and society...
January 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28094087/-management-of-jaundice-in-the-newborn%C3%A2-35%C3%A2-gw-from-screening-to-follow-up-after-discharge-guidelines-for-clinical-practice
#8
A Cortey, L Renesme, J Raignoux, A Bedu, C Casper, P Tourneux, P Truffert
Jaundice due to unconjugated bilirubin is an everyday condition in the neonatal period because it results from the adaptation of bilirubin metabolism at this time of life. Hyperbilirubinemia has a potential neurotoxicity and although it most often resolves spontaneously, it can lead to acute and sometimes chronic encephalopathy. The latter condition is called kernicterus and induces severe and irreversible neurological sequelae. This rare complication is still reported in all countries throughout the world even if severe hyperbilirubinemia can be prevented and critical points points of failure in jaundice management are identified...
January 13, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28093642/the-ethical-framework-for-performing-research-with-rare-inherited-neurometabolic-disease-patients
#9
Viviana Giannuzzi, Hugo Devlieger, Lucia Margari, Viveca Lena Odlind, Lamis Ragab, Cinzia Maria Bellettato, Francesca D'Avanzo, Christina Lampe, Linda Cassis, Elisenda Cortès-Saladelafont, Ángels Garcia Cazorla, Ivo Barić, Ljerka Cvitanović-Šojat, Ksenija Fumić, Christine I Dali, Franco Bartoloni, Fedele Bonifazi, Maurizio Scarpa, Adriana Ceci
: The need for performing clinical trials to develop well-studied and appropriate medicines for inherited neurometabolic disease patients faces ethical concerns mainly raising from four aspects: the diseases are rare; include young and very young patients; the neurological impairment may compromise the capability to provide 'consent'; and the genetic nature of the disease leads to further ethical implications. This work is intended to identify the ethical provisions applicable to clinical research involving these patients and to evaluate if these cover the ethical issues...
January 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#10
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28086771/naturalistic-study-of-guideline-implementation-tool-use-via-evaluation-of-website-access-and-physician-survey
#11
Melissa J Armstrong, Gary S Gronseth, Richard Dubinsky, Sonja Potrebic, Rebecca Penfold Murray, Thomas S D Getchius, Carol Rheaume, Anna R Gagliardi
BACKGROUND: Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development...
January 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28078733/therapeutic-apheresis-in-immunologic-renal-and-neurological-diseases
#12
REVIEW
Rolf Bambauer, Reinhard Latza, Daniel Burgard, Ralf Schiel
Since the mid 1970s, when membrane modules became available, plasma separation techniques have gained in importance especially in the past few years. The advantages of this method are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate and higher efficacy. Systemic autoimmune diseases based on an immune pathogenesis produce autoantibodies and circulating immune complexes, which cause inflammation in the tissues of various organs. In most cases, these diseases have a poor prognosis without treatment...
January 12, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28077494/practice-guideline-summary-use-of-fmri-in-the-presurgical-evaluation-of-patients-with-epilepsy-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#13
Jerzy P Szaflarski, David Gloss, Jeffrey R Binder, William D Gaillard, Alexandra J Golby, Scott K Holland, Jeffrey Ojemann, David C Spencer, Sara J Swanson, Jacqueline A French, William H Theodore
OBJECTIVE: To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes. METHODS: An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded...
January 11, 2017: Neurology
https://www.readbyqxmd.com/read/28077490/improving-uniformity-in-brain-death-determination-policies-over-time
#14
Hilary H Wang, Panayiotis N Varelas, Galen V Henderson, Eelco F M Wijdicks, David M Greer
OBJECTIVE: To demonstrate that progress has been made in unifying brain death determination guidelines in the last decade by directly comparing the policies of the US News and World Report's top 50 ranked neurologic institutions from 2006 and 2015. METHODS: We solicited official hospital guidelines in 2015 from these top 50 institutions, generated summary statistics of their criteria as benchmarked against the American Academy of Neurology Practice Parameters (AANPP) and the comparison 2006 cohort in 5 key categories, and statistically compared the 2 cohorts' compliance with the AANPP...
January 11, 2017: Neurology
https://www.readbyqxmd.com/read/28070884/a-national-survey-of-neurological-monitoring-practice-after-obstetric-regional-anaesthesia-in-the-uk
#15
E Roderick, J Hoyle, S M Yentis
Neuraxial anaesthesia is widely used in obstetrics and neurological complications are rare. However, when they occur, subsequent investigation and management are time-critical and correlate with the extent of neurological recovery. The Third National Audit Project recommended the implementation of guidelines in obstetric epidural management, including advice on monitoring for early signs of problems and acting upon concerns. However, no national guideline exists for postoperative management in the obstetric population...
January 10, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28069419/hyperbaric-oxygen-therapy-for-the-prevention-of-arterial-gas-embolism-in-food-grade-hydrogen-peroxide-ingestion
#16
Stephen M Hendriksen, Nicholas L Menth, Bjorn C Westgard, Jon B Cole, Joseph W Walter, Thomas C Masters, Christopher J Logue
Food grade hydrogen peroxide ingestion is a relatively rare presentation to the emergency department. There are no defined guidelines at this time regarding the treatment of such exposures, and providers may not be familiar with the potential complications associated with high concentration hydrogen peroxide ingestions. In this case series, we describe four patients who consumed 35% hydrogen peroxide, presented to the emergency department, and were treated with hyperbaric oxygen therapy. Two of the four patients were critically ill requiring intubation...
December 14, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28060219/multicenter-study-of-adverse-events-after-intravenous-tissue-type-plasminogen-activator-treatment-of-acute-ischemic-stroke
#17
Hannah Fernandez-Gotico, Tiffany Lightfoot, Melissa Meighan
BACKGROUND AND PURPOSE: The approved treatment by the Food and Drug Administration for acute ischemic stroke is intravenous tissue-type plasminogen activator (IV tPA). After IV tPA administration, patients are monitored for adverse events using an American Heart Association/American Stroke Association guideline instituted in 1996. There is limited evidence describing the safest and most efficient method to monitor patients during the first 24 hours after tPA administration. Although the overall rates of adverse events have been reported, the time when patients may be at most risk for an event has not been studied...
February 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28057897/review-and-update-of-the-hong-kong-epilepsy-guideline-on-status-epilepticus
#18
REVIEW
E Lw Fung, B Bh Fung
Convulsive status epilepticus is the most extreme form of seizure. It is a medical and neurological emergency that requires prompt and appropriate treatment. Treatment of convulsive status epilepticus is usually divided into stages/steps. The International League Against Epilepsy has released a new definition of status epilepticus that may help to unify the definition in future studies. Over the last few years new information has become available regarding its management. The Rapid Anticonvulsant Medication Prior to Arrival Trial demonstrated non-inferiority of intramuscular midazolam in early status epilepticus compared with intravenous lorazepam...
January 6, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28053925/reliability-and-validity-of-a-chinese-version-of-the-stroke-action-test-a-new-instrument-for-assessment-of-stroke-knowledge-and-response
#19
Mei Ha, Xiaoling Qian, Hong Yang, Jichun Huang, Changjiang Liu
BACKGROUND: The public's cognition of stroke and responses to stroke symptoms are important to prevent complications and decrease the mortality when stroke occurs. The aim of study was to develop and validate the Chinese version of the Stroke Action Test (C-STAT) in a Chinese population. METHODS: This study was rigorously implemented with the published guideline for the translation, adaptation and validation of instruments for the cross-cultural use in healthcare care research...
December 2016: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28051764/the-use-of-fibrin-sealant-during-non-emergency-surgery-a-systematic-review-of-evidence-of-benefits-and-harms
#20
Steven J Edwards, Fay Crawford, Michelle Helena van Velthoven, Andrea Berardi, George Osei-Assibey, Mariana Bacelar, Fatima Salih, Victoria Wakefield
BACKGROUND: Fibrin sealants are used in different types of surgery to prevent the accumulation of post-operative fluid (seroma) or blood (haematoma) or to arrest haemorrhage (bleeding). However, there is uncertainty around the benefits and harms of fibrin sealant use. OBJECTIVES: To systematically review the evidence on the benefits and harms of fibrin sealants in non-emergency surgery in adults. DATA SOURCES: Electronic databases [MEDLINE, EMBASE and The Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and the Cochrane Central Register of Controlled Trials)] were searched from inception to May 2015...
December 2016: Health Technology Assessment: HTA
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