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https://www.readbyqxmd.com/read/28203061/herding-a-new-phenomenon-affecting-medical-decision-making-in-multiple-sclerosis-care-lessons-learned-from-discutir-ms
#1
Gustavo Saposnik, Jorge Maurino, Angel P Sempere, Christian C Ruff, Philippe N Tobler
PURPOSE: Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS) when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors) of herding in the management of MS...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28196453/near-infrared-spectroscopy-in-gait-disorders
#2
Vera Gramigna, Giovanni Pellegrino, Antonio Cerasa, Simone Cutini, Roberta Vasta, Giuseppe Olivadese, Iolanda Martino, Aldo Quattrone
Walking is a complex motor behavior with a special relevance in clinical neurology. Many neurological diseases, such as Parkinson's disease and stroke, are characterized by gait disorders whose neurofunctional correlates are poorly investigated. Indeed, the analysis of real walking with the standard neuroimaging techniques poses strong challenges, and only a few studies on motor imagery or walking observation have been performed so far. Functional near-infrared spectroscopy (fNIRS) is becoming an important research tool to assess functional activity in neurological populations or for special tasks, such as walking, because it allows investigating brain hemodynamic activity in an ecological setting, without strong immobility constraints...
January 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/28196426/development-of-a-functional-observational-battery-in-the-minipig-for-regulatory-neurotoxicity-assessments
#3
Miao Zhong, Catherine Shoemake, Amber Fuller, David White, Chris Hanks, Derek Brocksmith, Jason Liu, Shayne Gad, Guy Bouchard, Alain Stricker-Krongrad
A functional observational battery (FOB) is recommended as the first-tier neurotoxicity screening in the preclinical safety pharmacology testing guidelines. Minipigs have increasingly been used in regulatory toxicology studies; however, no current FOB protocol is available for neurotoxicity testing in these species. Hence, a minipig FOB instrument was developed. A complete crossover study with Sinclair minipigs was performed to evaluate physiologic, neurologic, and behavioral effects of amphetamine, ketamine, and diazepam...
January 1, 2017: International Journal of Toxicology
https://www.readbyqxmd.com/read/28147417/neurologic-prognostication-neurologic-examination-and-current-guidelines
#4
Claudio Sandroni, Sonia D'Arrigo
Clinical examination is paramount for prognostication in patients who are comatose after resuscitation from cardiac arrest. At 72 hours from recovery of spontaneous circulation (ROSC), an absent or extensor motor response to pain (M ≤ 2) is a very sensitive, but not specific predictor of poor neurologic outcome. Bilaterally absent pupillary or corneal reflexes are less sensitive, but highly specific predictors. Besides the clinical examination, investigations such as somatosensory evoked potentials (SSEPs), electroencephalography (EEG), blood levels of neuron-specific enolase (NSE), or imaging studies can be used for neuroprognostication...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28127506/chemotherapy-induced-neuropathies-a-growing-problem-for-patients-and-health-care-providers
#5
Marta Banach, Judyta K Juranek, Aneta L Zygulska
INTRODUCTION: Chemotherapy-induced neuropathies are one of the most common side effects of cancer treatment, surpassing bone marrow suppression and kidney dysfunction. Chemotherapy effects on the nervous system vary between different classes of drugs and depend on specific chemical and physical properties of the drug used. The three most neurotoxic classes of anti-cancer drugs are: platinum-based drugs, taxanes, and thalidomide and its analogs; other, less neurotoxic but also commonly used drugs are: bortezomib, ixabepilone, and vinca alkaloids...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28125370/a-systematic-review-of-the-effect-of-cancer-treatment-on-work-productivity-of-patients-and-caregivers
#6
Khalid M Kamal, Jordan R Covvey, Ankur Dashputre, Somraj Ghosh, Surbhi Shah, Monali Bhosle, Christopher Zacker
BACKGROUND: Cancer is a leading cause of death with substantial financial costs. While significant data exist on the economic burden of care, less is known about the indirect costs of treatment and, specifically, the effect on work productivity of patients and their caregivers. To examine the full effect of cancer and the potential value of new therapies, all aspects of care, including indirect costs and patient-reported outcomes, should be evaluated. OBJECTIVE: To perform a systematic review of the literature examining the effect of cancer treatment on work productivity in patients and their caregivers...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#7
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#8
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/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#9
Subeer K Wadia, Mark Belkin, Kelsey S 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...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28007358/hypnic-jerks-are-an-underestimated-sleep-motor-phenomenon-in-patients-with-parkinsonism-a-video-polysomnographic-and-neurophysiological-study
#10
Giacomo Chiaro, Giovanna Calandra-Buonaura, Luisa Sambati, Annagrazia Cecere, Caterina Ferri, Maria Turchese Caletti, Pietro Cortelli, Federica Provini
INTRODUCTION: Hypnic jerks (HJs) are sudden contractions of one or more body segments occurring mostly at sleep onset. They are highly sporadic and affect all ages and both sexes with prevalence between 60% and 70% in the general population. STUDY OBJECTIVES: This study describes the frequency and the neurophysiological characteristics of HJs in a population of patients with parkinsonism by means of nocturnal video-polysomnographic recordings. METHODS: This is a prospective cohort study and is reported following the STROBE guidelines...
October 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#11
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27977331/cell-therapies-administered-in-the-chronic-phase-after-stroke-a-meta-analysis-examining-safety-and-efficacy
#12
David J Unsworth, Jane L Mathias, Diana S Dorstyn
AIM: To assess the safety and efficacy of cell therapies for chronic stroke. METHODOLOGY: Five databases were searched for treatments administered >90 days post-stroke. Reporting quality, adherence to research guidelines, treatment safety (risk ratios/pooled incidence rates) and neurological/functional efficacy (Hedge's g) were all evaluated. RESULTS: Twenty-three studies examined 17 treatments. Reporting quality scores were medium to high, but adherence to recommended guidelines was lower...
January 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/27929229/the-mental-status-examination
#13
David Norris, Molly S Clark, Sonya Shipley
The mental status examination includes general observations made during the clinical encounter, as well as specific testing based on the needs of the patient and physician. Multiple cognitive functions may be tested, including attention, executive functioning, gnosia, language, memory, orientation, praxis, prosody, thought content, thought processes, and visuospatial proficiency. Proprietary and open-source clinical examination tools are available, such as the Mini-Mental State Examination and the Mini-Cog...
October 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27913818/-amyloid-positron-emission-tomography-with-18-%C3%A2-f-florbetaben-in-the-diagnostic-workup-of-dementia-patients
#14
S Schönecker, C Prix, T Raiser, N Ackl, E Wlasich, G Stenglein-Krapf, E Mille, M Brendel, O Sabri, M Patt, H Barthel, P Bartenstein, J Levin, A Rominger, A Danek
BACKGROUND: To this day the definite diagnosis of Alzheimer's disease still relies on post-mortem histopathological detection of neurofibrillary tangles and beta-amyloid deposits. Amyloid positron emission tomography (PET) is a new diagnostic tool that enables the in vivo quantification of pathological beta-amyloid deposits. The aim of the current study was to evaluate to what extent (18)F-florbetaben-PET (FBB-PET) influences the diagnosis of patients with dementia. MATERIAL AND METHODS: Imaging with FBB-PET was performed on 33 patients from our outpatient department for cognitive neurology...
December 2, 2016: Der Nervenarzt
https://www.readbyqxmd.com/read/27907967/modern-approach-to-brain-death
#15
Panayiotis N Varelas, Ariane Lewis
People die either when their heart and respiration stop or when their brain irreversibly stops functioning. This latter mode of death by neurologic criteria (also called brain death) emerged after the development of ventilators and intensive care units in the late 1950s and 1960s. Brain death is universally accepted as a modern entity, but the complex process for declaring a patient brain dead is not uniformly followed across country and state lines or even hospital policies, creating unacceptable variability and risks for falsely pronouncing a patient dead...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27894459/dsm-5-somatic-symptom-disorder-in-patients-with-vertigo-and-dizziness-symptoms
#16
Karina Limburg, Heribert Sattel, Katharina Radziej, Claas Lahmann
OBJECTIVE: DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. METHODS: We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires...
December 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27848247/hospital-rehabilitation-for-patients-with-obesity-a-scoping-review
#17
Jennifer C Seida, Arya M Sharma, Jeffrey A Johnson, Mary Forhan
PURPOSE: To explore the evidence on rehabilitation for hospitalized patients with obesity. METHODS: Medline, Embase, CENTRAL, CINAHL, and PubMed were searched from 1994 to May 2016. Grey literature was hand-searched. Two reviewers independently selected studies examining patients with obesity receiving hospital-based therapy for a physical impairment. One reviewer extracted the data and a second reviewer verified a random sample. RESULTS: Thirty-nine studies (two trials, 37 observational) were included...
November 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27834089/an-audit-of-the-effectiveness-of-large-group-neurology-tutorials-for-irish-undergraduate-medical-students
#18
H Kearney, A Krakar, A Drazyk, E Maloney, I Callinan, N Tubridy
The aim of this audit was to determine the effectiveness of large group tutorials for teaching neurology to medical students. Students were asked to complete a questionnaire rating their confidence on a ten point Likert scale in a number of domains in the undergraduate education guidelines from the Association of British Neurologists (ABN). We then arranged a series of interactive large group tutorials for the class and repeated the questionnaire one month after teaching. In the three core domains of neurological: history taking, examination and differential diagnosis, none of the students rated their confidence as nine or ten out of ten prior to teaching...
August 8, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27831965/care-track-towards-appropriate-care-for-low-back-pain
#19
Shanthi A Ramanathan, Peter D Hibbert, Chris G Maher, Richard O Day, Diane M Hindmarsh, Tamara D Hooper, Natalie A Hannaford, William B Runciman
STUDY DESIGN: Retrospective medical record review to assess compliance with low back pain (LBP) care indicators. OBJECTIVE: To establish baseline estimates of the appropriateness of LBP care in the general Australian population provided by a range of healthcare providers in various real-world settings. SUMMARY OF BACKGROUND DATA: Low back pain (LBP) is a costly condition and accounts for the greatest burden of disease worldwide, yet the care provided is often at variance with guidelines...
November 9, 2016: Spine
https://www.readbyqxmd.com/read/27799842/variations-in-the-management-of-fibromyalgia-by-physician-specialty-rheumatology-versus-primary-care
#20
Stephen L Able, Rebecca L Robinson, Kurt Kroenke, Philip Mease, David A Williams, Yi Chen, Madelaine Wohlreich, Bill H McCarberg
PURPOSE: To evaluate the effect of physician specialty regarding diagnosis and treatment of fibromyalgia (FM) and assess the clinical status of patients initiating new treatment for FM using data from Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments. PATIENTS AND METHODS: Outpatients from 58 sites in the United States were enrolled. Data were collected via in-office surveys and telephone interviews. Pairwise comparisons by specialty were made using chi-square, Fisher's exact tests, and Student's t-tests...
2016: Pragmat Obs Res
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