Read by QxMD icon Read

Clinical Trials and Neurology

Elyse M Cornett, Matthew B Novitch, Andrew J Brunk, Kelly S Davidson, Bethany L Menard, Richard D Urman, Alan D Kaye
There are currently new drugs being developed that have benzodiazepine properties. This review will examine remimazolam, 3-hydroxyphenazapam, adinazolam, clonazolam, and deschloroetizolam as well as other novel agents. All benzodiazepines are protein bound and only moderately lipid soluble. In addition to their baseline properties, they can be enzymatically broken down into active metabolites. The mechanism of action of these medications is related to polysynaptic pathway inhibition via direct interaction with GABA and modifiable chloride channels...
June 2018: Best Practice & Research. Clinical Anaesthesiology
(no author information available yet)
BACKGROUND: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function...
October 15, 2018: Systematic Reviews
Lisa Kearns, Alison Bateman-House, Arthur Caplan
Patients who suffer from life-threatening illnesses or are stricken with conditions that could result in serious morbidity who have exhausted all appropriate treatments may choose to try, through the Food and Drug Administration's expanded access program, an investigational drug or device in development. The program has succeeded for decades in allowing patients to access potentially helpful but still experimental agents. Nevertheless, the administration of investigational drugs outside of clinical trials raises several ethical issues...
October 2018: Seminars in Neurology
Julian P Tuazon, Regine Sitruk-Ware, Cesario V Borlongan
Neurological diseases such as ischemic stroke can be debilitating and have limited treatments available. The progestin Nestorone® (segesterone acetate) has been evaluated for use in birth control and hormone replacement therapy due to its potency and high affinity for the progesterone receptor. Interestingly, Nestorone also exerts neuroprotection in animals afflicted with various central nervous system diseases, including stroke, which implicates its potential for treating these maladies in clinical settings...
October 12, 2018: Brain Research
Silvio Piffer, Valeria Bignamini, Umberto Rozzanigo, Piero Poletti, Stefano Merler, Elisabetta Gremes, Domenico Marco Bonifati
INTRODUCTION AND STUDY AIM: Embolic strokes of undetermined source (ESUS) represent a rather recent diagnostic entity under clinical research for relapse prevention in cryptogenic stroke patients. Despite strict diagnostic criteria, ESUS definition ignores major clinical and radiological aspects, so including heterogeneous cases and probably influencing trial results. This study researches clinically relevant phenotypes among ESUS patients. PATIENTS AND METHODS: We evaluated ESUS patients admitted at Trento Stroke Unit over a 4-year period...
October 12, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Gráinne Kelly, Aoife Reilly, Hannah Moloney, Jonathan Moran, Caitriona Cunningham, Julie Broderick
BACKGROUND: Randomised controlled trials (RCTs) are described as the gold standard of investigative clinical research. Evidence based practice is critical to the physiotherapy profession, and it is therefore important to explore the research underpinning practice by examining published RCTs. OBJECTIVES: The main aims of this review were to profile the quantity and quality of RCTs published in the journal Physiotherapy over the past 50 years. DATA SOURCES: Physiotherapy journal, hand searched (1967 to 1987) and electronically (1988 to 2017)...
August 24, 2018: Physiotherapy
Massimo R Mannarino, Amirhossein Sahebkar, Vanessa Bianconi, Maria-Corina Serban, Maciej Banach, Matteo Pirro
The serine protease proprotein convertase subtilisin/kexin type 9 (PCSK9) modulates the levels of low-density lipoprotein cholesterol and cardiovascular risk. Potential risks of adverse neurological effects of intensive lipid-lowering treatment have been hypothesized, as cholesterol is a component of the central nervous system. Moreover, several observations suggest that PCSK9 might play a role in neurogenesis, neuronal migration and apoptosis. In rodents, increased expression of PCSK9 has been detected in specific areas of the central nervous system during embryonic development; also, PCSK9 modulates low-density lipoprotein receptor levels in the ischemic brain areas...
September 2018: Journal of Clinical Lipidology
Gustavo Noffs, Thushara Perera, Scott Camaron Kolbe, Camille Jessica Shanahan, Frederique Maria Christina Boonstra, Andrew Evans, Helmut Butzkueven, Anneke van der Walt, Adam Phillip Vogel
IMPORTANCE: Multiple sclerosis produces neurological impairments that are variable in duration, severity and quality. Speech is frequently impaired, resulting in decreased communication skills and quality of life. Advancements in technology now makes it possible to use quantitative acoustic assessment of speech as biomarkers of disease progression. OBSERVATIONS: Four domains of speech have been identified: articulation (slow articulation and imprecise consonants), voice (pitch and loudness instability), respiration (decreased phonatory time and expiratory pressure) and prosody (longer and frequent pauses, deficient loudness control)...
October 11, 2018: Autoimmunity Reviews
Anastasia N L Newman, Janelle Gravesande, Stephanie Rotella, Stephen S Wu, Nam Topp-Nguyen, Michelle E Kho, Jocelyn E Harris, Alison Fox-Robichaud, Patricia Solomon
PURPOSE: This scoping review summarizes the literature on the safety and effectiveness of physiotherapy interventions in patients with neurological and/or traumatic injuries in the intensive care unit (ICU), identifies literature gaps and provides recommendations for future research. MATERIALS AND METHODS: We searched five databases from inception to June 2, 2018. We included published retrospective studies, case studies, observation and randomized controlled trials describing physiotherapy interventions in ICU patients with neurotrauma injuries...
October 3, 2018: Journal of Critical Care
David Michelson, Emma Ciafaloni, Stephen Ashwal, Elliot Lewis, Pushpa Narayanaswami, Maryam Oskoui, Melissa J Armstrong
OBJECTIVE: To identify the level of evidence for use of nusinersen to treat spinal muscular atrophy (SMA) and review clinical considerations regarding use. METHODS: The author panel systematically reviewed nusinersen clinical trials for patients with SMA and assigned level of evidence statements based on the American Academy of Neurology's 2017 therapeutic classification of evidence scheme. Safety information, regulatory decisions, and clinical context were also reviewed...
October 12, 2018: Neurology
Alipio Pinto, Clara Berdasco, David Arenas-Mosquera, Adriana Cangelosi, Patricia A Geoghegan, Myriam C Nuñez, Jorge Goldstein
Infections by Enterohemorrhagic Escherichia coli may cause in addition to hemolytic uremic syndrome neurological disorders which may lead to fatal outcomes in patients. The brain striatum is usually affected during this outcome. The aim of this study was to determine in this area the role of the microglia in pro-inflammatory events that may occur during Shiga toxin 2 intoxication and consequently to this, whether oligodendrocytes were being affected. In the present paper we demonstrated that anti-inflammatory treatments reduced deleterious effects in brain striatal cells exposed to Shiga toxin 2 and LPS...
October 4, 2018: International Journal of Medical Microbiology: IJMM
Sarah Michiels, Annemarie Christien van der Wal, Evelien Nieste, Paul Van de Heyning, Marc Braem, Corine Visscher, Vedat Topsakal, Annick Gilles, Laure Jacquemin, Marianne Hesters, Willem De Hertogh
BACKGROUND: Tinnitus is a highly prevalent symptom affecting 10-15% of the adult population. It often affects patient quality of life and frequently causes distress. When subjective tinnitus can be elicited by the somatosensory system of the cervical spine or temporomandibular area it is termed somatic tinnitus. The first aim of the current study is to investigate the effect of the best evidence conservative temporomandibular disorder (TMD) treatment on tinnitus in patients with co-existence of tinnitus and TMD or oral parafunctions compared to no treatment...
October 12, 2018: Trials
Thirimon Moe-Byrne, Jennifer Valeska Elli Brown, William McGuire
BACKGROUND: Naloxone, a specific opioid antagonist, is available for the treatment of newborn infants with cardiorespiratory or neurological depression that may be due to intrauterine exposure to opioid. It is unclear whether newborn infants may benefit from this therapy and whether naloxone has any harmful effects. OBJECTIVES: To determine the effect of naloxone on the need for and duration of neonatal unit stay in infants of mothers who received opioid analgesia prior to delivery or of mothers who have used a prescribed or non-prescribed opioid during pregnancy...
October 12, 2018: Cochrane Database of Systematic Reviews
Vaclav Kremen, Benjamin H Brinkmann, Inyong Kim, Hari Guragain, Mona Nasseri, Abigail L Magee, Tal Pal Attia, Petr Nejedly, Vladimir Sladky, Nathanial Nelson, Su-Youne Chang, Jeffrey A Herron, Tom Adamski, Steven Baldassano, Jan Cimbalnik, Vince Vasoli, Elizabeth Fehrmann, Tom Chouinard, Edward E Patterson, Brian Litt, Matt Stead, Jamie Van Gompel, Beverly K Sturges, Hang Joon Jo, Chelsea M Crowe, Timothy Denison, Gregory A Worrell
Brain stimulation has emerged as an effective treatment for a wide range of neurological and psychiatric diseases. Parkinson's disease, epilepsy, and essential tremor have FDA indications for electrical brain stimulation using intracranially implanted electrodes. Interfacing implantable brain devices with local and cloud computing resources have the potential to improve electrical stimulation efficacy, disease tracking, and management. Epilepsy, in particular, is a neurological disease that might benefit from the integration of brain implants with off-the-body computing for tracking disease and therapy...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Courtney R Sparks, Angela Gorney, Kim Williams, Emily H Griffith, Sofia Cerda-Gonzalez, B Duncan X Lascelles, Natasha J Olby
BACKGROUND: Cavalier King Charles Spaniels (CKCS) suffer pain associated with Chiari-like malformation and syringomyelia (CMSM). People suffer from a similar condition and describe numerous sensory abnormalities. Sensory changes have not been quantified in affected CKCS. OBJECTIVES: To use quantitative sensory testing (QST) to quantify thermal and mechanical thresholds in CKCS and to compare QST in dogs with and without syringomyelia (SM). ANIMALS: Forty-four CKCS...
October 11, 2018: Journal of Veterinary Internal Medicine
Ingrid Faber, Alberto Rolim Muro Martinez, Carlos Roberto Martins, Maidane Luise Maia, Juliana Pasquotto Souza, Charles Marques Lourenço, Wilson Marques, Celeste Montecchiani, Antonio Orlacchio, Jose Luiz Pedroso, Orlando Graziani Povoas Barsottini, Celso Darío Ramos, Íscia Lopes-Cendes, Joseph H Friedman, Bárbara Juarez Amorim, Marcondes Cavalcante França
BACKGROUND: Molecular imaging has proven to be a powerful tool to elucidate degenerated paths in a wide variety of neurological diseases and has not been systematically studied in hereditary spastic paraplegias. OBJECTIVES: To investigate dopaminergic degeneration in a cohort of 22 patients with hereditary spastic paraplegia attributed to SPG11 mutations and evaluate treatment response to l-dopa. METHODS: Patients and controls underwent single-photon emission computed tomography imaging utilizing 99m Tc-TRODAT-1 tracer...
October 10, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Danica B Stanimirovic, Jagdeep K Sandhu, Will J Costain
Antibody, immuno- and gene therapies developed for neurological indications face a delivery challenge posed by various anatomical and physiological barriers within the central nervous system (CNS); most notably, the blood-brain barrier (BBB). Emerging delivery technologies for biotherapeutics have focused on trans-cellular pathways across the BBB utilizing receptor-mediated transcytosis (RMT). 'Traditionally' targeted RMT receptors, transferrin receptor (TfR) and insulin receptor (IR), are ubiquitously expressed and pose numerous translational challenges during development, including species differences and safety risks...
October 10, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Jack J Miller, James T Grist, Sébastien Serres, James R Larkin, Angus Z Lau, Kevin Ray, Katherine R Fisher, Esben Hansen, Rasmus Stilling Tougaard, Per Mose Nielsen, Jakob Lindhardt, Christoffer Laustsen, Ferdia A Gallagher, Damian J Tyler, Nicola Sibson
Hyperpolarised MRI with Dynamic Nuclear Polarisation overcomes the fundamental thermodynamic limitations of conventional magnetic resonance, and is translating to human studies with several early-phase clinical trials in progress including early reports that demonstrate the utility of the technique to observe lactate production in human brain cancer patients. Owing to the fundamental coupling of metabolism and tissue function, metabolic neuroimaging with hyperpolarised [1-13 C]pyruvate has the potential to be revolutionary in numerous neurological disorders (e...
October 10, 2018: Scientific Reports
Eric Albrecht, Leon Vorobeichik, Alain Jacot-Guillarmod, Nicolas Fournier, Faraj W Abdallah
BACKGROUND: Both dexamethasone and dexmedetomidine are effective peripheral nerve block (PNB) perineural adjuncts that prolong block duration. However, each is associated with side effects. With paucity of head-to-head comparisons of these adjuncts, the question of the best adjunct to mix with local anesthetics (LA) for PNB is unanswered. This meta-analysis aims to inform current practice and future research by identifying the superior adjunct by comparing dexamethasone and dexmedetomidine...
October 9, 2018: Anesthesia and Analgesia
Ann Monahan, Joanne Guay, John Hajduk, Santhanam Suresh
BACKGROUND: The aim of this systematic review was to compare the effects of regional analgesic (RA) techniques with systemic analgesia on postoperative pain, nausea and vomiting, resources utilization, reoperation, death, and complications of the analgesic techniques in children undergoing cardiac surgery. METHODS: A search was done in May 2018 in PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing RA techniques with systemic analgesia...
October 8, 2018: Anesthesia and Analgesia
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"