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clinical practice neurology

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https://www.readbyqxmd.com/read/28431632/combined-evaluation-of-personality-risk-and-coping-in-ms-patients-a-step-towards-individualized-treatment-choice-the-pericoms-study-i
#1
G Bsteh, E Monz, L Zamarian, S Hagspiel, H Hegen, M Auer, S Wurth, F Di Pauli, F Deisenhammer, T Berger
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory neurological disease requiring disease-modifying treatment (DMT). To provide patients with the optimal individual therapeutic option, treatment recommendations should be based not only on individual disease course and DMT specific benefit-risk estimates, but also on patient's individual characteristics such as personality, risk attitude and coping strategies. However, these characteristics are difficult to objectify in clinical routine practice without the support of appropriate evaluation instruments...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28430672/lamotrigine-uses-in-psychiatric-practice-beyond-bipolar-prophylaxis-a-hope-or-hype
#2
Ahmed Naguy, Najah Al-Enezi
BACKGROUND: Lamotrigine (LAM), an antiepileptic, with panoply of indications and uses in neurology, is FDA approved, in psychiatry, for bipolar prophylaxis. Apart from this indication, trend of its use in psychiatry is on the rise addressing a multitude of disorders. STUDY QUESTION: LAM remains one of only few psychotropic drugs with antiglutamate activity. This might render LAM a potential therapeutic option in treatment-resistant major psychiatric disorders. We reviewed LAM pharmacology and its diverse indications while examining the extant evidence...
April 19, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28429077/-implementation-of-the-german-s3-guidelines-on-dementia-in-clinical-practice-wish-or-reality
#3
H Lohmann, F Kulessa, H Holling, A Johnen, S Reul, G Lueg, T Duning
BACKGROUND: Published in 2009, the German S3 guidelines on dementia define a milestone in quality improvement of the diagnostics and treatment of dementia. In clinical practice patients suffering from dementia are primarily treated by physicians in private practice; therefore, this study examined how the guidelines are implemented in outpatient clinical settings. Furthermore, it aimed at the identification of behavioral determinants that govern the actual diagnostic and therapeutic approach in clinical practice...
April 20, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28428166/vascular-cognitive-impairment-in-a-memory-clinic-population-rationale-and-design-of-the-utrecht-amsterdam-clinical-features-and-prognosis-in-vascular-cognitive-impairment-trace-vci-study
#4
EDITORIAL
Jooske Marije Funke Boomsma, Lieza Geertje Exalto, Frederik Barkhof, Esther van den Berg, Jeroen de Bresser, Rutger Heinen, Huiberdina Lena Koek, Niels Daniël Prins, Philip Scheltens, Henry Chanoch Weinstein, Wiesje Maria van der Flier, Geert Jan Biessels
BACKGROUND: Vascular Cognitive Impairment (VCI) refers to cognitive dysfunction due to vascular brain injury, as a single cause or in combination with other, often neurodegenerative, etiologies. VCI is a broad construct that captures a heterogeneous patient population both in terms of cognitive and noncognitive symptoms and in terms of etiology and prognosis. This provides a challenge when applying this construct in clinical practice. OBJECTIVE: This paper presents the rationale and design of the TRACE-VCI study, which investigates the clinical features and prognosis of VCI in a memory clinic setting...
April 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28427972/endovascular-treatment-of-complex-distal-posterior-cerebral-artery-aneurysms-with-the-pipeline-embolization-device
#5
Paul Mazaris, Tapan Mehta, Mohammed Hussain, Violiza Inoa, Justin Singer, Gary Spiegel, Inam Kureshi, Martin Ollenschleger
INTRODUCTION: The purpose of our study is to assess the safety and efficacy of the Pipeline Embolization Device (PED) for endovascular treatment of complex, distal posterior cerebral artery (PCA) aneurysms. METHODS: We conducted a retrospective review of patients who underwent endovascular treatment of complex PCA aneurysms with PED from November 2012 to December 2015. A total of 4 patients were identified and treated. 12 month angiographic and clinical follow-up was available for all patients...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28425689/normal-values-of-creatine-kinase-and-of-mb-creatine-kinase-at-birth-in-healthy-babies
#6
Carlo V Bellieni, Barbara Tomasini, Carlotta Bracciali, Giuseppe Buonocore
BACKGROUND: Today, few studies have been accomplished in order to determine serum creatine kinase (CK) activity in newborns by considering small groups of babies and without taking into account gestational age (GA) differences. Some authors have demonstrated that neonatal CK activity value at birth is higher than the normal range of CK activity considering for adults or older children. The objective of this study is to assess normal values of CK and MB-CK in neonatal blood, according to babies' GA...
April 20, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28425221/conceptualizing-movement-by-expert-bobath-instructors-in-neurological-rehabilitation
#7
Julie Vaughan-Graham, Kara Patterson, Karl Zabjek, Cheryl A Cott
RATIONALE, AIMS, AND OBJECTIVES: Movement, a core aspect of physiotherapy practice, and integral to the clinical reasoning process has undergone limited theoretical development. Instead, research has focused on intervention effectiveness embedded within the positivist paradigm. The purpose of this study was to explore how expert neurorehabilitation therapists conceptualize movement as part of their clinical reasoning. METHOD: A qualitative interpretive descriptive approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews was used...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28420294/smart-recognising-the-value-of-existing-practice-and-introducing-recent-developments-leaving-no-stone-unturned-in-the-assessment-and-treatment-of-the-pdoc-patient
#8
H Gill-Thwaites, K E Elliott, R Munday
Over the last 25 years there have been a number of papers highlighting the issues of high rates of misdiagnosis in prolonged disorders of consciousness (PDOC) (Andrews, K., Murphy, L., Munday, R., & Littlewood, C. (1996). Misdiagnosis of the vegetative state: Retrospective study in a rehabilitation unit. BMJ, 313(7048), 13-16; Childs, N. L., Mercer, W. N., & Childs, H. W. (1993). Accuracy of diagnosis of persistent vegetative state. Neurology, 43(8), 1465-1467). Surprisingly, these rates still remain at the same level despite defined criteria for diagnosis (Schnakers, C...
April 18, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28419741/optimal-treatment-strategy-for-acute-cholecystitis-based-on-predictive-factors-japan-taiwan-multicenter-cohort-study
#9
Itaru Endo, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Rintaro Mori, Fumihiko Miura, Masamichi Yokoe, Takao Itoi, Harumi Gomi, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: Although early laparoscopic cholecystectomy is widely performed for acute cholecystitis, the optimal timing of a cholecystectomy in clinically ill patients remains controversial. This study aims to determine the best practice for the patients presenting with acute cholecystitis focused on disease severity and co-morbidities. PATIENTS AND METHODS: An international multicentric retrospective observational study was conducted over a 2-year period. Patients were divided into four groups, Group A: primary cholecystectomy, Group B: cholecystectomy after gallbladder drainage, Group C: gallbladder drainage alone, and Group D: medical treatment alone...
April 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28419544/adults-born-preterm-a-review-of-general-health-and-system-specific-outcomes
#10
REVIEW
Tonse N K Raju, Sonia Buist, Carol J Blaisdell, Marva Moxey-Mims, Saroj Saigal
In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioral abnormalities, cardio-pulmonary functional limitations, systemic hypertension, and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems, and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20(th) century and later...
April 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28418828/a-comparison-of-blood-and-cerebrospinal-fluid-cytokines-il-1%C3%AE-il-6-il-18-tnf-%C3%AE-in-neonates-with-perinatal-hypoxia
#11
Darinka Šumanović-Glamuzina, Filip Čulo, Melanie Ivana Čulo, Paško Konjevoda, Marjana Jerković-Raguž
Perinatal hypoxia-ischemia is a specific and important pathological event in neonatal care practice. The data on relationship between the concentrations of cytokines in blood and cerebrospinal fluid (CSF) and perinatal brain injury are scarce. The aim of this study is to evaluate changes in interleukin (IL-1β, IL-6, and IL-18) and tumor necrosis factor alpha (TNF-α) levels in newborns with perinatal hypoxia (PNH). CSF and serum samples of 35 term and near-term (35-40 weeks) newborns with PNH, at the age of 3-96 hours, were analyzed using enzyme-linked immunosorbent assay...
April 18, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28417344/biotherapy-in-inflammatory-diseases-of-the-cns-current-knowledge-and-applications
#12
REVIEW
Nicolas Collongues, Laure Michel, Jérôme de Seze
Biotherapy represents an innovative therapeutic approach that includes immunotherapy (vaccines, apheresis, and antibodies); gene therapy; and stem cell transplants. Their development helps to cross the bridge from bench to bedside and brings new hope of a cure for severe diseases in different fields of medicine. In neurology, a growing range of applications is being developed for these medications. Valuable results are now available in the field of autoimmunity, neuro-oncology, paraneoplastic manifestations, and neurodegenerative disorders...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28414816/fourier-transform-power-spectrum-is-a-potential-measure-of-tissue-alignment-in-standard-mri-a-multiple-sclerosis-study
#13
Shrushrita Sharma, Yunyan Zhang
Loss of tissue coherency in brain white matter is found in many neurological diseases such as multiple sclerosis (MS). While several approaches have been proposed to evaluate white matter coherency including fractional anisotropy and fiber tracking in diffusion-weighted imaging, few are available for standard magnetic resonance imaging (MRI). Here we present an image post-processing method for this purpose based on Fourier transform (FT) power spectrum. T2-weighted images were collected from 19 patients (10 relapsing-remitting and 9 secondary progressive MS) and 19 age- and gender-matched controls...
2017: PloS One
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#14
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28408338/the-value-of-urodynamics-in-an-academic-specialty-referral-practice
#15
Anne M Suskind, Lindsey Cox, J Quentin Clemens, Ann Oldendorf, John T Stoffel, Bahaa Malaeb, Yongmei Qin, Anne P Cameron
OBJECTIVES: To describe and evaluate the use of urodynamic (UDS) studies for all indications in an academic specialty referral urology practice. METHODS: This is a prospective questionnaire-based study wherein clinicians completed a pre- and post-UDS questionnaire on each UDS that they ordered for all clinical indications between May 2013 and August 2014. Questions pertained to patient demographics and history, the clinical indication for the UDS, the clinician's pre- and post-UDS clinical impressions, and changes in post-UDS management plans...
April 10, 2017: Urology
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#16
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
https://www.readbyqxmd.com/read/28405719/-pruritus-of-the-scalp-simply-pulling-out-your-hair
#17
REVIEW
M Beigi, E Weisshaar
Scalp pruritus is a frequent symptom and can be caused by dermatologic diseases, contact allergies, neurologic, psychiatric/somatoform and systemic diseases. In daily clinical practice scalp pruritus is a diagnostic and therapeutic challenge, especially if no detectable lesions are present. A detailed patient history and the inspection of scalp and the skin of the whole body are essential for diagnosis. Depending on the clinical findings, further dermatological diagnostic tests, laboratory analysis, imaging techniques and, where necessary, an interdisciplinary specific diagnostic check-up should be performed...
April 12, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28399922/the-elusive-ideal-of-inclusiveness-lessons-from-a-worldwide-survey-of-neurologists-on-the-ethical-issues-raised-by-whole-genome-sequencing
#18
Thierry Hurlimann, Iris Jaitovich Groisman, Béatrice Godard
The anticipation of ethical issues that may arise with the clinical use of genomic technologies is crucial to envision their future implementation in a manner sensitive to local contexts. Yet, populations in low- and middle-income countries are underrepresented in studies that aim to explore stakeholders' perspectives on the use of such technologies. Within the framework of a research project entitled "Personalized medicine in the treatment of epilepsy", we sought to increase inclusiveness by widening the reach of our survey, inviting neurologists from around the world to share their views and practices regarding the use of whole-genome sequencing in clinical neurology and its associated ethics...
April 11, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28398680/cytomegalovirus-infection-in-pregnancy
#19
REVIEW
Nicole L Davis, Caroline C King, Athena P Kourtis
Cytomegalovirus (CMV) is a DNA herpesvirus that is common worldwide. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children. Primary infection occurs in approximately 1 to 4% of pregnancies, and is mostly asymptomatic in immunocompetent adults. However, primary infection may manifest as a mild mononucleosis or flu-like syndrome with persistent fever and fatigue. CMV can be transmitted from mother-to-child in utero, intrapartum, or during breastfeeding...
March 15, 2017: Birth Defects Res
https://www.readbyqxmd.com/read/28393757/prehospital-randomised-assessment-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-trial-and-economic-evaluation
#20
Simon Gates, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Kate Wilson, Garry Parcell, Andrew Rosser, Richard Whitfield, Amanda Williams, Rebecca Jones, Helen Pocock, Nicola Brock, John Jm Black, John Wright, Kyee Han, Gary Shaw, Laura Blair, Joachim Marti, Claire Hulme, Christopher McCabe, Silviya Nikolova, Zenia Ferreira, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA...
March 2017: Health Technology Assessment: HTA
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