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clinical practice neurology

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https://www.readbyqxmd.com/read/28107340/association-of-diabetes-related-complications-with-heart-rate-variability-among-a-diabetic-population-in-the-uae
#1
Ahsan H Khandoker, Haitham M Al-Angari, Kinda Khalaf, Sungmun Lee, Wael Almahmeed, Habiba S Al Safar, Herbert F Jelinek
Microvascular, macrovascular and neurological complications are the key causes of morbidity and mortality among type II diabetes mellitus (T2DM) patients. The aim of this study was to investigate the alterations of cardiac autonomic function of diabetic patients in relation to three types of diabetes-related complications. ECG recordings were collected and analyzed from 169 T2DM patients in supine position who were diagnosed with nephropathy (n = 55), peripheral neuropathy (n = 64) and retinopathy (n = 106) at two hospitals in the UAE...
2017: PloS One
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#2
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/28103591/searching-the-footprints-of-pioneers-on-neurology-a-bibliometric-analysis
#3
Kang Min Park, Jee-Eun Kim, Yerim Kim, Si Eun Kim, Dae Young Yoon, Jong Seok Bae
BACKGROUND: We identify the most cited articles that have influenced the clinical practices of neurologists. METHODS: We first analyzed the top 100 cited articles published in 50 neurology journals with high impact factors. We collected all of the original articles on clinical neurology published in all 554 medical journals. The Institute for Scientific Information Web of Science search tools were used to identify the top 100 cited articles in the database of Journal Citation Reports since 1950, which were then manually reviewed to discover their contents...
January 20, 2017: European Neurology
https://www.readbyqxmd.com/read/28103532/timing-of-anticoagulant-re-initiation-following-intracerebral-hemorrhage-in-mechanical-heart-valves-survey-of-neurosurgeons-and-thrombosis-experts
#4
Fahad AlKherayf, Yan Xu, Harrison Westwick, Ioana Doina Moldovan, Philip S Wells
BACKGROUND: While oral anticoagulation (OAC) is universally indicated for patients with mechanical heart valves (MHVs), OAC resumption following anticoagulant-associated intracerebral hemorrhage (ICH) is an area of uncertainty. We sought to determine the practice preferences of North American neurosurgeons and thrombosis experts on optimal timing of OAC re-initiation. METHODS: A cross-sectional survey was disseminated to North American members of the American Association of Neurological Surgeons and the International Society for Thrombosis and Haemostasis...
January 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28099516/clinical-practice-guidelines-for-rare-diseases-the-orphanet-database
#5
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/28096918/perioperative-outcomes-following-radical-prostatectomy-for-patients-with-disseminated-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-database
#6
Raj Satkunasivam, Christopher J D Wallis, James Byrne, Azik Hoffman, Douglas C Cheung, Girish S Kulkarni, Avery B Nathens, Robert K Nam
INTRODUCTION: We sought to determine whether patients undergoing radical prostatectomy (RP) in the context of disseminated cancer have higher 30-day complications. METHODS: We conducted a retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database. Men undergoing RP (from January 1, 2005 to December 31, 2014) for prostate cancer were identified and stratified by presence (n=97) or absence (n=27 868) of disseminated cancer. The primary outcome was major complications (death, re-operation, cardiac or neurologic events) within 30 days of surgery...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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
#7
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/28092984/vipera-ammodytes-bites-treated-with-antivenom-viperatab-a-case-series-with-pharmacokinetic-evaluation
#8
Miran Brvar, Tihana Kurtović, Damjan Grenc, Maja Lang Balija, Igor Križaj, Beata Halassy
CONTEXT: In clinical practice it is difficult to differentiate between V. berus and V. ammodytes venomous bites. In the past this was not a concern, but due to the current shortage in Viperfav™ and European viper venom antiserum availability, V. a. ammodytes venomous bites have recently been treated with ViperaTAb(®), which is a pharmaceutical formulation containing a monospecific ovine Fab fragments against the venom of V. berus. OBJECTIVE: To evaluate ViperaTAb(®) in V...
January 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28088349/stroke-biomarkers-in-clinical-practice-a-critical-appraisal
#9
REVIEW
Geelyn J L Ng, Amy M L Quek, Christine Cheung, Thiruma V Arumugam, Raymond C S Seet
Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described...
January 11, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28079351/effect-of-age-on-outcomes-and-practice-patterns-for-patients-with-anterior-communicating-artery-aneurysms
#10
Federico Cagnazzo, Waleed Brinjikji, Giuseppe Lanzino
BACKGROUND: With widespread utilization of noninvasive imaging, small enraptured anterior communicating artery (AcoA) aneurysms are increasingly detected in the general population, particularly in elderly patients. We investigated the association between age and clinical characteristics and outcomes of patients with unruptured AcoA aneurysms. METHODS: Between January 2008 and May 2016, information on 179 consecutive patients with unruptured AcoA aneurysms was obtained and included demographic data, aneurysm features, risk factors for formation and rupture, treatment type, complications, and follow-up information...
January 12, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28072757/organ-procurement-organization-survey-of-practices-and-beliefs-regarding-prerecovery-percutaneous-liver-biopsy-in-donation-after-neurologic-determination-of-death
#11
Joseph Benton Oliver, Andrea Fleisch Marcus, Mark Paster, Joseph Nespral, Advaith Bongu, George Dikdan, Lloyd Brown, Nikole Neidlinger, Baburao Koneru
BACKGROUND: Prerecovery liver biopsy (PLB) allows histological evaluation of the organ prior to procurement. The opinions and what factors might influence PLB use within Organ Procurement Organizations (OPOs) are unknown. METHODS: A survey instrument was distributed by the Association of OPOs to the clinical directors of all 58 OPOs. Descriptive statistics were calculated. Results were also stratified based on OPO characteristics. RESULTS: 84...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28057660/protocol-for-intraoperative-assessment-of-the-human-cerebrovascular-glycocalyx
#12
R H L Haeren, H Vink, J Staals, M A M J van Zandvoort, J Dings, J J van Overbeeke, G Hoogland, K Rijkers, O E M G Schijns
INTRODUCTION: Adequate functioning of the blood-brain barrier (BBB) is important for brain homoeostasis and normal neuronal function. Disruption of the BBB has been described in several neurological diseases. Recent reports suggest that an increased permeability of the BBB also contributes to increased seizure susceptibility in patients with epilepsy. The endothelial glycocalyx is coating the luminal side of the endothelium and can be considered as the first barrier of the BBB. We hypothesise that an altered glycocalyx thickness plays a role in the aetiology of temporal lobe epilepsy (TLE), the most common type of epilepsy...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28053551/genetics-of-tuberous-sclerosis-complex-implications-for-clinical-practice
#13
REVIEW
Carolina Caban, Nubaira Khan, Daphne M Hasbani, Peter B Crino
Tuberous sclerosis complex (TSC) is a multisystem disorder that results from heterozygous mutations in either TSC1 or TSC2. The primary organ systems that are affected include the brain, skin, lung, kidney, and heart, all with variable frequency, penetrance, and severity. Neurological features include epilepsy, autism, and intellectual disability. There are more than 1,500 known pathogenic variants for TSC1 and TSC2, including deletion, nonsense, and missense mutations, and all pathogenic mutations are inactivating, leading to loss of function effects on the encoded proteins TSC1 and TSC2...
2017: Application of Clinical Genetics
https://www.readbyqxmd.com/read/28049738/when-the-heart-rules-the-head-ischaemic-stroke-and-intracerebral-haemorrhage-complicating-infective-endocarditis
#14
REVIEW
Estabrak Jiad, Sumanjit K Gill, Maria Krutikov, David Turner, Michael H Parkinson, Carmel Curtis, David J Werring
Sir William Osler meticulously described the clinical manifestations of infective endocarditis in 1885, concluding that: 'few diseases present greater difficulties in the way of diagnosis … which in many cases are practically insurmountable'. Even with modern investigation techniques, diagnosing infective endocarditis can be hugely challenging, yet is critically important in patients presenting with stroke (both cerebral infarction and intracranial haemorrhage), its commonest neurological complication. In ischaemic stroke, intravenous thrombolysis carries an unacceptably high risk of intracranial haemorrhage, while in intracerebral haemorrhage, mycotic aneurysms require urgent treatment to avoid rebleeding, and in all cases, prompt treatment with antibiotics and valve surgery may be life-saving...
January 2017: Practical Neurology
https://www.readbyqxmd.com/read/28045855/the-interpretation-of-muscle-motor-evoked-potentials-for-spinal-cord-monitoring
#15
Karl F Kothbauer
OBJECTIVE: To provide a summary of the intraoperative monitoring of muscle motor evoked potentials (MEPs) based on the presence-absence concept during neurosurgical operations along the spinal cord. METHOD: Expert review. DISCUSSION: The measurable parameters of MEPs, such as signal amplitudes and thresholds vary considerably both during a single surgery in a single individual patient as well as between individuals and operations. The presence or absence of responses irrespective of stimulus intensity and response amplitude is much more clearly defined...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28044336/monitoring-regional-blockade
#16
REVIEW
K Ode, S Selvaraj, A F Smith
This review attempts to draw on the published literature to address three practical clinical questions. First, what means of testing the degree of regional blockade pre-operatively are available, and can eventual success or failure be determined soon after injection? Second, is it possible to predict if a block inserted after the induction of general anaesthesia will be effective when the patient wakes? Third, what features, and what duration, should cause concern when a block does not resolve as expected after surgery? Although the relevant literature is limited, we recommend testing of multiple sensory modalities before surgery commences; temperature and thermographic changes may offer additional early warning of success or failure...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28042926/the-potential-impact-of-gut-microbiota-on-your-health-current-status-and-future-challenges
#17
Stitaya Sirisinha
Our health and probably also our behaviors and mood depend not only on what we eat or what we do (lifestyle behaviors), but also on what we host. It is well established for decades that all vertebrates including humans are colonized by a wide array of bacteria, fungi, eukaryotic parasites and viruses, and that, at steady state (homeostasis), this community of microbes establishes a friendly mutual relationship with the host. The term microbiota was originally meant to represent an ecological community of commensals and potentially pathogenic microbes that live within our bodies, but it is now used interchangeably with the term microbiome which was initially meant to represent a collective genome of the microbiota...
December 2016: Asian Pacific Journal of Allergy and Immunology
https://www.readbyqxmd.com/read/28042905/the-neurostimulation-appropriateness-consensus-committee-nacc-recommendations-on-bleeding-and-coagulation-management-in-neurostimulation-devices
#18
Timothy R Deer, Samer Narouze, David A Provenzano, Jason E Pope, Steven M Falowski, Marc A Russo, Honorio Benzon, Konstantin Slavin, Julie G Pilitsis, Kenneth Alo, Jonathan D Carlson, Porter McRoberts, Shivanand P Lad, Jeffrey Arle, Robert M Levy, Brian Simpson, Nagy Mekhail
INTRODUCTION: The Neurostimulation Appropriateness Consensus Committee (NACC) was formed by the International Neuromodulation Society (INS) in 2012 to evaluate the evidence to reduce the risk of complications and improve the efficacy of neurostimulation. The first series of papers, published in 2014, focused on the general principles of appropriate practice in the surgical implantation of neurostimulation devices. The NACC was reconvened in 2014 to address specific patient care issues, including bleeding and coagulation...
January 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28035841/rehabilitation-robotics-for-the-upper-extremity-review-with-new-directions-for-orthopaedic-disorders
#19
Renée M Hakim, Brandon G Tunis, Michael D Ross
The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity...
December 30, 2016: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28035750/bleeding-risk-of-terminally-ill-patients-hospitalized-in-palliative-care-units-the-rheso-study
#20
Bernard Tardy, Stéphane Picard, Frédéric Guirimand, Céline Chapelle, Marie Delerue Danel, Thomas Celarier, Jean-François Ciais, Pascale Vassal, Sébastien Salas, Marilène Filbet, Jean-Marie Gomas, Aline Guillot, Jean-Baptiste Gaultier, Adel Merah, Anne Richard, Silvy Laporte, Laurent Bertoletti
BACKGROUND: The value of primary thromboprophylaxis in patients admitted to palliative care units is debated. Moreover, the bleeding risk of these patients is unknown. OBJECTIVES: Our primary aim was to assess the bleeding risk of patients in a real-world practice setting of hospital palliative care. Our secondary aim was to determine the incidence of symptomatic deep-vein thrombosis and to identify risk factors for bleeding. PATIENTS/METHODS: In this prospective, observational study in 22 French palliative care units, 1199 patients (median age: 71 years, male: 45...
December 30, 2016: Journal of Thrombosis and Haemostasis: JTH
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