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evidence based guideline neurology

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https://www.readbyqxmd.com/read/29770929/two-cases-of-sarcoidosis-presenting-as-longitudinally-extensive-transverse-myelitis
#1
REVIEW
Amanda Mary Scott, Janeth Yinh, Timothy McAlindon, Robert Kalish
Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment...
May 17, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29755403/has-the-time-come-to-stratify-and-score-sudep-risk-to-inform-people-with-epilepsy-of-their-changes-in-safety
#2
Rohit Shankar, Craig Newman, Alistair Gales, Brendan N McLean, Jane Hanna, Samantha Ashby, Matthew C Walker, Josemir W Sander
Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29726966/pattern-of-dengue-virus-infections-in-adult-patients-from-sri-lanka
#3
Umesh Jayarajah, Pradeep K de Silva, Priyankara Jayawardana, Upul Dissanayake, Aruna Kulatunga, Harshini Fernando, Lakshika Perera, Vibhavee Kannangara, Champika Udayangani, Ranga Peiris, Shuaib Faizer, Pamodh Yasawardene, Ishan de Zoysa, Suranjith L Seneviratne
Background: Sri Lanka experienced its largest dengue epidemic in 2017. This study describes the disease pattern of adult dengue patients from two hospitals in Sri Lanka. Methods: Demographic, clinical and investigation findings of adult dengue patients admitted to the two hospitals from June to August 2017 were collected and analysed. Results: A total of 1167 patients (777 males [66.2%], mean age 32.9 y) were studied. There were 775 (66.4%) patients with dengue fever (DF), 334 (28...
May 2, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29724415/acr-appropriateness-criteria-%C3%A2-orbits-vision-and-visual-loss
#4
Tabassum A Kennedy, Amanda S Corey, Bruno Policeni, Vikas Agarwal, Judah Burns, H Benjamin Harvey, Jenny Hoang, Christopher H Hunt, Amy F Juliano, William Mack, Gul Moonis, Gregory J A Murad, Jeffrey S Pannell, Matthew S Parsons, William J Powers, Jason W Schroeder, Gavin Setzen, Matthew T Whitehead, Julie Bykowski
Visual loss can be the result of an abnormality anywhere along the visual pathway including the globe, optic nerve, optic chiasm, optic tract, thalamus, optic radiations or primary visual cortex. Appropriate imaging analysis of visual loss is facilitated by a compartmental approach that establishes a differential diagnosis on the basis of suspected lesion location and specific clinical features. CT and MRI are the primary imaging modalities used to evaluate patients with visual loss and are often complementary in evaluating these patients...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29720544/advantages-of-virtual-reality-in-the-rehabilitation-of-balance-and-gait-systematic-review
#5
REVIEW
Desiderio Cano Porras, Petra Siemonsma, Rivka Inzelberg, Gabriel Zeilig, Meir Plotnik
BACKGROUND: Virtual reality (VR) has emerged as a therapeutic tool facilitating motor learning for balance and gait rehabilitation. The evidence, however, has not yet resulted in standardized guidelines. The aim of this study was to systematically review the application of VR-based rehabilitation of balance and gait in 6 neurologic cohorts, describing methodologic quality, intervention programs, and reported efficacy. METHODS: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
May 2, 2018: Neurology
https://www.readbyqxmd.com/read/29708189/vestibular-evoked-myogenic-potential-testing-payment-policy-review-for-clinicians-and-payers
#6
REVIEW
Terry D Fife, Saty Satya-Murti, Robert F Burkard, John P Carey
Purpose of review: A recent American Academy of Neurology Evidence-Based Practice Guideline on vestibular myogenic evoked potential (VEMP) testing has described superior canal dehiscence syndrome (SCDS) and evaluated the merits of VEMP in its diagnosis. SCDS is an uncommon but now well-recognized cause of dizziness and auditory symptoms. This article familiarizes health care providers with this syndrome and the utility and shortcomings of VEMP as a diagnostic test and also explores payment policies for VEMP...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29701555/stereotactic-radiosurgery-for-trigeminal-neuralgia-a-systematic-review
#7
Constantin Tuleasca, Jean Régis, Arjun Sahgal, Antonio De Salles, Motohiro Hayashi, Lijun Ma, Roberto Martínez-Álvarez, Ian Paddick, Samuel Ryu, Ben J Slotman, Marc Levivier
OBJECTIVES The aims of this systematic review are to provide an objective summary of the published literature specific to the treatment of classical trigeminal neuralgia with stereotactic radiosurgery (RS) and to develop consensus guideline recommendations for the use of RS, as endorsed by the International Society of Stereotactic Radiosurgery (ISRS). METHODS The authors performed a systematic review of the English-language literature from 1951 up to December 2015 using the Embase, PubMed, and MEDLINE databases...
April 27, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29686116/practice-guideline-recommendations-summary-disease-modifying-therapies-for-adults-with-multiple-sclerosis-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#8
Alexander Rae-Grant, Gregory S Day, Ruth Ann Marrie, Alejandro Rabinstein, Bruce A C Cree, Gary S Gronseth, Michael Haboubi, June Halper, Jonathan P Hosey, David E Jones, Robert Lisak, Daniel Pelletier, Sonja Potrebic, Cynthia Sitcov, Rick Sommers, Julie Stachowiak, Thomas S D Getchius, Shannon A Merillat, Tamara Pringsheim
OBJECTIVE: To develop recommendations for disease-modifying therapy (DMT) for multiple sclerosis (MS). METHODS: A multidisciplinary panel developed DMT recommendations, integrating findings from a systematic review; followed an Institute of Medicine-compliant process to ensure transparency and patient engagement; and developed modified Delphi consensus-based recommendations concerning starting, switching, and stopping DMTs pertinent to people with relapsing-remitting MS, secondary progressive MS, primary progressive MS, and clinically isolated syndromes of demyelination...
April 24, 2018: Neurology
https://www.readbyqxmd.com/read/29685920/comment-on-2018-american-academy-of-neurology-guidelines-on-disease-modifying-therapies-in-ms
#9
REVIEW
John R Corboy, Brian G Weinshenker, Dean M Wingerchuk
The American Academy of Neurology has published a comprehensive review and guidelines for the use of disease-modifying therapies (DMTs) in multiple sclerosis (MS) for the first time since 2002. These guidelines represent the work of MS experts, patients, and guideline experts and are based on their review of randomized controlled trials and observational evidence that addresses a set of prespecified questions related to starting, switching, and potentially discontinuing DMTs. Many of the recommendations address decision-making regarding the use of DMTs and incorporate the perspective of patients...
April 23, 2018: Neurology
https://www.readbyqxmd.com/read/29685062/prospective-observational-evaluation-of-sedation-and-pain-management-guideline-adherence-across-new-jersey-intensive-care-units
#10
Alison Brophy, Maria Cardinale, Liza B Andrews, Justin B Kaplan, Christopher Adams, Yekaterina Opsha, Kimberly A Brandt, Deepali Dixit, Steven F Nerenberg, Julie A Saleh
BACKGROUND: The practice guidelines for the management of pain, agitation, and delirium (PAD) from the Society of Critical Care Medicine shifted from primarily focusing on the treatment of anxiety in 2002 to the treatment of pain in 2013. OBJECTIVE: This prospective, observational, multicenter study aimed to assess the degree of practice adherence to the PAD guidelines for ventilated patients in New Jersey intensive care units (ICUs). METHODS: Pharmacist investigators at 8 centers designated 4 days at least 10 days apart to evaluate all patients on mechanical ventilation...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29661944/atrial-fibrillation-burden-moving-beyond-atrial-fibrillation-as-a-binary-entity-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Lin Y Chen, Mina K Chung, Larry A Allen, Michael Ezekowitz, Karen L Furie, Pamela McCabe, Peter A Noseworthy, Marco V Perez, Mintu P Turakhia
Our understanding of the risk factors and complications of atrial fibrillation (AF) is based mostly on studies that have evaluated AF in a binary fashion (present or absent) and have not investigated AF burden. This scientific statement discusses the published literature and knowledge gaps related to methods of defining and measuring AF burden, the relationship of AF burden to cardiovascular and neurological outcomes, and the effect of lifestyle and risk factor modification on AF burden. Many studies examine outcomes by AF burden classified by AF type (paroxysmal versus nonparoxysmal); however, quantitatively, AF burden can be defined by longest duration, number of AF episodes during a monitoring period, and the proportion of time an individual is in AF during a monitoring period (expressed as a percentage)...
April 16, 2018: Circulation
https://www.readbyqxmd.com/read/29656532/of-lamp-posts-keys-and-fabled-drunkards-a-perspectival-tale-of-4-guidelines
#12
Trisha Greenhalgh
BACKGROUND: Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. THE CASE: The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time)...
April 15, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29650740/managing-complexity-in-care-of-patients-with-intellectual-and-developmental-disabilities-natural-fit-for-the-family-physician-as-an-expert-generalist
#13
REVIEW
Elizabeth Grier, Dara Abells, Ian Casson, Meg Gemmill, Jessica Ladouceur, Amanda Lepp, Ullanda Niel, Samantha Sacks, Kyle Sue
OBJECTIVE: To delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter. SOURCES OF INFORMATION: The authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29627761/following-the-patient-s-orders-recommending-vs-offering-choice-in-neurology-outpatient-consultations
#14
Paul Chappell, Merran Toerien, Clare Jackson, Markus Reuber
The UK's Royal College of Surgeons (2016) has argued that health professionals must replace a 'paternalistic' approach to consent with 'informed choice'. We engage with these guidelines through analysis of neurology consultations in two UK-based neuroscience centres, where informed choice has been advocated for over a decade. Based on 223 recorded consultations and related questionnaire data (collected in 2012), we used conversation analysis (CA) to identify two practices for offering choice: patient view elicitors (PVEs) and option-lists...
March 26, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29620698/complex-polypharmacy-in-patients-with-schizophrenia-spectrum-disorders-before-a-psychiatric-hospitalization-prescribing-patterns-and-associated-clinical-features
#15
Brandon A Gaudiano, Carolina Guzman Holst, Alexandra Morena, Lauren E Reeves, Valerie J Sydnor, Gary Epstein-Lubow, Lauren M Weinstock
BACKGROUND: Current evidence-based guidelines provide unclear support for many common polypharmacy practices in schizophrenia. Excessive or complex polypharmacy (≥4 psychotropics) has been studied in patients with bipolar disorder, but not in schizophrenia to date. METHODS: We conducted a digital medical record data extraction of 829 patients consecutively admitted to a psychiatric hospital and diagnosed as having schizophrenia-spectrum disorders. RESULTS: In those prescribed psychiatric medication preadmission, 28...
April 3, 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29617925/sutureless-and-rapid-deployment-aortic-valve-replacement-international-registry-surd-ir-early-results-from-3343-patients
#16
Marco Di Eusanio, Kevin Phan, Paolo Berretta, Thierry P Carrel, Martin Andreas, Giuseppe Santarpino, Roberto Di Bartolomeo, Thierry Folliguet, Bart Meuris, Carmelo Mignosa, Gianluca Martinelli, Martin Misfeld, Mattia Glauber, Utz Kappert, Malak Shrestha, Alberto Albertini, Kevin Teoh, Emmanuel Villa, Tristan Yan, Marco Solinas
OBJECTIVES: The Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR) was established by a consortium of 18 research centres-the International Valvular Surgery Study Group (IVSSG)-to overcome limitations of the literature and provide adequately powered evidence on sutureless and rapid-deployment aortic valves replacement (SURD-AVR). METHODS: Data from 3343 patients undergoing SURD-AVR over a 10-year period (2007-2017) were collected in the registry...
March 30, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29600832/bullous-pemphigoid-italian-guidelines-adapted-from-edf-eadv-guidelines
#17
Emanuele Cozzani, Angelo V Marzano, Marzia Caproni, Claudio Feliciani, Piergiacomo Calzavara-Pinton
Bullous pemphigoid is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localised or generalised bullous lesions. In up to 20% of affected patients blister may be completely absent, and only excoriations, prurigo-like lesions, eczematous lesions, urticated lesions, and/or infiltrated plaques are observed. The disease is significantly associated with neurological disorders. The morbidity of bullous pemphigoid and its impact on the quality of life are significant...
March 30, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29589152/genetic-test-utilization-and-diagnostic-yield-in-adult-patients-with-neurological-disorders
#18
Tanya M Bardakjian, Ingo Helbig, Colin Quinn, Lauren B Elman, Leo F McCluskey, Steven S Scherer, Pedro Gonzalez-Alegre
To determine the diagnostic yield of different genetic test modalities in adult patients with neurological disorders, we evaluated all adult patients seen for genetic diagnostic evaluation in the outpatient neurology practice at the University of Pennsylvania between January 2016 and April 2017 as part of the newly created Penn Neurogenetics Program. Subjects were identified through our electronic medical system as those evaluated by the Program's single clinical genetic counselor in that period. A total of 377 patients were evaluated by the Penn Neurogenetics Program in different settings and genetic testing recommended...
March 28, 2018: Neurogenetics
https://www.readbyqxmd.com/read/29582975/feasibility-of-endoscopic-endonasal-approach-for-clip-application-of-cerebral-aneurysms-a-systematic-review
#19
Jonathan A Forbes, Sophie D' Herbemont, Kurt R Lehner, Diego Pineda Martinez, Ignacio P Navarro-Chávez, Diego Mendez Rosito, Theodore H Schwartz
INTRODUCTION: While open, microsurgical clipping and endovascular coiling remain the gold standards for treatment of cerebral aneurysms, a growing number of aneurysms treated via endoscopic endonasal methods have been reported in the literature. The aim of this study was to conduct a systematic review of the literature to gain a more thorough appreciation of the potential benefits and drawbacks of the endoscopic endonasal strategy in this setting. EVIDENCE ACQUISITION: We performed a detailed systematic review of the medical literature on endoscopic endonasal skull base surgery for treatment of cerebral aneurysms utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29554317/stereotactic-radiosurgery-for-benign-world-health-organization-grade-i-cavernous-sinus-meningiomas-international-stereotactic-radiosurgery-society-isrs-practice-guideline-a-systematic-review
#20
Cheng-Chia Lee, Daniel M Trifiletti, Arjun Sahgal, Antonio DeSalles, Laura Fariselli, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martínez Álvarez, Ian Paddick, Jean Regis, Samuel Ryu, Ben Slotman, Jason Sheehan
BACKGROUND: Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas. OBJECTIVE: To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International Stereotactic Radiosurgery Society. METHODS: Articles published from January 1963 to December 2014 were systemically reviewed...
March 15, 2018: Neurosurgery
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