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evidence based guideline neurology

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https://www.readbyqxmd.com/read/28717430/knowledge-attitude-and-practices-among-iranian-neurologists-toward-evidence-based-medicine
#1
Kaveh Shafiei, Fatemeh Sedaghati
Background: Evidence-based medicine (EBM) is a current practice in medicine to produce clinical practice guidelines from well-designed, randomized, controlled trials. We studied knowledge, attitude, and practice of EBM of neurologists who participated in the Iranian congress of neurology. Methods: A self-administered anonymous questionnaire was distributed and filled by neurologists. Results: A total of 200 neurologists were randomly sampled and with response rate of 56%. 33.9% of responder had previously participated in EBM courses...
January 5, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28716996/long-term-benzodiazepine-and-z-drugs-use-in-the-uk-a-survey-of-general-practice
#2
James Davies, Todd C Rae, Luke Montagu
BACKGROUND: Current British National Formulary (BNF) guidelines state that benzodiazepines and zolpidem, zopiclone, and zaleplon, commonly known as Z-drugs (BZD), be prescribed for no more than 4 weeks, although anecdotal data suggest that many patients are prescribed BZDs for much longer. As there are no recent, evidence-based estimates of long-term (>12 months) BZD use in the UK, the scale of this potential problem is unknown. AIM: To produce the first reliable, evidence-based estimate of long-term BZD use in the UK...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28715518/early-accurate-diagnosis-and-early-intervention-in-cerebral-palsy-advances-in-diagnosis-and-treatment
#3
Iona Novak, Cathy Morgan, Lars Adde, James Blackman, Roslyn N Boyd, Janice Brunstrom-Hernandez, Giovanni Cioni, Diane Damiano, Johanna Darrah, Ann-Christin Eliasson, Linda S de Vries, Christa Einspieler, Michael Fahey, Darcy Fehlings, Donna M Ferriero, Linda Fetters, Simona Fiori, Hans Forssberg, Andrew M Gordon, Susan Greaves, Andrea Guzzetta, Mijna Hadders-Algra, Regina Harbourne, Angelina Kakooza-Mwesige, Petra Karlsson, Lena Krumlinde-Sundholm, Beatrice Latal, Alison Loughran-Fowlds, Nathalie Maitre, Sarah McIntyre, Garey Noritz, Lindsay Pennington, Domenico M Romeo, Roberta Shepherd, Alicia J Spittle, Marelle Thornton, Jane Valentine, Karen Walker, Robert White, Nadia Badawi
Importance: Cerebral palsy describes the most common physical disability in childhood and occurs in 1 in 500 live births. Historically, the diagnosis has been made between age 12 and 24 months but now can be made before 6 months' corrected age. Objectives: To systematically review best available evidence for early, accurate diagnosis of cerebral palsy and to summarize best available evidence about cerebral palsy-specific early intervention that should follow early diagnosis to optimize neuroplasticity and function...
July 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28697713/an-update-of-the-italian-stroke-organization-stroke-prevention-awareness-diffusion-group-guidelines-on-carotid-endarterectomy-and-stenting-a-personalized-medicine-approach
#4
Gaetano Lanza, Carlo Setacci, Stefano Ricci, Patrizio Castelli, Alberto Cremonesi, Jessica Lanza, Claudio Novali, Carlo Pratesi, Paola Santalucia, Francesco Speziale, Augusto Zaninelli, Gian Franco Gensini
Although proof-based medicine has generated much valid evidence for the drawing up of guidelines and recommendations for best clinical practice in symptomatic and asymptomatic carotid stenosis, whether and when it is better to employ endarterectomy or stenting as the intervention of choice still remain matters of debate. Moreover, guidelines have been targeted up to now to the 'representative' patient, as resulting from the statistical analyses of the studies conducted on the safety and efficacy of both interventions as well as on medical therapy alone...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28697570/adherence-to-clinical-practice-guidelines-during-dementia-work-up-in-a-real-world-setting-a-study-from-the-registry-of-dementias-of-girona
#5
Oriol Turró-Garriga, Laia Calvó-Perxas, Joan Vilalta-Franch, Marta Hernández-Ferrándiz, Margarita Flaqué, Marta Linares, Marta Cullell, Jordi Gich, Isabel Casas, Héctor Perkal, Josep Garre-Olmo
BACKGROUND: There are several position statements and clinical practice guidelines (CPG) for diagnosing dementia. OBJECTIVE: Our aims were to evaluate the adherence to CPG among specialists in the 7 memory clinics included in the Registry of Dementias of Girona (ReDeGi), and to compare the results between 2007-2011 and 2012-2015. We also determined the time and number of visits required to achieve a diagnosis, the supplementary tests ordered, and the drugs prescribed according to dementia subtypes...
July 4, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28684957/practice-guideline-summary-sudden-unexpected-death-in-epilepsy-incidence-rates-and-risk-factors-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology-and-the-american-epilepsy-society
#6
Cynthia Harden, Torbjörn Tomson, David Gloss, Jeffrey Buchhalter, J Helen Cross, Elizabeth Donner, Jacqueline A French, Anthony Gil-Nagel, Dale C Hesdorffer, W Henry Smithson, Mark C Spitz, Thaddeus S Walczak, Josemir W Sander, Philippe Ryvlin
OBJECTIVE: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. METHODS: Systematic review of evidence; modified Grading Recommendations Assessment, Development and Evaluation process for developing conclusions; recommendations developed by consensus. RESULTS: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0-17 years) is 0...
May 2017: Epilepsy Currents
https://www.readbyqxmd.com/read/28644261/is-intravenous-thrombolysis-safe-and-effective-in-central-retinal-artery-occlusion-a-critically-appraised-topic
#7
Oana M Dumitrascu, Joanne F Shen, Madhavi Kurli, Maria I Aguilar, Lisa A Marks, Bart M Demaerschalk, Dean M Wingerchuk, Cumara B O'Carroll
BACKGROUND: Central retinal artery occlusion (CRAO) is a neurological and ophthalmologic emergency associated with poor visual recovery. There is a dilemma regarding the appropriate treatment, as formal guidelines are lacking. Despite being considered an ocular equivalent of cerebral infarction, the time window of intravenous (IV) thrombolysis administration for maximum efficacy and safety in CRAO remains uncertain. OBJECTIVE: To critically assess the current evidence regarding the safety and effectiveness of IV thrombolysis in the treatment of patients with CRAO...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28640977/neurogenic-bowel-dysfunction-clinical-management-recommendations-of-the-neurologic-incontinence-committee-of-the-fifth-international-consultation-on-incontinence-2013
#8
REVIEW
Nikki Cotterill, Helmut Madersbacher, Jean J Wyndaele, Apostolos Apostolidis, Marcus J Drake, Jerzy Gajewski, John Heesakkers, Jalesh Panicker, Piotr Radziszewski, Ryuji Sakakibara, Karl-Dietrich Sievert, Rizwan Hamid, Thomas M Kessler, Anton Emmanuel
BACKGROUND: Evidence-based guidelines for the management of neurological disease and lower bowel dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. AIMS: To update clinical management of neurogenic bowel dysfunction from the recommendations of the 4th ICI, 2009. MATERIALS AND METHODS: A series of evidence reviews and updates were performed by members of the working group...
June 22, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28622489/the-role-of-exercise-and-patient-education-in-the-noninvasive-management-of-whiplash-a-clinical-commentary
#9
Trudy Rebbeck
Synopsis The majority of people with whiplash associated disorder (WAD) do not have neurological deficit or fracture and are therefore largely managed with non-surgical interventions such as exercise, patient education, and behavioral based-interventions. To date clinical guidelines, systematic reviews, and the results of high quality randomized controlled trials recommend exercise and patient education as the primary interventions for people in both acute and chronic stages after injury. However, the relatively weak evidence and small effect sizes in individual trials have led authors of some systematic reviews to reach equivocal recommendations for either exercise or patient education and for policy makers and funders to question whether the more expensive intervention (exercise) should be funded at all...
June 16, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28605557/practice-patterns-for-neurosurgical-utilization-and-outcome-in-acute-intracerebral-hemorrhage-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trials-1-and-2-studies
#10
Rui Guo, David J Blacker, Xia Wang, Hisatomi Arima, Pablo M Lavados, Richard I Lindley, John Chalmers, Craig S Anderson, Thompson Robinson
BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28603768/consensus-guidelines-for-lumbar-puncture-in-patients-with-neurological-diseases
#11
Sebastiaan Engelborghs, Ellis Niemantsverdriet, Hanne Struyfs, Kaj Blennow, Raf Brouns, Manuel Comabella, Irena Dujmovic, Wiesje van der Flier, Lutz Frölich, Daniela Galimberti, Sharmilee Gnanapavan, Bernhard Hemmer, Erik Hoff, Jakub Hort, Ellen Iacobaeus, Martin Ingelsson, Frank Jan de Jong, Michael Jonsson, Michael Khalil, Jens Kuhle, Alberto Lleó, Alexandre de Mendonça, José Luis Molinuevo, Guy Nagels, Claire Paquet, Lucilla Parnetti, Gerwin Roks, Pedro Rosa-Neto, Philip Scheltens, Constance Skårsgard, Erik Stomrud, Hayrettin Tumani, Pieter Jelle Visser, Anders Wallin, Bengt Winblad, Henrik Zetterberg, Flora Duits, Charlotte E Teunissen
INTRODUCTION: Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as post-LP headache or back pain. METHODS: We provide consensus guidelines for the LP procedure to minimize the risk of complications. The recommendations are based on (1) data from a large multicenter LP feasibility study (evidence level II-2), (2) systematic literature review on LP needle characteristics and post-LP complications (evidence level II-2), (3) discussion of best practice within the Joint Programme Neurodegenerative Disease Research Biomarkers for Alzheimer's disease and Parkinson's Disease and Biomarkers for Multiple Sclerosis consortia (evidence level III)...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28596449/noninvasive-ventilatory-correction-in-patients-with-acute-ischemic-stroke-a-systematic-review-and-meta-analysis
#12
Georgios Tsivgoulis, Andrei V Alexandrov, Aristeidis H Katsanos, Kristian Barlinn, Robert Mikulik, Vaia Lambadiari, Anastasios Bonakis, Anne W Alexandrov
BACKGROUND AND PURPOSE: Even though current guidelines suggest that noninvasive ventilatory correction (NIVC) could be considered for acute ischemic stroke patients with obstructive sleep apnea, available evidence is conflicting, with no adequately powered randomized clinical trial being available to date. METHODS: We conducted a systematic review and meta-analysis of all available literature data evaluating the effect of NIVC on neurological improvement (based on decrease in National Institutes of Health Stroke Scale score), vascular events (recurrent stroke, transient ischemic attack, myocardial infarction and unstable angina), and mortality during the follow-up period...
June 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28595534/a-review-of-levetiracetam-in-neonates
#13
Amit Agrawal, Anita Banergee
BACKGROUND: Neonatal seizures are the most common clinical manifestation of central nervous system (CNS) dysfunction and are associated with various neurological sequelae. There are currently no evidence-based guidelines for the management of neonatal seizures and currently used drugs such as phenobarbital, and phenytoin have limited efficacy and potential toxicities. Newer second line anticonvulsant, levetiracetam, has been used in refractory neonatal seizures despite limited data and off-label use...
June 6, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28593859/european-association-for-neuro-oncology-eano-guidelines-for-palliative-care-in-adults-with-glioma
#14
REVIEW
Andrea Pace, Linda Dirven, Johan A F Koekkoek, Heidrun Golla, Jane Fleming, Roberta Rudà, Christine Marosi, E Le Rhun, Robin Grant, Kathy Oliver, Ingela Oberg, Helen J Bulbeck, Alasdair G Rooney, Roger Henriksson, H Roeline W Pasman, Stefan Oberndorfer, Michael Weller, Martin J B Taphoorn
Patients with glioma present with complex palliative care needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliative care approach. The multidisciplinary palliative care task force of the European Association of Neuro-Oncology did a systematic review of the available scientific literature to formulate the best possible evidence-based recommendations for the palliative care of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase...
June 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28586081/bed%C3%A3-mning-av-neuro%C3%A2-logisk-prognos-efter-hj%C3%A3-rtstopp-uppdaterade-rekommendationer-fr%C3%A3-n-svenska-hlr-r%C3%A3-dets-expertgrupp
#15
Christian Rylander, Hans Friberg, Elna-Marie Larsson, Lars Johan Liedholm, Sten Rubertsson, Tobias Cronberg
Assessment of neurologic prognosis after cardiac arrest. Updated recommendations from the Swedish CPR Council Expert Group European Resuscitation Council (ERC) issued updated guidelines for postresuscitation care in 2015. This paper provides updated Swedish recommendations for neurological prognostication of patients remaining unconscious after cardiac arrest (CA). The prognostication should be based on independent methods; clinical and neurophysiological examinations, imaging and biomarkers. It should not be performed earlier than three days after CA and any influence from sedatives must be negligible...
June 2, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28528582/searching-the-web-a-survey-on-the-quality-of-advice-on-postnatal-sequelae-of-intrauterine-growth-restriction-and-the-implication-of-developmental-origins-of-health-and-disease
#16
S Perzel, H Huebner, W Rascher, C Menendez-Castro, A Hartner, F B Fahlbusch
Intrauterine growth restriction (IUGR) and fetal growth restriction (FGR) are pregnancy complications associated with morbidity in later life. Despite a growing body of evidence from current research on developmental origins of health and disease (DOHaD), little information is currently provided to parents on long-term metabolic, cardiovascular and neurologic consequences. As parents strongly rely on internet-based health-related information, we examined the quality of information on IUGR/FGR sequelae and DOHaD in webpages used by laypersons...
May 22, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#17
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 30, 2017: Neurology
https://www.readbyqxmd.com/read/28483271/-mindful-neuropsychology-mindfulness-based-cognitive-remediation
#18
E Bulzacka, S Lavault, A Pelissolo, C Bagnis Isnard
OBJECTIVES: Mindfulness based interventions (MBI) have recently gained much interest in western medicine. MBSR paradigm is based on teaching participants to pay complete attention to the present experience and act nonjudgmentally towards stressful events. During this mental practice the meditator focuses his or her attention on the sensations of the body. While the distractions (mental images, thoughts, emotional or somatic states) arise the participant is taught to acknowledge discursive thoughts and cultivate the state of awareness without immediate reaction...
May 5, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28473091/acr-appropriateness-criteria-%C3%A2-cerebrovascular%C3%A2-disease
#19
Michael B Salmela, Shabnam Mortazavi, Bharathi D Jagadeesan, Daniel F Broderick, Judah Burns, Tejaswini K Deshmukh, H Benjamin Harvey, Jenny Hoang, Christopher H Hunt, Tabassum A Kennedy, Alexander A Khalessi, William Mack, Nandini D Patel, Joel S Perlmutter, Bruno Policeni, Jason W Schroeder, Gavin Setzen, Matthew T Whitehead, Rebecca S Cornelius, Amanda S Corey
Diseases of the cerebral vasculature represent a heterogeneous group of ischemic and hemorrhagic etiologies, which often manifest clinically as an acute neurologic deficit also known as stroke or less commonly with symptoms such as headache or seizures. Stroke is the fourth leading cause of death and is a leading cause of serious long-term disability in the United States. Eighty-seven percent of strokes are ischemic, 10% are due to intracerebral hemorrhage, and 3% are secondary to subarachnoid hemorrhage. The past two decades have seen significant developments in the screening, diagnosis, and treatment of ischemic and hemorrhagic causes of stroke with advancements in CT and MRI technology and novel treatment devices and techniques...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473090/acr-appropriateness-criteria-%C3%A2-suspected-physical-abuse-child
#20
Sandra L Wootton-Gorges, Bruno P Soares, Adina L Alazraki, Sudha A Anupindi, Jeffrey P Blount, Timothy N Booth, Molly E Dempsey, Richard A Falcone, Laura L Hayes, Abhaya V Kulkarni, Sonia Partap, Cynthia K Rigsby, Maura E Ryan, Nabile M Safdar, Andrew T Trout, Roger F Widmann, Boaz K Karmazyn, Susan Palasis
The youngest children, particularly in the first year of life, are the most vulnerable to physical abuse. Skeletal survey is the universal screening examination in children 24 months of age and younger. Fractures occur in over half of abused children. Rib fractures may be the only abnormality in about 30%. A repeat limited skeletal survey after 2 weeks can detect additional fractures and can provide fracture dating information. The type and extent of additional imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and social considerations...
May 2017: Journal of the American College of Radiology: JACR
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