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https://www.readbyqxmd.com/read/28437319/quality-of-antiepileptic-treatment-among-older-medicare-beneficiaries-with-epilepsy-a-retrospective-claims-data-analysis
#1
Maria Pisu, Joshua Richman, Kendra Piper, Roy Martin, Ellen Funkhouser, Chen Dai, Lucia Juarez, Jerzy P Szaflarski, Edward Faught
BACKGROUND: Enzyme-inducing antiepileptic drugs (EI-AEDs) are not recommended for older adults with epilepsy. Quality Indicator for Epilepsy Treatment 9 (QUIET-9) states that new patients should not receive EI-AEDs as first line of treatment. In light of reported racial/ethnic disparities in epilepsy care, we investigated EI-AED use and QUIET-9 concordance across major racial/ethnic groups of Medicare beneficiaries. RESEARCH DESIGN: Retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries 67 years old and above in 2009 augmented for minority representation...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28437057/psychotic-and-bipolar-disorders-behavioral-disorders-in-dementia
#2
Sherri Morgan
Psychosis is one of the most common conditions in later life, with dementia being a main contributing factor. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), now categorizes the various types of dementia as neurocognitive disorders. Alzheimer disease is a common cause of dementia and psychosis. Psychosis also is seen in patients with vascular dementia and dementia with Lewy bodies. Psychosis can be primary, caused by a psychiatric disorder listed in the DSM-5, or secondary, due to a medical or neurologic condition...
April 2017: FP Essentials
https://www.readbyqxmd.com/read/28435899/hematologic-parameters-to-predict-negative-cerebrospinal-fluid-examination-results-among-neurologically-intact-patients-who-underwent-lumbar-puncture-on-suspicion-of-central-nervous-system-infection
#3
Ji Hwan Kim, Hong-Jik Kim, Ji Ung Na, Sang Kuk Han, Pil Cho Choi, Dong Hyuk Shin
OBJECTIVE: Cerebrospinal fluid (CSF) examination is mandatory whenever central nervous system (CNS) infection is suspected. However, pleocytosis is not detected in a substantial number of suspected patients who undergo CSF examination. This study aimed to identify parameters that can aid in predicting negative CSF examination results (defined as a white blood cell count of <5 cells/high-power field). METHODS: The study included 101 neurologically intact patients who underwent lumbar puncture because of suspicion of CNS infection...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435477/acrodermatitis-enteropathica-in-a-pair-of-twins
#4
Abdullatif Al Rashed, Mohja Al Shehri, Feroze Kaliyadan
BACKGROUND: Acrodermatitis enteropathica (AE) is a rare autosomal recessive metabolic disorder. First described by Brandt in 1936 and was named by Danbolt. A mutation in the SLC39A4 gene on chromosome 8 q24.3 is responsible for this disorder, which encodes zinc transporter Zip4. The diagnosis is made by the clinical presentation and histopathology and laboratory tests. In this case, we reported a twin presented with a typical rash and low zinc level. To our knowledge, very few cases reported as a twin with typical acrodermatitis enteropathica presentation...
December 31, 2016: Journal of Dermatological Case Reports
https://www.readbyqxmd.com/read/28435320/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-in-patients-from-a-rural-area-in-south-carolina
#5
Jimmy Pruitt, Carolina Moracho-Vilrriales, Tiffaney Threatt, Sarah Wagner, Jun Wu, E Alfonso Romero-Sandoval
Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434123/conversion-disorder-functional-neurological-symptom-disorder-and-chronic-pain-comorbidity-assessment-and-treatment
#6
REVIEW
Patricia Tsui, Andrew Deptula, Derek Y Yuan
PURPOSE OF REVIEW: This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms. RECENT FINDINGS: Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions...
June 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28434058/medical-conditions-in-the-first-years-of-life-associated-with-future-diagnosis-of-asd-in-children
#7
Stacey E Alexeeff, Vincent Yau, Yinge Qian, Meghan Davignon, Frances Lynch, Phillip Crawford, Robert Davis, Lisa A Croen
This study examines medical conditions diagnosed prior to the diagnosis of autism spectrum disorder (ASD). Using a matched case control design with 3911 ASD cases and 38,609 controls, we found that 38 out of 79 medical conditions were associated with increased ASD risk. Developmental delay, mental health, and neurology conditions had the strongest associations (ORs 2.0-23.3). Moderately strong associations were observed for nutrition, genetic, ear nose and throat, and sleep conditions (ORs 2.1-3.2). Using machine learning methods, we clustered children based on their medical conditions prior to ASD diagnosis and demonstrated ASD risk stratification...
April 22, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28433236/stretch-for-the-treatment-and-prevention-of-contracture-an-abridged-republication-of-a-cochrane-systematic-review
#8
Lisa A Harvey, Owen M Katalinic, Robert D Herbert, Anne M Moseley, Natasha A Lannin, Karl Schurr
QUESTION: Is stretch effective for the treatment and prevention of contractures in people with neurological and non-neurological conditions? DESIGN: A Cochrane Systematic Review with meta-analyses of randomised trials. PARTICIPANTS: People with or at risk of contractures. INTERVENTION: Trials were considered for inclusion if they compared stretch to no stretch, or stretch plus co-intervention to co-intervention only...
April 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/28433110/animal-models-of-wilson-disease
#9
Valentina Medici, Dominik Huster
Wilson disease (WD) is caused by ATPase copper-transporting beta (ATP7B) mutations and results in copper toxicity in liver and brain. Although the defective gene was identified in 1993, the specific mechanisms underlying copper toxicity and the remarkable phenotypic diversity of the disease are still poorly understood. Animal models harboring defects in the ATP7B homolog have helped to reveal new insights into pathomechanisms of WD. Four rodent models with ATP7B gene defects have been described - the Long-Evans Cinnamon (LEC) rat, inbred mouse models (toxic milk (tx), the Jackson Laboratory toxic milk (tx-j)), and the genetically engineered ATP7B(-/-) (knockout) mouse - all of which develop liver disease to different extents...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28433101/wilson-disease-currently-used-anticopper-therapy
#10
Anna Członkowska, Tomasz Litwin
Wilson disease (WD) is a genetic disorder of copper metabolism that can be treated successfully with pharmacologic treatment. Two groups of drugs are currently used: chelators (e.g., d-penicillamine and trientine), which increase urinary copper excretion, and zinc salts, which inhibit copper absorption in the digestive tract. The mechanisms of action lead to a negative copper balance, stopping pathologic accumulation of copper in the tissues and clearing affected organs of copper overload. Due to a lack of prospective clinical trials, the use of drugs depends mainly on center experience and the accessibility in different countries or regions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28433100/diagnosis-of-wilson-disease
#11
Peter Ferenci
Clinical presentation of Wilson disease can vary widely; therefore diagnosis is not always straightforward. Wilson disease is not just a disease of children and young adults, but may present at any age. The key features of Wilson disease are liver disease and cirrhosis, neuropsychiatric disturbances, Kayser-Fleischer rings, and acute episodes of hemolysis, often in association with acute liver failure. Diagnosis is particularly difficult in children and in adults presenting with active liver disease. None of the available laboratory tests is perfect and may not be specific for Wilson disease...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28433096/wilson-disease-neurologic-features
#12
Anna Członkowska, Tomasz Litwin, Grzegorz Chabik
Wilson disease (WD) is a neurodegenerative disorder, which presents as a spectrum of neurologic manifestations that includes tremor, bradykinesia, rigidity, dystonia, chorea, dysarthria, and dysphagia, together with a combination of neurologic symptoms that can easily lead to misdiagnosis. An early diagnosis of WD, and appropriate anticopper treatment, usually leads to a marked improvement in patient health. Conversely, delayed diagnosis can result in persistent pathology, which, left untreated, can ultimately prove lethal...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28432758/specificity-and-sensitivity-of-magnetic-resonance-imaging-findings-in-the-diagnosis-of-progressive-supranuclear-palsy
#13
REVIEW
Stephen Bacchi, Ivana Chim, Sandy Patel
Progressive supranuclear palsy (PSP) is a neurodegenerative condition that can only be diagnosed conclusively on pathological examination. Currently, the diagnosis is based upon the National Institute of Neurological Disorders and Stroke and the Society for PSP criteria. These criteria consist of purely clinical findings. Elements of brain MRI that are being investigated for this role include identifying structural features on conventional MRI, volume changes, signal abnormalities and diffusion changes. The aim of this study is to conduct a systematic search to identify which MRI findings have evidence to support their sensitivity/specificity/accuracy in the diagnosis of PSP...
April 22, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28432757/headache-patients-satisfaction-with-telemedicine-a-12-month-follow-up-randomized-non-inferiority-trial
#14
K I Müller, K B Alstadhaug, S I Bekkelund
BACKGROUND AND PURPOSE: We investigated non-acute headache patients' long-term satisfaction with a telemedicine consultation and consultation preferences in northern Norway. We hypothesized that patients were not less satisfied with telemedicine than traditional consultations. We also examined the influence of gender, age and education on satisfaction. METHODS: For 2.5 years, patients were consecutively screened, recruited and randomly assigned to telemedicine or traditional visits with a consultation at a neurological outpatient department...
April 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28431030/using-multivariate-base-rates-to-interpret-low-scores-on-an-abbreviated-battery-of-the-delis-kaplan-executive-function-system
#15
Justin E Karr, Mauricio A Garcia-Barrera, James A Holdnack, Grant L Iverson
Objective: Executive function consists of multiple cognitive processes that operate as an interactive system to produce volitional goal-oriented behavior, governed in large part by frontal microstructural and physiological networks. Identification of deficits in executive function in those with neurological or psychiatric conditions can be difficult because the normal variation in executive function test scores, in healthy adults when multiple tests are used, is largely unknown. This study addresses that gap in the literature by examining the prevalence of low scores on a brief battery of executive function tests...
May 1, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28430860/increased-brainstem-perfusion-but-no-blood-brain-barrier-disruption-during-attacks-of-migraine-with-aura
#16
Anders Hougaard, Faisal M Amin, Casper E Christensen, Samaira Younis, Frauke Wolfram, Stig P Cramer, Henrik B W Larsson, Messoud Ashina
The migraine aura is characterized by transient focal cortical disturbances causing dramatic neurological symptoms that are usually followed by migraine headache. It is currently not understood how the aura symptoms are related to the headache phase of migraine. Animal studies suggest that cortical spreading depression, the likely mechanism of migraine aura, causes disruption of the blood-brain barrier and noxious stimulation of trigeminal afferents leading to activation of brainstem nuclei and triggering of migraine headache...
April 18, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28430672/lamotrigine-uses-in-psychiatric-practice-beyond-bipolar-prophylaxis-a-hope-or-hype
#17
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/28430293/three-cases-of-ectopic-sphenoid-sinus-pituitary-adenoma
#18
Ernest Jan Bobeff, Karol Wiśniewski, Wielisław Papierz, Ludomir Stefańczyk, Dariusz Jan Jaskólski
<i><b>Introduction</b>: Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke's pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. <b>Aims</b>: To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. <b>Material and methods: </b> Analysis of three cases: two females and one man, aged 61-70...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28430292/failure-of-the-vascular-hypothesis-of-multiple-sclerosis-in-a-rat-model-of-chronic-cerebrospinal-venous-insufficiency
#19
Maha M A Zakaria, Shahira Y Mikhael, Azza K Abu Hussein, Rania A Salah El-Din, Hany W Abd El-Malak, Iman H Hewedi, Hany S Nadim
<i>Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. The present study was designed to validate this hypothesis using a rat model of CCSVI. Bilateral jugular vein ligation (JVL) was performed on female albino rats (n = 15), and sham-operated rats (n = 15) were used as a control group...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28429801/the-dizzy-patient-don-t-forget-disorders-of-the-central-vestibular-system
#20
REVIEW
Thomas Brandt, Marianne Dieterich
Vertigo and dizziness are among the most common complaints in neurology clinics, and they account for about 13% of the patients entering emergency units. In this Review, we focus on central vestibular disorders, which are mostly attributable to acute unilateral lesions of the bilateral vestibular circuitry in the brain. In a tertiary interdisciplinary outpatient dizziness unit, central vestibular disorders, including vestibular migraine, comprise about 25% of the established diagnoses. The signs and symptoms of these disorders can mimic those of peripheral vestibular disorders with sustained rotational vertigo...
April 21, 2017: Nature Reviews. Neurology
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