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Neurology Resident

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https://www.readbyqxmd.com/read/29785228/evaluating-the-utility-of-a-structured-clinical-protocol-for-reducing-the-impact-of-behavioural-and-psychological-symptoms-of-dementia-in-progressive-neurological-diseases-a-pilot-study
#1
Nicholas P Ryan, Laura Scott, Maryanne McPhee, Susan Mathers, Marie-Claire Davis, Roxanne Maule, Fiona Fisher
Objectives: Behavioural and psychological symptoms of dementia (BPSD) cause significant distress to both aged care residents and staff. Despite the high prevalence of BPSD in progressive neurological diseases (PNDs) such as multiple sclerosis, Huntington's disease, and Parkinson's disease, the utility of a structured clinical protocol for reducing BPSD has not been systematically evaluated in PND populations. Method: Staff ( n = 51) and individuals with a diagnosis of PND ( n = 13) were recruited into the study, which aimed to evaluate the efficacy of a PND-specific structured clinical protocol for reducing the impact of BPSD in residential aged care (RAC) and specialist disability accommodation (SDA) facilities...
2018: Behavioural Neurology
https://www.readbyqxmd.com/read/29784718/opinion-and-special-articles-stress-when-performing-the-first-lumbar-puncture-may-compromise-patient-safety
#2
Mikael Johannes Vuokko Henriksen, Troels Wienecke, Jesper Kristiansen, Yoon Soo Park, Charlotte Ringsted, Lars Konge
OBJECTIVE: To quantify physician stress levels when performing lumbar puncture (LP) and explore operator stress effect on patient outcomes. METHODS: This was a cross-sectional, multicenter study. Novices, intermediates, and experts in performing LP were recruited from 4 departments of neurology and emergency medicine. Stress was measured before and during performance of the LP using cognitive appraisal (CA), State-Trait Anxiety Inventory-Short (STAI-S) questionnaire, and the heart rate variability measure low frequency/high frequency index (LF/HF ratio)...
May 22, 2018: Neurology
https://www.readbyqxmd.com/read/29784546/complexity-of-the-medication-regimen-for-polypathological-patients
#3
L Bellostas-Muñoz, J Díez-Manglano
OBJECTIVE: To determine the complexity of the therapeutic regimen for polypathological patients hospitalised in internal medicine departments. METHODS: A multicentre observational study included polypathological patients hospitalised in internal medicine departments. Patients who were readmitted or died were excluded. Data were collected on age, sex, residence, disease, Charlson, Barthel and Lawton-Brody indices, Pfeiffer questionnaire, Gijón scale, number of hospitalisations in the previous year, delirium, need for and availability of caregivers and the PROFUND index score...
May 18, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29779041/the-potential-importance-of-myeloid-derived-suppressor-cells-mdscs-in-the-pathogenesis-of-alzheimer-s-disease
#4
REVIEW
Antero Salminen, Kai Kaarniranta, Anu Kauppinen
The exact cause of Alzheimer's disease (AD) is still unknown, but the deposition of amyloid-β (Aβ) plaques and chronic inflammation indicates that immune disturbances are involved in AD pathogenesis. Recent genetic studies have revealed that many candidate genes are expressed in both microglia and myeloid cells which infiltrate into the AD brains. Invading myeloid cells controls the functions of resident microglia in pathological conditions, such as AD pathology. AD is a neurologic disease with inflammatory component where the immune system is not able to eliminate the perpetrator, while, concurrently, it should prevent neuronal injuries induced by inflammation...
May 19, 2018: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/29777396/neurology-training-for-psychiatry-residents-practices-challenges-and-opportunities
#5
EDITORIAL
Daniel Shalev, Nuri Jacoby
No abstract text is available yet for this article.
May 18, 2018: Academic Psychiatry
https://www.readbyqxmd.com/read/29774058/the-role-of-dopaminergic-immune-cell-signalling-in-poststroke-inflammation
#6
REVIEW
Daniela Talhada, Monika Rabenstein, Karsten Ruscher
Upon ischaemic stroke, brain-resident and peripheral immune cells accumulate in the central nervous system (CNS). Interestingly, these cells express pattern specific to neurotransmitter receptors and, therefore, seem to be susceptible to neurotransmitter stimulation, potentially modulating their properties and functions. One of the principal neurotransmitters in the CNS, dopamine, is involved in the regulation of processes of brain development, motor control and higher brain functions. It is constantly released in the brain and there is experimental and clinical evidence that dopaminergic signalling is involved in recovery of lost neurological function after stroke...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29774022/acute-zika-virus-infection-in-an-endemic-area-shows-modest-proinflammatory-systemic-immunoactivation-and-cytokine-symptom-associations
#7
Jéssica Barletto de Sousa Barros, Paulo Alex Neves da Silva, Rosemary de Carvalho Rocha Koga, Patrícia Gonzalez-Dias, José Rodrigues Carmo Filho, Patrícia Resende Alo Nagib, Verônica Coelho, Helder I Nakaya, Simone Gonçalves Fonseca, Irmtraut Araci Hoffmann Pfrimer
An early immune response to Zika virus (ZIKV) infection may determine its clinical manifestation and outcome, including neurological effects. However, low-grade and transient viremia limits the prompt diagnosis of acute ZIKV infection. We have investigated the plasma cytokine, chemokine, and growth factor profiles of 36 individuals from an endemic area displaying different symptoms such as exanthema, headache, myalgia, arthralgia, fever, hyperemia, swelling, itching, and nausea during early-phase infection...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29772808/mercury-levels-in-women-and-children-from-interior-villages-in-suriname-south-america
#8
Paul E Ouboter, Gwendolyn Landburg, Gaitrie U Satnarain, Sheryl Y Starke, Indra Nanden, Bridget Simon-Friedt, William B Hawkins, Robert Taylor, Maureen Y Lichtveld, Emily Harville, Jeffrey K Wickliffe
Natural sources of mercury, historical gold mining, and contemporary artisanal and small-scale gold mining (ASGM) activities have led to mercury contamination in Suriname. Our primary objective was to evaluate mercury levels in hair of women and children from interior villages in Suriname where mercury levels in fish are elevated. We also estimated blood levels of mercury using an established mathematical conversion to facilitate comparison with other biomonitoring programs in the United States. Estimated levels of mercury in the blood of participants from Suriname were significantly higher than those in women from a heavy marine fish-consuming population in southeast Louisiana and estimates of the US national average...
May 17, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29766914/training-residents-and-fellows-in-the-procedure-of-diagnostic-cervicocerebral-angiography-techniques-to-avoid-complications
#9
Xianli Lv, Wei Li, Youxiang Li
We examine the problems arising when training residents/fellows (RFs) initiate the learning of diagnostic cervicocerebral angiography (DCCA) and describe the steps on how to facilitate the learning process while avoiding complications. The risk of permanent neurological deficit as a result of DCCA ranges from 0.3-0.5%. Factors that correlated with complications include the following: the history of cerebral infarction, infusion of a large amount of contrast medium, a prolonged fluoroscopic time (>80 min) and the efficiency of training received...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29763856/hospital-readmission-risks-in-older-adults-following-inpatient-subacute-care-a-six-month-follow-up-study
#10
Den-Ching A Lee, Cylie Williams, Aislinn F Lalor, Ted Brown, Terry P Haines
BACKGROUND: High rates of unplanned hospital readmissions are a burden on healthcare systems and individuals. This study examined factors at, and after initial hospital discharge and their associations with unplanned hospital readmission for older adults up to six months post-discharge from subacute care. METHODS: Older subacute care patients were surveyed prior to discharge, and assessed monthly post-discharge for six months. Data included the Geriatric Depression Scale, Phone-Fitt sub-scales, Friendship Scale, modified Lubben Social Network Scale, unplanned hospital readmission, self-reported physical capacity and falls in the last month were collected...
May 9, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29760676/helsinki-stroke-model-is-transferrable-with-real-world-resources-and-reduced-stroke-thrombolysis-delay-to-34-min-in-christchurch
#11
Teddy Y Wu, Erin Coleman, Sarah L Wright, Deborah F Mason, Jon Reimers, Roderick Duncan, Mary Griffiths, Michael Hurrell, David Dixon, James Weaver, Atte Meretoja, John N Fink
Background: Christchurch hospital is a tertiary hospital in New Zealand supported by five general neurologists with after-hours services provided mainly by onsite non-neurology medical residents. We assessed the transferrability and impact of the Helsinki Stroke model on stroke thrombolysis door-to-needle time (DNT) in Christchurch hospital. Methods: Key components of the Helsinki Stroke model were implemented first in 2015 with introduction of patient pre-notification and thrombolysis by the computed tomography (CT) suite, followed by implementation of direct transfer to CT on ambulance stretcher in May 2017...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29738851/intranasally-delivered-small-interfering-rna-mediated-suppression-of-scavenger-receptor-mac-1-attenuates-microglial-phenotype-switching-and-working-memory-impairment-following-hypoxia
#12
Sudeshna Das, K P Mishra, Lilly Ganju, S B Singh
Brain, being the highest consumer of oxygen, is prone to increased risk of hypoxia-induced neurological insults. In response to hypoxia, microglia, the major resident immune cells of brain switches to an activated phenotype and promote inflammatory responses leading to tissue damage and loss of cognitive functions including working memory impairment. Till date, no proven clinical therapeutics is available to retard the progression of neurodegenerative memory impairment. In the present study, we investigated the therapeutic potential of intranasal small interfering RNA (siRNA) delivery in a mouse model of hypoxia-induced working memory impairment using microglial receptor, Mac-1 as a target gene...
May 5, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29735771/opinion-and-special-articles-amateur-fundus-photography-with-various-new-devices-our-experience-as-neurology-residents
#13
Saman Zafar, Ylec Mariana Cardenas, Lakshmi Leishangthem, Sridhara Yaddanapudi
Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We were enthusiastic to replicate the success of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study in our neurology department, but encountered problems in terms of cost, setup, feasibility, and portability of the device...
May 8, 2018: Neurology
https://www.readbyqxmd.com/read/29731353/advances-in-meningeal-immunity
#14
REVIEW
Rejane Rua, Dorian B McGavern
The central nervous system (CNS) is an immunologically specialized tissue protected by a blood-brain barrier. The CNS parenchyma is enveloped by a series of overlapping membranes that are collectively referred to as the meninges. The meninges provide an additional CNS barrier, harbor a diverse array of resident immune cells, and serve as a crucial interface with the periphery. Recent studies have significantly advanced our understanding of meningeal immunity, demonstrating how a complex immune landscape influences CNS functions under steady-state and inflammatory conditions...
May 3, 2018: Trends in Molecular Medicine
https://www.readbyqxmd.com/read/29713938/the-urgent-neurological-consultation-in-the-population-of-the-province-of-ferrara-italy
#15
Vittorio Govoni, Elena Della Coletta, Elisa Fallica, Edward Cesnik
In the province of Ferrara, Italy, the urgent neurological consultation (UNC) cases in the population correspond to the resident outpatients who undergo a UNC in the ER of the university hospital of Ferrara (UHFe). Thanks to this health organization a retrospective survey identified 612 UNC cases (range of age 7-102 years, median 67,5 years) in the study period giving a period prevalence rate of 173 per 100,000 (95% CI 159.3-187.3) which increased with age (χ2 for trend = 178.4 p < 0.001). The daily UNC cases (range 0-14, mean = 7...
May 1, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29708407/it-takes-time-building-relationships-and-understanding-through-an-intergenerational-ballet-programme
#16
Shelley E Canning, Michael Gaetz, Darren Blakeborough
Individuals living in long-term residential care homes are often viewed through a negative lens. These residents have increasingly complex care needs, and their functional, communication and cognitive challenges can support conceptualizations of difference and disability perpetuating negative stereotypes of age and dementia. However, engaging in meaningful activities and relationships with older adults, including those with dementia, has been shown to promote positive attitudes. Specifically, intergenerational programming that provides opportunities for meaningful engagement between children and older adults has been shown to support positive emotional experiences through socializing and building relationships...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29708218/stroke-code-simulation-benefits-advanced-practice-providers-similar-to-neurology-residents
#17
Muhib Khan, Grayson L Baird, Theresa Price, Tricia Tubergen, Omran Kaskar, Michelle De Jesus, Joseph Zachariah, Adam Oostema, Raymond Scurek, Robert R Coleman, Wendy Sherman, Cynthia Hingtgen, Tamer Abdelhak, Brien Smith, Brian Silver
Background: Advanced practice providers (APPs) are important members of stroke teams. Stroke code simulations offer valuable experience in the evaluation and treatment of stroke patients without compromising patient care. We hypothesized that simulation training would increase APP confidence, comfort level, and preparedness in leading a stroke code similar to neurology residents. Methods: This is a prospective quasi-experimental, pretest/posttest study. Nine APPs and 9 neurology residents participated in 3 standardized simulated cases to determine need for IV thrombolysis, thrombectomy, and blood pressure management for intracerebral hemorrhage...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29707176/predictors-of-short-term-mortality-after-acute-stroke-in-east-azerbaijan-province-2014
#18
Seyed Morteza Shamshirgaran, Hamid Barzkar, Darioush Savadi-Oskouei, Mohammad Yazdchi Marandi, Abdolrasoul Safaiyan, Ehsan Sarbazi, Hossein Novbakht, Saber Gaffari
Introduction: Stroke is one of the important causes of death and disability in Iran. This study aimed to examine the factors influencing the short-term mortality of stroke in Northwest of Iran. Methods: Study population were all patients with confirming the diagnosis of the first-ever stroke who were hospitalized in two referral teaching hospitals from October 2013 to March 2015. They were followed up to 30 days after onset of stroke. A neurology year three resident was responsible for extracting the clinical data and assessment of stroke severity on admission using National Institute of Health Stroke Scale (NIHSS), and information about risk factors and socio-demographic factors were collected using face to face interview...
2018: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29705625/survey-of-physician-attitudes-towards-psychogenic-nonepileptic-seizures-and-driving
#19
Umer Farooq, Saeed Ahmed, Jayakrishna Madabush, Venkata Kolli, Michael Esang, Vijaya Padma Kotapati, Rizwan Ahmed, Cornel N Stanciu
BACKGROUND: Physicians from various disciplines encounter patients presenting with psychogenic nonepileptic seizures (PNES) as part of their routine clinical practice. Recommendations towards assessing fitness to drive and reporting are clearer for conditions such as neurocognitive disorders and epilepsy, but such guidelines do not exist for patients with PNES. Here, we assess physicians' attitudes towards driving for patients diagnosed with PNES. METHODS: Electronic questionnaires were sent to Neurology and Family Medicine physicians practicing at Creighton University Medical Center and Psychiatry physicians practicing at Creighton-Nebraska Psychiatry Residency Program to assess their opinion regarding driving risk when encountering PNES...
April 26, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29686763/international-medical-graduates-in-the-us-physician-workforce-and-graduate-medical-education-current-and-historical-trends
#20
Awad A Ahmed, Wei-Ting Hwang, Charles R Thomas, Curtiland Deville
Background : Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective : We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods : We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties...
April 2018: Journal of Graduate Medical Education
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