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https://www.readbyqxmd.com/read/28426872/importance-and-difficulties-of-pursuing-rtms-research-in-acute-stroke
#1
James R Carey, Diane M Chappuis, Marsha J Finkelstein, Kate L Frost, Lynette K Leuty, Allison L McNulty, Lars I E Oddsson, Erin M Seifert, Teresa J Kimberley
Although much research has been done on repetitive transcranial magnetic stimulation (rTMS) in chronic stroke, only sparse research has been done in acute stroke despite the particularly rich potential for neuroplasticity in this stage. We attempted a preliminary clinical trial in one active, high-quality inpatient rehabilitation facility (IRF) in the -United States. But after enrolling only 4 patients in the grant period, the study was stopped because of low enrollment. The purpose of this paper is to offer a perspective describing the important physiologic rationale for including rTMS in the early phase of stroke, the reasons for our poor patient enrollment in our attempted study, and recommendations to help future studies succeed...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28425221/conceptualizing-movement-by-expert-bobath-instructors-in-neurological-rehabilitation
#2
Julie Vaughan-Graham, Kara Patterson, Karl Zabjek, Cheryl A Cott
RATIONALE, AIMS, AND OBJECTIVES: Movement, a core aspect of physiotherapy practice, and integral to the clinical reasoning process has undergone limited theoretical development. Instead, research has focused on intervention effectiveness embedded within the positivist paradigm. The purpose of this study was to explore how expert neurorehabilitation therapists conceptualize movement as part of their clinical reasoning. METHOD: A qualitative interpretive descriptive approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews was used...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28424147/treatment-of-leukoencephalopathy-with-calcifications-and-cysts-with-bevacizumab
#3
Alex J Fay, Allison A King, Joshua S Shimony, Yanick J Crow, Jan E Brunstrom-Hernandez
BACKGROUND: Leukoencephalopathy with calcifications and cysts is a rare, autosomal recessive cerebral microangiopathy that causes progressive white matter disease, calcifications, and cysts within the brain. It is typically associated with slowly progressive psychomotor regression, seizures, and movement disorders. Although leukoencephalopathy with calcifications and cysts affects only the central nervous system, it demonstrates remarkable neuropathologic and radiologic overlap with Coats plus, a disorder of small vessels of the brain, eyes, gastrointestinal tract, and bone...
March 23, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#4
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28422076/zeglobaltox-an-innovative-approach-to-address-organ-drug-toxicity-using-zebrafish
#5
Carles Cornet, Simone Calzolari, Rafael Miñana-Prieto, Sylvia Dyballa, Els van Doornmalen, Helma Rutjes, Thierry Savy, Davide D'Amico, Javier Terriente
Toxicity is one of the major attrition causes during the drug development process. In that line, cardio-, neuro-, and hepatotoxicities are among the main reasons behind the retirement of drugs in clinical phases and post market withdrawal. Zebrafish exploitation in high-throughput drug screening is becoming an important tool to assess the toxicity and efficacy of novel drugs. This animal model has, from early developmental stages, fully functional organs from a physiological point of view. Thus, drug-induced organ-toxicity can be detected in larval stages, allowing a high predictive power on possible human drug-induced liabilities...
April 19, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28420985/mapping-dorsal-and-ventral-caudate-in-older-adults-method-and-validation
#6
Haiqing Huang, Peter T Nguyen, Nadine A Schwab, Jared J Tanner, Catherine C Price, Mingzhou Ding
The caudate nucleus plays important roles in cognition and affect. Depending on associated connectivity and function, the caudate can be further divided into dorsal and ventral aspects. Dorsal caudate, highly connected to dorsolateral prefrontal cortex (DLPFC), is implicated in executive function and working memory; ventral caudate, more interconnected with the limbic system, is implicated in affective functions such as pain processing. Clinically, certain brain disorders are known to differentially impact dorsal and ventral caudate...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28416497/prognostication-in-critically-ill-patients-with-severe-traumatic-brain-injury-the-tbi-prognosis-multicentre-feasibility-study
#7
Alexis F Turgeon, François Lauzier, Ryan Zarychanski, Dean A Fergusson, Caroline Léger, Lauralyn A McIntyre, Francis Bernard, Andrea Rigamonti, Karen Burns, Donald E Griesdale, Robert Green, Damon C Scales, Maureen O Meade, Martin Savard, Michèle Shemilt, Jérôme Paquet, Jean-Luc Gariépy, André Lavoie, Kesh Reddy, Draga Jichici, Giuseppe Pagliarello, David Zygun, Lynne Moore
OBJECTIVE: Severe traumatic brain injury is a significant cause of morbidity and mortality in young adults. Assessing long-term neurological outcome after such injury is difficult and often characterised by uncertainty. The objective of this feasibility study was to establish the feasibility of conducting a large, multicentre prospective study to develop a prognostic model of long-term neurological outcome in critically ill patients with severe traumatic brain injury. DESIGN: A prospective cohort study...
April 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28414396/postural-tachycardia-syndrome-diagnosis-and-management-in-adolescents-and-young-adults
#8
Geoffrey L Heyer
Postural tachycardia syndrome (POTS) represents a common form of orthostatic intolerance that disproportionately affects young women from puberty through adulthood. Patients with POTS have day-to-day orthostatic symptoms with the hallmark feature of an excessive, sustained, and symptomatic rise in heart rate during orthostatic testing. Although considerable overlap exists, three subtypes of POTS have been described: neuropathic, hyperadrenergic, and hypovolemic forms. The wide spectrum of symptoms and comorbidities can make treatment particularly challenging...
April 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28409893/spotlight-on-anti-cgrp-monoclonal-antibodies-in-migraine-the-clinical-evidence-to-date
#9
REVIEW
Lanfranco Pellesi, Simona Guerzoni, Luigi Alberto Pini
Migraine, a common neurovascular brain disorder, represents a severe and widespread health problem; along with medication-induced (medication-overuse) headache, it is the third-leading cause of disability worldwide. Currently, its therapeutic management remains unsatisfactory for several reasons; up to 40% of migraineurs are eligible for prophylactic treatment, but there are issues of efficacy, safety, and adherence. In recent years the evidence on the role of calcitonin gene-related peptide (CGRP) in migraine pathophysiology has been consolidated, so new and promising treatments for migraine pain and its possible prevention have been developed...
April 14, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28409827/topiramate-for-essential-tremor
#10
REVIEW
Elisa Bruno, Alessandra Nicoletti, Graziella Quattrocchi, Roberta Allegra, Graziella Filippini, Carlo Colosimo, Mario Zappia
BACKGROUND: Essential tremor (ET) is one of the most common movement disorders. The management is primarily based on pharmacological agents and in clinical practice propranolol and primidone are considered the first-line therapy. However, these treatments can be ineffective in 25% to 55% of people and are frequently associated with serious adverse events (AEs). For these reasons, it is worthwhile evaluating other treatments for ET. Topiramate has been suggested as a potentially useful agent for the treatment of ET but there is uncertainty about its efficacy and safety...
April 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28409565/can-pornography-be-addictive-an-fmri-study-of-men-seeking-treatment-for-problematic-pornography-use
#11
Mateusz Gola, Małgorzata Wordecha, Guillaume Sescousse, Michał Lew-Starowicz, Bartosz Kossowski, Marek Wypych, Scott Makeig, Marc N Potenza, Artur Marchewka
Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms. Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related 'wanting' from reward-related 'liking' among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU...
April 14, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28409284/development-prevention-and-treatment-of-feeding-tube-dependency
#12
REVIEW
Hilde Krom, J Peter de Winter, Angelika Kindermann
Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach...
April 13, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28409160/peripheral-and-autonomic-neuropathy-in-south-asians-and-white-caucasians-with-type-2-diabetes-mellitus-possible-explanations-for-epidemiological-differences
#13
Abd A Tahrani, Q A Altaf, Milan K Piya, Anthony H Barnett
Objectives. To compare the prevalence of diabetic peripheral neuropathy (DPN) and that of cardiac autonomic neuropathy (CAN) between South Asians and White Caucasians with type 2 diabetes and to explore reasons for observed differences. Methods. A cross-sectional study of casually selected South Asian and White Caucasian adults attending a hospital-based diabetes clinic in the UK. DPN and CAN were assessed using the Michigan Neuropathy Screening Instrument (MNSI) and heart rate variability testing, respectively...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28408041/nontraumatic-head-and-neck-injuries-a-clinical-approach-part-2
#14
B Brea Álvarez, L Esteban García, M Tuñón Gómez, Y Cepeda Ibarra
Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons. As explained in the first part of this update, these entities affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Maintaining the same approach as in the first part, focusing on the clinical presentations in the emergency department rather than on the anatomic regions affected, we will study the entities that present with two patterns: those that present with a combination of cervical numbness, dysphagia, and dyspnea and those that present with acute sensory deficits...
April 10, 2017: Radiología
https://www.readbyqxmd.com/read/28399922/the-elusive-ideal-of-inclusiveness-lessons-from-a-worldwide-survey-of-neurologists-on-the-ethical-issues-raised-by-whole-genome-sequencing
#15
Thierry Hurlimann, Iris Jaitovich Groisman, Béatrice Godard
The anticipation of ethical issues that may arise with the clinical use of genomic technologies is crucial to envision their future implementation in a manner sensitive to local contexts. Yet, populations in low- and middle-income countries are underrepresented in studies that aim to explore stakeholders' perspectives on the use of such technologies. Within the framework of a research project entitled "Personalized medicine in the treatment of epilepsy", we sought to increase inclusiveness by widening the reach of our survey, inviting neurologists from around the world to share their views and practices regarding the use of whole-genome sequencing in clinical neurology and its associated ethics...
April 11, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28399551/risks-factors-for-reoperation-in-patients-treated-surgically-for-degenerative-spondylolisthesis-a-subanalysis-of-the-8-year-data-from-the-sport-trial
#16
Michael C Gerling, Dante Leven, Peter G Passias, Virgnie Lafage, Kristina Bianco, Alexandra Lee, Tamara S Morgan, Jon D Lurie, Tor D Tosteson, Wenyan Zhao, Kevin F Spratt, Kristen Radcliff, Thomas J Errico
STUDY DESIGN: Retrospective analysis of prospective data from the degenerative spondylolisthesis (DS) arm of the Spine Patient Outcomes Research Trial. OBJECTIVE: To identify risk factors for reoperation in patients treated surgically for DS and compare outcomes between patients who underwent reoperation with non-reoperative patients. SUMMARY OF BACKGROUND DATA: Several studies have examined outcomes following surgery for DS, but few have identified risk factors for reoperation...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28397412/prevalence-incidence-indication-and-choice-of-antidepressants-in-patients-with-and-without-chronic-kidney-disease-a-matched-cohort-study-in-uk-clinical-practice-research-datalink
#17
Masao Iwagami, Laurie A Tomlinson, Kathryn E Mansfield, Helen I McDonald, Liam Smeeth, Dorothea Nitsch
PURPOSE: People with chronic kidney disease (CKD) have an increased prevalence of depression, anxiety, and neuropathic pain. We examined prevalence, incidence, indication for, and choice of antidepressants among patients with and without CKD. METHODS: Using the UK Clinical Practice Research Datalink, we identified patients with CKD (two measurements of estimated glomerular filtration rate < 60 mL/min/1.73m(2) for ≥3 months) between April 2004 and March 2014...
April 11, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28395915/local-failure-and-acute-radiodermatological-toxicity-in-patients-undergoing-radiation-therapy-with-and-without-post-mastectomy-chest-wall-bolus-is-bolus-ever-necessary
#18
Stephen Abel, Paul Renz, Mark Trombetta, Michael Cowher, E Day Werts, Thomas B Julian, Rodney Wegner
PURPOSE: Postmastectomy chest wall radiation therapy has historically used bolus to increase dose at the skin surface. Despite the theoretical benefits of bolus, the clinical implications of locoregional tumor control, cosmesis, and the incidence of radiodermatitis are less well characterized. We hypothesized that treatment in the presence or absence of bolus results in equivalent chest wall recurrence rates, but its presence results in more severe acute dermatologic toxicity. METHODS AND MATERIALS: Locally advanced breast cancer patients undergoing chest wall radiation therapy were retrospectively reviewed from 2005 to 2015 (n = 106; 53 with bolus, 53 without)...
October 30, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28395427/-etiological-analysis-on-patients-in-department-of-vertigo-and-dizziness-oriented-outpatient
#19
F Li, X G Wang, J H Zhuang, Y Chen, X W Zhou, B Gao, H H Gu
Objective: We aimed to explore the spectrum of causes for patients in department of vertigo and dizziness oriented outpatient, in order to provide a reference for diagnosis and treatment of patients with vertigo or dizziness. Methods: Retrospective analysis were carried out with clinical data of patients in our department of vertigo and dizziness oriented outpatient. The target group under study was diagnosed based on the uniform diagnostic criteria, and re-visiting patients were excluded. Results: This clinical study was conducted on 5 348 cases, who visited our vertigo and dizziness oriented outpatient from December 2012 to July 2015...
April 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28394534/-modern-view-on-etiology-pathogenesis-and-treatment-of-chronic-pelvic-pain-syndrome
#20
A Z Vinarov
The manuscript presents the analysis of scientific manuscripts written by Russian and foreign researchers devoted to chronic pelvic pain syndrome (CPPS) studies. In spite of widespread disease, there is no clear understanding on etiopathogenetic mechanisms of CPPS development and it is shown that besides infectious process cardiovascular, neuronal, locomotor, endocrine and immune systems are involved into pathological process of CPPS. Mentioned factors complicate the doctors task on effective therapy choice and stress the reasonability of complex approach to CPPS treatment...
April 2017: Urologii︠a︡
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